Endometrial cancer: risk factors, symptoms, diagnosis, and treatment
Complete information about risk factors, symptoms, diagnosis, and treatment of endometrial cancer.
The uterine cavity is lined by three layers: the peritoneal serosa, the myometrium, and the endometrium (the innermost layer). The endometrium is a mucous membrane whose main function is to allow the implantation of a fertilized egg. When fertilization or implantation fails, this tissue sheds, giving rise to menstruation. The endometrium subsequently regenerates to begin a new menstrual cycle.
The most common alterations that affect the endometrium are endometrial polyps , submucosal fibroids, endometrial hyperplasia, and endometrial cancer.
Today we will focus on the latter, which is more common in developed countries and generally occurs a few decades after the onset of menopause. It is associated with excessive exposure to estrogen or an imbalance in another hormone called progesterone.
Risk factors associated with endometrial cancer
Endometrial cancer can occur in both premenopausal (20%) and postmenopausal (80%) women. The most common age range is between 50 and 59 years , but cases are also frequently seen in women under 40.
Generally, this tumor can cause symptoms that raise suspicion in the early stages of the disease. This, combined with regular gynecological checkups, allows for a very favorable prognosis in most cases.
Most women with endometrial cancer have a history of elevated estrogen levels accompanied by insufficient levels of estrogen's natural opponent, progesterone.
Elevated estrogen levels and, therefore, an increased risk of suffering from this disease may be due to:
- Obesity, especially >15 kg overweight.
- Estrogen-containing medications.
- Nulliparous women. That is, those who have never become pregnant.
- Sterility or inability to become pregnant.
- Premature menarche: the onset of menstruation at a very early age.
- Late menopause: cessation of menstruation at a very late age.
- Arterial hypertension.
- Syndrome polycystic ovary.
- Additionally, women with a history of endometrial polyps, those using estrogen hormone replacement therapy (if not taking regular progesterone at the same time), and those with diabetes are at increased risk of developing endometrial cancer.
- The drug tamoxifen, used to treat breast cancer, may also increase the risk of endometrial cancer.
Endometrial cancer
Symptom
- El abnormal vaginal bleeding -bleeding between periods or after menopause- is one of the most common symptoms that can detect endometrial cancer.
- Also anemia, caused by chronic blood loss, especially if the patient has ignored the symptoms of prolonged or abnormally frequent menstrual bleeding.
- Lower abdominal pain or intrapelvic cramps.
- Pain during sex.
- Whitish or colorless vaginal discharge in postmenopausal women.
These symptoms can be caused by other conditions, so it's very important to see a gynecologist as soon as possible if you detect any of them.
Discovery
The diagnosis of endometrial cancer consists of several phases.
It can be suspected based on the clinical picture, an altered cytology result, or endometrial thickening visible on vaginal ultrasound.
Following this, a diagnostic hysteroscopy with biopsy and histopathological examination is essential. The study should be completed with a pelvic-abdominal CT scan and/or magnetic resonance imaging (MRI).
Treatment
The treatment for endometrial cancer is surgical.
- Removal of the uterus and ovaries by laparoscopy or abdominal surgery, known as total hysterectomy with double annexectomy; and also:
- Removal of the pelvic and para-aortic lymph nodes when the tumor extends beyond the endometrium, invading more than half of the myometrium.
- In advanced cases, surgery must be supplemented with radiotherapy. In even more advanced cases, hormone therapy and chemotherapy are necessary.
If you found this article interesting and would like to be seen by a specialist in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized department in this area. You can request more information by calling 91 387 51 72/73/74 or schedule an in-person appointment with top specialists.