Everything You Need to Know About Endometrial Cancer

When it comes to women’s health, one condition that is often not discussed enough is endometrial cancer. Endometrial cancer, a type of uterine cancer has become a health concern and hence awareness regarding it is crucial. In this article, we will understand what is endometrial cancer, what are endometrial cancer causes, its stages and the risk factors associated with it. We will also understand the type of endometrial cancer and look at its treatment options and how it can be prevented.

What is endometrial cancer?

Endometrial cancer, a form of uterine cancer, originates in the endometrium – the inner lining of the uterus. As per the data provided by the National Cancer Institute, (NCI), it is believed that 3 out of every 100 women are at risk of being diagnosed with uterine cancer once in their lifetime. While talking about the survival rate, 80 percent of women survive for 5 years or even more after receiving the treatment. Thus, early detection and diagnosis increase the chances of recovery from endometrial cancer.

Symptoms of endometrial cancer

Abnormal vaginal bleeding stands out as the predominant symptom linked to endometrial cancer. Further symptoms include:

• Changes in menstrual cycle flow and length
• Bleeding or spotting occurring between menstrual periods
• Vaginal bleeding after menopause

Some other symptoms include:

• Pain during intercourse
• Unexplained weight loss
• Discomfort experienced in the pelvic and lower abdominal regions
• Blood-tinged or watery discharge from the vagina

If one experiences any of the above listed symptoms then do consult a doctor. At times these may not be a sign of serious issues but to be on the safer side a consultation is ideal.

Menopause or other non-cancerous issues can cause bleeding in the vagina. Though in some cases it is associated with endometrial cancer and other gynecological cancer.

It is your doctor only who can identify the cause and put you on the right treatment.

Causes of endometrial cancer

The exact endometrial cancer causes are still unknown. Experts attribute it to the changes occurring in the hormone levels of estrogen and progesterone as they affect the endometrium. The increased levels of estrogen cause the endometrial cells to multiply and divide.

Genetic mutations occurring in the endometrial cells can cause them to rapidly grow and transform into tumours.

There are numerous studies being conducted to understand what causes normal endometrial cells to convert into cancer cells.

Risk factors associated with endometrial cancer

Age is associated with an increased risk of endometrial cancer. According to reports, people under the age group of 45 to 75 are more prone to be affected by endometrial cancer.
A number of other factors are also connected with the increased risk of endometrial cancer. These include changes seen in the level of sex hormones of the woman, certain medical conditions, family history of cancer, obesity, and more. Let’s discuss some of these factors further:
1. Hormone levels
Female sex hormones estrogen and progesterone are mainly responsible for the health of the endometrium. Drastic increases in the production of these hormones can increase the risk of being diagnosed with endometrial cancer.
2. Patient medical history
A woman’s medical history is also known to have an effect on the sex hormone leading to higher chances of developing endometrial cancer, including:
● Longer years of menstruation and early menarche or late menopause increase endometrial cancer risk.
● Lack of pregnancies heightens risk, especially with infertility-related issues.
● Polycystic ovarian syndrome (PCOS) elevates risk due to hormonal imbalances
● Granulosa cell tumors in ovaries releasing estrogen raise endometrial cancer risk
3. Medication:
Medications like estrogen replacement therapy (ERT) or tamoxifen can impact hormone balance. Tamoxifen, used for breast cancer, may increase endometrial cancer risk.
4. Birth control
Birth control pills lower endometrial cancer risk, with longer use offering greater protection. Intrauterine devices (IUDs) are linked to reduced endometrial cancer risk.
5. Endometrial hyperplasia
Endometrial hyperplasia is a disorder where the lining of the uterus becomes thick but it cannot be termed cancerous. At times it goes away on its own, and in other cases it can be treated with HRT or surgery. Endometrial hyperplasia, when not treated, can turn into endometrial cancer. Abnormal vaginal bleeding is known to be the most common symptom of endometrial hyperplasia.
6. Obesity
People who are obese and have extra weight are more at risk of suffering from type 2 diabetes which is a risk factor for endometrial cancer. Higher the chances of obesity in people having type 2 diabetes, the more they are prone to endometrial cancer.
7. History of cancer
Your chances of developing endometrial cancer are much higher if other members of the family have had it. Moreover, a family history of Lynch syndrome also increases the chances of developing cancer. Having suffered from breast cancer or ovarian cancer raises your risk of endometrial cancer. Also, radiation therapy on the pelvis increases your chances of having endometrial cancer.
One should be cautious about these risk factors also. In some cases, people who have been identified as suffering from certain factors may never develop endometrial cancer and on the other hand, people who never showed any risk factors may develop endometrial cancer.

What are the stages of endometrial cancer?

With time, endometrial cancer can extend to other parts of the body from the uterus.

There are four stages into which cancer has been identified depending on its growth in the body:

• Stage 1: Presence of cancer in the uterus only.
• Stage 2: Cancer has spread in the uterus and cervix.
• Stage 3: Cancer is spreading beyond the uterus, but has not affected the rectum or bladder. Though its presence can be seen in the fallopian tubes, ovaries, vagina, and near the lymph nodes.
• Stage 4: The spread of the cancer can be noted beyond the pelvic region. It might have affected the bladder, rectum, and/or distant tissues or organs.

If someone is detected suffering from endometrial cancer, the treatment options are identified depending upon the stage the cancer is in. Early detection of the cancer makes the treatment more effective.

How is endometrial cancer diagnosed?

If you notice possible symptoms of endometrial cancer, it's crucial to schedule an appointment with your primary care doctor or gynecologist immediately.

During the appointment, your medical history and symptoms will be discussed. A pelvic exam will be conducted to identify any abnormalities in your uterus and reproductive organs. To further investigate, a transvaginal ultrasound exam might be recommended.

This type of imaging test employs sound waves to create internal pictures. For the test, a healthcare professional will insert an ultrasound probe into your vagina, which will transmit images onto a screen.

In case any irregularities be detected, your doctor may recommend additional tests to obtain tissue samples:

Endometrial Biopsy: A thin tube is inserted through your cervix into the uterus to suction a small piece of endometrial tissue.

Hysteroscopy: Using a flexible tube equipped with a camera, the doctor visually inspects the endometrium and extracts biopsy samples.

Dilation and Curettage (D&C): If biopsy results are inconclusive, this procedure involves dilating the cervix and scraping tissue from the endometrium.

Samples collected during these tests are sent to a lab for analysis. If endometrial cancer is confirmed, further tests will be ordered to determine the extent of its spread. Blood tests, X-rays, and other imaging methods might be utilized for this purpose.

Different types of endometrial cancer

Endometrial cancer develops from mucus-producing glands known as adenocarcinomas. Less common forms of endometrial cancer include:

• Uterine carcinosarcoma (CS)
• Squamous cell carcinoma
• Small cell carcinoma
• Transitional carcinoma
• Serous carcinoma

There are two types of endometrial cancer:

• Type 1- These are slow-growing and do not easily extend to other organs or tissues.
• Type 2 – These spread quickly and extend outside of the uterus.

Type 1 cancers are common in comparison to type 2 cancers and are easy to treat.

How is endometrial cancer treated?

Treatment options for endometrial depend upon factors like cancer type, stage, and your overall health. There are different treatment options and each approach comes with potential benefits and risks, which your doctor will discuss with you.

Surgery: The main surgical treatment is a hysterectomy, where the uterus is removed. Sometimes ovaries and fallopian tubes are also taken out (bilateral salpingo-oophorectomy). Lymph nodes near the uterus might be removed to check for spread, known as lymphadenectomy. Additional surgeries could be advised if the cancer has spread further.

Radiation Therapy: Radiation therapy employs high-energy beams to kill cancer cells. External beam radiation targets the uterus from outside, while internal radiation (brachytherapy) places radioactive materials inside the vagina or uterus. Your doctor can recommend either one or both of these. These can follow surgery to eliminate remaining cancer cells.

Chemotherapy: Chemotherapy uses drugs to kill cancer cells. Depending on the type, it could be taken orally or intravenously. It's recommended if cancer has spread or returned after treatment.

Targeted Therapy and Immunotherapy: Targeted therapy uses drugs designed to attack specific changes in cancer cells. Immunotherapy enhances the immune system's ability to recognize and combat cancer cells. These newer approaches are often used with chemotherapy or each other.

Hormone Therapy: Hormone therapy involves using hormones or hormone-blocking drugs to alter hormone levels. This slows cancer cell growth. It might be suggested for stage III or IV cancer, or for cancer that has returned.

Your doctor's treatment recommendation is guided by your unique circumstances. They'll consider cancer specifics, your overall health, and your preferences to design the most suitable plan.

Can endometrial cancer be prevented?

While this condition cannot be prevented, a number of factors can help lower the risk of endometrial cancer:

• Maintaining a healthy weight: This can lessen the chances of developing endometrial cancer. It also lowers the chances of return of the cancer if you develop it.
• Workout regularly: Few minutes of workout have been linked to lowering chances of cancer development.
• Treatment in case of abnormal vaginal bleeding: It is important to treat vaginal bleeding. Even if it is caused by endometrial hyperplasia, it is wise to consult a doctor and discuss the available treatment options.
• Discussing benefits and disadvantages of hormone therapy: In case your doctor decides to go for HRT then do discuss the benefits and drawbacks associated with the therapy.  
• Discuss the benefits of contraceptives: it has been found that contraceptive pills and IUDs have been associated with lowering the risk of endometrial cancer. Check with your doctor about the potential benefits and drawbacks associated with the treatment.
• Monitoring family history for cancer: It is recommended to discuss with your doctor if anyone in the family has previously been affected by them, especially ovarian or colon cancer.  Genetic testing might help.

Conclusion

Endometrial cancer is a serious health condition. Hopefully, this blog helped you understand what is endometrial cancer, endometrial cancer causes and risk factors. You should have also understood types of endometrial cancer. However, such diseases always lead to financial consequences. Hence, it is important to consider investing in health insurance for cancer. A health insurance for cancer can provide the necessary financial support in case one is diagnosed with endometrial cancer. By detecting cancer early and making the appropriate choices, you can effectively combat this disease.