Endometrial cancer is a cancer that begins in the lining of the uterus, which is called the endometrium. It is the most common type of uterine cancer, and the most common gynaecological cancer diagnosed in Australian women.
The most common sign of endometrial cancer is abnormal vaginal discharge, particularly if it occurs after menopause. The discharge can appear watery or bloody and may have an abnormal smell.
The most common symptom of endometrial cancer is abnormal vaginal discharge. Other common symptoms include:
Many conditions can cause these symptoms, including endometrial cancer. If you have any of these symptoms, we suggest that you talk to your doctor. Your doctor may refer you for tests to see if you have cancer.
A series of tests are involved to confirm a diagnosis of endometrial cancer. These include:
Your doctor will feel your abdomen and may also do a vaginal or cervical examination.
This test uses sound waves to create a picture of your internal organs. Using the ultrasound, the doctor can look at the size of your ovaries and uterus and the thickness of the endometrium (the lining of the uterus). If anything appears unusual, the doctor will suggest you have a biopsy.
An endometrial biopsy (also known as a pipelle biopsy) may be done by a gynaecologist to examine the cells of your endometrium. A narrow plastic tube that removes a small sample of endometrial cells using suction is inserted into the uterus.
A hysteroscopy allows the doctor to see inside your uterus by inserting a device called a hysteroscope through the cervix. The doctor will remove some tissue to send to a pathologist for examination under a microscope.
A dilation and curettage (D&C) is the most common and accurate way to remove tissue from the lining of the uterus for a biopsy. It is usually done along with hysteroscopy and takes a few hours in the hospital or at a day procedure clinic, under a light general anaesthetic. Period-like cramps and light bleeding may occur after the D&C and can last for a few days.
Further tests are often needed to determine the size and position of the cancer, and whether it has spread. This process is called staging. These tests can include a blood test, x-ray, CT, MRI, or Pet scans.
If you are diagnosed with endometrial cancer, you will be referred to a gynaecological oncologist who works in a multidisciplinary team. Treatment can include:
Endometrial cancer is usually treated with surgery to remove the uterus, cervix, fallopian tubes or ovaries, and sometimes also lymph nodes as well. Breast cancer, lung cancer and brain cancer are other types of cancer that primarily use surgery as a form of cancer treatment.
A total hysterectomy is the surgical removal of the uterus and cervix. In most cases, the fallopian tubes and ovaries are also removed – this is called a bilateral salpingo-oophorectomy. The ovaries are removed either because the cancer may have spread to the ovaries, or because the ovaries produce oestrogen, a hormone that may cause the cancer to grow.
If endometrial cancer has spread into the muscular wall of the uterus, this increases the risk that it will spread to other areas near the uterus and to the pelvic lymph nodes. Your doctor may discuss the need to remove some of the lymph nodes in your pelvic region, to make sure the cancer doesn’t spread further. Surgically removing your lymph nodes is called a lymphadenectomy. Lymph node removal is not recommended for all women.
Radiation therapy (radiotherapy) uses high-energy X-rays to remove the cancer cells. It is often used after surgery to reduce the risk of the cancer coming back. You might have radiation therapy to your pelvic area to treat endometrial cancer. Radiation therapy may also be recommended if the cancer has come back or spread. Other types of cancers that are treated with radiation therapy include bowel cancer, lung cancer and brain cancer.
Chemotherapy uses drugs to remove cancer cells or slow their growth, and may involve a number of treatments (‘cycles’) over several months.
Some cancers of the uterus depend on hormones (such as oestrogen) for their growth. Hormone therapy uses tablets with hormones in them that can stop the cancer cells from growing.
Australian women have a 1 in 40 chance of being diagnosed with endometrial cancer before their 85th birthday. Every year, there are more than 3,000 new cases and 550 deaths from endometrial cancer in Australia.
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References:
Cancer Australia
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