What is Endometrial Cancer?

Endometrial cancer is cancer of the uterus (womb) that develops in the inner lining of the uterus. Cancer is the abnormal growth of cells that grow together to form tumors.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of endometrial cancers. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Signs and symptoms of endometrial cancer can include:

• Abdominal pain and bloating
• Abnormal vaginal discharge or bleeding
• Pelvic pain and pressure
• Unexplained weight loss

Diagnosis

To diagnose endometrial cancer, a physical examination, including a pelvic exam, are performed. A physician will also ask about symptoms and family medical history. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Blood tests: Substances released into the blood can be checked to determine if cancer is present.

D&C (dilation and curettage): This procedure may be done if an endometrial biopsy does not provide enough tissue for examination. During the procedure, the cervix is enlarged and a special tool is used to remove cells from the lining of the uterus.

Endometrial biopsy: During this procedure, a thin, flexible tube is inserted through the vagina and into the uterus to remove a small amount of tissue that will be studied under a microscope to look for cancer cells.

Genetic testing: If a woman previously had endometrium cancer, or she or a family member have had cancer of the colon or rectum or Lynch syndrome, testing can provide insight into ways to prevent developing endometrial cancer.

Hysteroscopy: During this procedure, a thin tube with a camera and light on the end is inserted into the vagina to the uterus. A physician will look at the uterus and fallopian tubes and may remove small pieces of tissue to be studied under a microscope to see if cancer is present. A D&C may be done along with this procedure.

Imaging tests: A computerized tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) can help locate and determine if endometrial cancer has spread elsewhere in the body.

Ultrasound: An ultrasound device can show if there are tumors in the uterus.

Risk Factors

Risk factors for the development of endometrial cancer can include:

Diet and physical activity: A diet high in fat and a lack of regular physical activity increases the risk for endometrial cancer.

Age: Women age 60 or older face a higher risk for getting endometrial cancer.

Medical conditions: Having diabetes, high blood pressure, breast, ovarian, or colon cancer, gallbladder disease or complex atypical endometrial hyperplasia, as well as being obese, increases the risk for developing endometrial cancer.

Estrogen replacement therapy:  Replacement of estrogen after menopause can increase the risk of developing endometrial cancer.

Endometrial polyps: A history of having these polyps can increase the risk for endometrial cancer.

Family history: A woman who has had uterine, ovarian or colon cancer or Lynch syndrome (hereditary non-polyposis colorectal cancer), or a family history of those conditions, is at higher risk for developing endometrial cancer.

Total number of menstrual cycles: Starting a period before age 12 or ending periods (menopause) after age 50 creates a greater risk for endometrial cancer.

Never being pregnant: Women who have never been pregnant face a higher risk of developing endometrial cancer than women who have had at least one pregnancy.

Polycystic ovary syndrome: Women of reproductive age with enlarged ovaries who have abnormal menstruation, excess facial hair, severe acne and male-patterned baldness caused by increased levels of male hormones are at increased risk for developing endometrial cancer.

Radiation: Previous radiation therapy to treat other kinds of cancer in the pelvis area can lead to an increased risk of endometrial cancer.

Prevention

While some risk factors cannot be controlled, there are ways you can help to prevent endometrial cancer:

Maintain a healthy lifestyle: Eat a well-balanced diet, limit intake of fat as well as alcohol consumption. Stay physically active.

Maintain a healthy weight or lose weight: The most common risk factor associated with endometrial cancer is being 30 to 50 pounds overweight. Fat cells produce estrogen and can affect the endometrial lining and can lead to the development of cancer cells.

Screenings: Women at increased risk of endometrial cancer, including those with Lynch syndrome, should have regular screenings.

Prognosis

The prognosis for endometrial cancer depends upon how early the disease is diagnosed and treated, the size and location of the tumor, and if it has spread. Endometrial cancer is highly curable if it is detected and treated early while contained to the uterus.

Treatment and Recovery

Endometrial cancer treatment depends upon the stage of cancer, size of the tumor, age and health of the woman, and if she wishes to get pregnant.

Hormone Replacement Therapy
In some cases, hormone or hormone-blocking therapy can treat endometrial cancer by slowing the growth of cancer cells.

Surgery
Surgery is the most common treatment for endometrial cancer. Surgery options can include:

• Hysterectomy: In this procedure, the uterus and cervix are removed. For abdominal hysterectomy, an incision is made through the abdomen to remove the uterus. During a vaginal hysterectomy, the uterus is removed through the vagina.
• Radical hysterectomy: In this procedure, the uterus, cervix and part of the vagina are removed. The ovaries, fallopian tubes and pelvic lymph nodes may also be removed.

Recovery After Surgery
Recovery from hysterectomies vary by the type performed. For an abdominal hysterectomy, a hospital stay can last three to seven days, and complete recovery takes four to six weeks. For a vaginal hysterectomy, the average hospital stay is one to two days, and two to three weeks for recovery. For a radical hysterectomy, most hospital stays are five to seven days and recovery takes four to six weeks.

Radiation Therapy
If endometrial cancer is contained to the uterus but has spread to the uterine wall, or if other high-risk conditions are present, radiation may be needed after surgery. Most often, radiation treatments are given five days a week for several weeks.

• External beam radiation: A high-energy X-ray machine is used to direct a beam of radiation to the tumor Frequency and duration of treatment is determined by the radiation oncologist.
• Vaginal brachytherapy: radiation is delivered through a cylinder placed inside the vagina to where the uterus used to be.

Chemotherapy
If cancer has spread outside of the uterus, chemotherapy is used, often in combination with radiation, for treatment of endometrial cancer. Chemotherapy drugs designed to kill cancer cells are typically injected into the bloodstream

Complications

Endometrial cancer can spread to other parts of the body and can recur. Complications of endometrial cancer can include:

• Anemia (loss of blood)
• Infertility
• Vaginal dryness
• Vaginal stenosis
• Premature menopause
• Lymphedema
• Fatigue