Endometrium Cancer
What is Uterine or Endometrium Cancer?
Uterine cancer arises from the uterus or womb. The uterus comprises of 2 layers - the uterine lining and the muscle layer. The uterine lining is also known as the endometrium. It comprises of many blood vessels and go through phases of increasing thickness before being shed as monthly menses.
The 2 common types of uterine cancers are those arising from the endometrium known as carcinoma or those arising from the muscle known as sarcoma.
How common is Endometrium Cancer ?
In Singapore, it is the 3rd commonest female genital tract cancer (after cervix and ovarian cancers)
Age of Onset
Endometrial cancer affects mainly women around menopause. 70% of the time, endometrial cancer occurs after age 50.
Risks and Causes
In about 40% of patients, no risk factors are identified.
Factors associated with endometrium cancer include obesity, diabetes mellites, hypertension and hormonal medication. Constant oestrogen stimulation without progesterone modification, which can be found in certain oral contraceptive pills, is a risk factor. Absence of ovulation, from whatever cause, is a risk factor.
Symptoms and Signs of Endometrial Cancer
The only significant clinical sign is abnormal vaginal bleeding or vaginal discharge and occasional pelvic pain.
Diagnostic Tests
Aspiration of endometrial contents can be performed as an outpatient procedure. A small tube called a pipelle is inserted through the cervix into the uterus and the endometrial contents are sampled or extracted by suction. If uterine cancer is suspected, an ultra sound of the pelvis will be a useful diagnostic tool. It will access the thickness of the endometrial lining of uterine wall.
To confirm the diagnosis or presence of cancer in the uterine lining, a dilatation and curettage is done. Specimen from the dilatation and curettage/pipelle aspiration are sent for analysis in the pathology laboratory.
Treatment of Endometrial Cancer
The mainstay of treatment for uterine cancer is surgical removal of the uterus with fallopian tubes and ovaries. It will also allow the doctors to assess the extent of spread of the cancer. This is also known as staging.
Following the surgery and staging, additional or adjunctive treatment such as radiotherapy, hormonal treatment or chemotherapy may or may not be required depending on the stage, grade and type of cancer.
Prognosis of Endometrial Cancer
Clinical examinations, x-rays and pathology reports all help the medical team decide what the progress of an individual case of endometrial cancer may be. Then, the appropriate course of treatment will be put into action. The treatment strategy may vary from person to person. Uterine cancers when detected in its early stage, can probably be cured with treatment.
Frequently Asked Questions about Endometrial Cancer
1. I bleed from the vagina after sexual intercourse. I am worried. Do you think it is cancer?
Although there may be other reasons that can cause vaginal bleeding, such as cervix infection or trauma, you should seek early medical attention. Many cancers of the uterus and cervix do present with bleeding. If detected and treated early, there is a higher chance of cure.
2. I am on hormone replacement therapy. Is there any risk of getting cancer?
Hormone replacement therapy has many benefits and some disadvantages. Before starting, you should ask your doctor, who knows your personal medical history, for the risks and benefits.
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