Endometrial cancer: The Need for Continuous Improvement is Now

April 2021

Endometrial cancer is a cancer that originates in the inner lining of the uterus. This inner layer, called the endometrium, thickens each month in order to prepare for pregnancy. The cells of this layer are not always able to differentiate between times when a woman is supposed to be preparing for pregnancy and times when she is not; therefore, they can start to divide uncontrollably. When these abnormal cells grow outside the uterus and invade other tissues in the body, they have turned into cancer. 

The first symptom of endometrial cancer may be vaginal bleeding or a discharge from the vagina that occurs during or after menopause. The bleeding is not always heavy, and the blood may sometimes look normal. The doctor can examine the uterus to determine whether or not it has a mass that could be endometrial cancer. This important examination, called an endometrial sampling, is performed by inserting a thin tube through the vagina and out through the cervix. A sample of cells is removed for testing by a pathologist. 

The diagnosis of endometrial cancer depends on clinical history, physical examination, pelvic computed tomography scan (CT) or magnetic resonance imaging (MRI). Treatment of choice depends on tumor stage and other factors such as age, menopausal status, radiotherapy history etc. These options could be hysterectomy, endometrial ablation, chemotherapy, or radiotherapy. 

Endometrial cancer is cancer of the lining of the uterus. There are two main types: "endometrioid" cancers, which are similar to other uterine cancers like ovarian and cervical; and "serous" cancers, which typically grow faster than endometrioid cancers and have a higher risk of spreading to other parts of the body. 

In this post we're going to go over how endometrial cancer is diagnosed, its symptoms, treatments, and prognosis. 

The two main types of endometrial cancer are: 

Non-serous: Endometrioid cancers make up about 80 to 85% of all endometrial cancers. They start in the cells of the endometrium and usually grow slowly. They can spread to other parts of the body, but they tend to grow locally. They usually have a better prognosis than serous cancers.

Endocervical cancer: Malignant cells that develop from cervical tissue (the lining of the uterus that lines the cervical canal) are known as cervical cancer . These cancer cells can spread to the endocervical lining and grow within it. 

Symptoms include:

Fatigue or feeling tired is the most commonly reported symptom in women with endometrial cancer. Lower abdominal pain is also common, but any new symptom should be discussed with a doctor. 

Endometrial cancer prognosis will depend on several factors: 

The type of endometrial cancer (endocervical versus non-endocervical) and other diseases present at diagnosis; age of the woman; stage of the disease at diagnosis; and, tumor markers found in the blood or urine like CA-125. 

The World Health Organization has classified endometrial cancer into several stages according to the size of the tumor and to whether cancer cells have spread from the endometrium into surrounding tissues or organs. Endometrial cancer is staged using a system known as the Federation Internationale Contra Cancrum-International Federation of Gynecology and Obstetrics-The American Joint Committee on Cancer system. The initial part of this staging system is known as the FIGO stage. In this classification, stage I endometrial cancers are small and appear to be confined to the uterus.

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