Endometrial cancer

Endometrial cancer can be present by different symptoms:

Irregular menses
Bleeding between menstrual cycles
Prolonged bleeding during the menstrual cycle
Bleeding after sex
Bleeding after menopause
Pelvic pain
Pelvic pressure
Urinary frequency or urgency
Change in bowel habits
Abnormal vaginal discharge
Fatigue
If you experienced symptoms of endometrial cancer,

visit your Gynaecologist who may direct you to an oncologist.

Different factors can increase the risk of developing endometrial cancer such as:



Family history of endometrial cancer



Obesity



Old age- >65 years old



Early menstruation



Late menopause



Infertility



Polycystic ovary syndrome



Using a drug for breast cancer called Tamoxifen



Using estrogen as hormonal therapy

Different tests and procedures may be used to diagnose and know the stage of endometrial cancer such as:

Pelvic examination: A physical examination by the doctor to find any abnormality or unusual masses in this area.

Transvaginal ultrasound: A imaging procedure that gets a picture of the uterus in addition to measuring its thickness.

Hysteroscopy: A procedure in which a telescope with light and camera is used to evaluate abnormal bleeding and visualize the uterine cavity by passing it through the vagina.

Other scans: Different techniques and devices are used to take a picture of the uterine cavity such as magnetic resonance imaging “MRI”, Computed tomography “CT”, and Positron emission tomography “PET” however, the last 2 are not very useful in the initial evaluation.

Biopsy: A process in which a sample is taken from the uterus to be examined under the microscope to confirm the diagnosis. This is considered the main process that confirms the diagnosis of endometrial cancer.

Staging

The staging of endometrial cancer depends on the size of the tumor, involvement of lymph nodes, and spreading to other parts of the body. It has stages from zero to four. stage four is the most severe one and indicates that cancer has spread to different organs.

Choosing the appropriate treatment depends on the size of the tumor, location, spreading, risk factors for the disease recurrence, and the patient's general health.

Treatment options are:

Surgery: Surgery is the mainstay for treating endometrial cancer and it depends on how much the disease has spread, so it may range from removing the uterus and cervix to removing other surrounding organs and lymph nodes.

Radiotherapy: It is using radiation to kill cancer cells. This procedure can be used in combination with chemotherapy after surgery to kill any remaining cancer cells and prevent the disease from coming back, in cases in which the patient is not a candidate for surgery, or to decrease the tumor size if the tumor has already spread.

Chemotherapy: A type of medicine that kills cancer cells. It is used in combination with radiotherapy after surgery to prevent the disease from coming back, when the patient is not a candidate for surgery, or in combination with surgery in advanced cases in which cancer has already spread to other organs. (ex: Carboplatin, Paclitaxel, Cisplatin, Doxorubicin).

Hormonal therapy: Hormones such as Progesterone are used in the early stages in which the patient needs to preserve fertility, but the patient should be counseled to do surgery to remove the uterus after having a child.

Immunotherapy: Medications such as Pembrolizumab, that help the immune system fight cancer.