Endometrial cancer: Symptoms, Stages, Causes, Treatments, Cost and Side Effects

Endometrial cancer is also known as uterine cancer and it is a type of cancer that affects the uterus initially. The uterus is a pear-shaped and hollow pelvic organ in women where the development of fetus occurs. It begins in the layer of cells that form the lining of the uterus which is known as endometrium. This cancer is generally detected in women when they are young as they suffer from abnormal vaginal bleeding and they have to consult a doctor. Endometrial cancer be easily cured if it is diagnosed early and uterus is surgically removed.

Types of Endometrial cancer are as follows:

1. Endometrial adenocarcinoma:

   This cancer starts in the glands of the endometrium and is one of the most common types of uterine cancer. Mostly uterine cancer comes under the category of adenocarcinoma but they vary in the degree of severity.

2. Papillary serous carcinoma:

   This cancer can occur again even if it gets caught at an early stage and it occupies 5% of endometrial cancer.

3. Uterine sarcoma:

   This type of cancer develops in the wall of the uterine muscle. This is one of the least types of uterine cancer but its speed of spreading is very fast.

4. Adenosquamous carcinoma:

   This comprises for about 10 percent of uterine cancer it includes two types of cells squamous cells and gland-like cells.

The signs and symptoms of endometrial cancer include:

1. Abnormal vaginal bleeding:

   This occurs in most of the women before menopause and if a woman has postmenopausal bleeding then she will have endometrial cancer.

2. Vaginal discharge:

   It can be a pin, watery liquid or even brown with a foul smell.

3. Painful urination:

   If you have difficulty in urination accompanied by pain then you must visit the doctor as there may be a risk of having endometrial cancer.

4. Unexpected or abnormal weight loss:

   If your weight starts decreasing abnormally then you must visit a doctor. Pain during intercourse: there is pain during intercourse if you are having endometrial cancer.

5. Weakness and pain in the lower back, abdomen, and legs:

   Most of the times this happens because cancer starts spreading to other organs as well.

The cause of endometrial cancer is not properly known. However, it is known that this ailment occurs due to a genetic mutation within cells in the endometrium. This genetic mutation causes healthy cells to turn into abnormal cells. Healthy cells grow and multiply at a set rate and they also die at a set time. But, on the other hand, abnormal cells multiply at an abnormal rate and they don’t even die at a set time. When these abnormal cells accumulate, they form a mass or tumor. Cancer cells affect the nearby healthy cells and can spread to other cells of the body.

Risk factors for endometrial cancer include:

1. Imbalance of hormones in females: The fluctuation of the hormones progesterone and estrogen causes changes in the endometrium. If the condition comes that only the level of estrogen is increased in the body and not the progesteron then it can lead to endometrial cancer.

2. Never have been pregnant: If a woman has never become pregnant then the chances of getting endometrial cancer increases.

3. More menstruation period: If a girl starts having her menstruation periods early or before the age of 12 or if the menopausal time increases then the chances of getting endometrial cancer increases.

4. Older age: Old age is of the common factor of having endometrial cancer because it mostly starts after the menopause.

5. Obesity: When you are obes excessive fat accumulates in the body thus altering the hormonal balance due to which the risk of endometrial cancer decreases.

6. Inherited colon cancer syndrome: Hereditary nonpolyposis colorectal cancer (HNPCC) is a syndrome which causes the risk of colon cancer and also includes endometrial cancer.

The stages of endometrial cancer are as follows:

1. Stage I: Cancer is restricted only to the uterus
2. Stage II: Cancer starts spreading to the cervix
3. Stage III: Cancer starts to spread more organs including vagina, ovaries, lymph nodes and ovaries
4. Stage IV: Cancer further spreads to urinary bladder, rectum, and even organs far from uterus including bones, lungs, etc.

Endometrial cancer starts spreading when the cancer cells start growing out of control become larger in number. The cancer cells also spread to other parts of the body such as vagina or liver.

1. Examining the pelvis:

   The pelvic exam is conducted and the doctor checks the outer portion of your genitals. FOr proper diagnosis, the doctor also inserts a speculum which gives a proper view of the cervix abnormalities and vagina.

2. Using sound waves to create a picture of the uterus:

   The doctor can also recommend a transvaginal ultrasound which gives a clear view of the structure and thickness of the endometrium and also helps in a clear view.

3. Removal of a sample tissue for testing:

   You may also be recommended with the endometrial biopsy so as to get a sample of cells from the uterus. It also involves tissue removal from the uterine lining which is used for laboratory testing.

4. Performing surgery to remove tissue for testing:

   If there is not the removal of enough tissues during the process of biopsy or if the result still remains unclear then the person will have to undergo dilation and curettage.

The treatment for endometric cancer depends on what stage the cancer is in, the general health of the patient and the preference of the person concerned. The different types of treatment include surgery to remove the uterus, radiation therapy, hormone therapy, chemotherapy and supportive palliative care.

Most women with endometrial cancer has to get their uterus removed surgically. She has to undergo hysterectomy to remove the uterus and also salpino-oophorectomy to remove the ovaries and the fallopian tubes. The surgeon generally inspects the areas around the uterus to find out if the cancer is spreading. However, a hysterectomy will make it impossible for a woman to bear children in the future.

A doctor may recommend radiation to reduce the risks of cancer affecting the individual again. Radiation therapy, which uses X-rays and protons, may also be used before surgery to reduce a tumor and thereby make it easier to remove. Radiation therapy may also be recommended for people who are not healthy enough to undergo surgery. Radiation therapy can be given from a machine outside your body (external beam radiation) and also by placing a radiation-filled device like small seeds, cylinder or a wire inside the vagina.

Hormone therapy requires having medications that affect the hormone levels and it is recommended if a person suffers from advanced endometrial cancer. Synthetic progestin helps to stop the endometrial cancer cells from growing further while medications that reduce the amount of estrogen in the body help to kill the endometrial cancer cells that depend on estrogen.

Women with recurrent or advanced form of endometric cancer are generally given chemotherapy. One drug or a combination of drugs can be used. The chemotherapy drugs can be taken orally in the form of pills or in the form of injections that is injected through the veins. The chemotherapy drugs travel through the blood stream and kill the cancer cells.

Radiation therapy and chemotherapy have their effects on the human body for a few weeks or months till after the surgery. So a person who has undergone chemotherapy or radiation therapy would require a few weeks or months to return to normal life. A person undergoing surgical procedures like hysterectomy will also require some time to get back to normal physical activities.

The survival rate of endometrial cancer is up to 95% if detected at an earlier stage.

There is no exact way to cure endometrial cancer but there can be ways in which the risk of endometrial cancer can be prevented like:

Physical activities: women should be physically active as it decreases the risk of physically active therefore regular exercise should be done. Adoption of a healthy lifestyle can keep you free from endometrial cancer.

Proper weight: if a woman is obes then the chances of getting endometrial cancer increases three times.

Getting treatment of endometrial problem: if you are having any problem related to endometrial cancer then you should visit the doctor as it can lower the risk.

Radiation therapy can come in different packages. However, two cycles of radiation therapy can cost around Rs 2,47,000. 50 mg of Aldactone, which is anti-androgen or testosterone blocker, can be obtained for Rs 25. One sheet of 100 mg Aldactone costs Rs 100. The cost of chemotherapy is roughly Rs 200000.

Chemotherapy, radiation therapy and other treatment may help a person to deal with the symptoms of endometrial cancer. However there are certain risk factors that may cause the ailment to recur again. The risk factors include changes in the balance of female hormones in the body, more years of menstruation, old age, never being pregnant, obesity and inherited colon cancer syndrome. So the results of the treatment may not be permanent.