Endometrial Cancer: Causes, Symptoms, Diagnosis And Treatment


Endometrial cancer is the rapid growth of cells in the endometrium (uterus lining). It is also known as uterine cancer. It's the fourth common cancer found in women and around 40,000 die every year from this disease. It mostly occurs in women post-menopause, mostly when they are in their seventies.

Endometrial cancer has worse chances of survival in a 5-year period than breast or prostate cancers. In the early stages, it can be treated by hysterectomy. However, it becomes lethal in the advanced stage.

The main risk factors associated with uterine cancer are menopause, obesity, diabetes, unopposed oestrogen and hypertension.

Women who mostly undergo postmenopausal treatment with hormones are at a higher risk of contracting uterine cancer than the rest of them. According to epidemiologic studies, frequent use of unopposed oestrogens can increase substantial risk, especially among lanky women. Hormone Replacement Therapy was widely used earlier for treating menopausal weakness, fatigue and heart disease. Nevertheless, it isn't used much these days, as it maximizes the possibility of breast cancer, blood clots and endometrial cancer. When endometrium is exposed to oestrogen, without added progesterone, it can stimulate rapid cell proliferation in the uterus, hence resulting in excess oestrogen without progesterone.

Obesity is a major risk factor for more than half of uterine cancer cases. Women with higher BMI are more susceptible to this cancer than the ones with normal BMI. Body fat, which is a complex endocrine gland, comprises adipocytes, preadipocytes, infiltrating macrophages, nerve, stromal and stem cells. All these combined secrete adipokines that have localized effects; it increases endometrial cell growth and can form tumours. Besides, adipose tissues in fats, also promote tumour formation, as it contains mesenchymal stem cells. More number of adipose tissues can cause aromatase activity, which converts androgens to estrogens. It can also cause hyperglycemia, which sources endometrial proliferation.

A Swedish mammography study found a positive relation between diabetes and decreased physical activity. Type 2 diabetes is associated with hyperinsulinaemia. It increases oestrogen levels by simultaneously lowering the sex hormone globulin. High levels of IGF-1 and IGF- binding protein-1, have been known to cause endometrial cancer, especially in elder obese women. C-reactive protein, an inflammatory biomarker increases by insulin resistance, which is caused during diabetes, thus increasing the chances of uterine cancer post menopause.

Although the relation between hypertension and endometrial cancer isn't significant, it can be attributed to factors like lifestyle changes, medical conditions revolving around diet, less exercise, BMI and diabetes. Hypertension inhibits apoptosis; it can also be related to hysterectomies, which has the potential to bias the risk analysis. The medications used to cure anxiety can increase the risk of cancer.

There are also other reasons that can be involved.

Mostly the signs and symptoms are accompanied by abnormal vaginal bleeding or pelvic region pain. One should immediately consult the doctor on observing such signs.

Usually, endometrial cancer is not detected easily in the Pap test, as the cell growth starts in the uterus. To find out the signs, a uterus tissue should be removed and examined under a microscope, to confirm cell growth . The following methods can be used for the purpose:

Other tests to diagnose the disease are given below.

This usually involves a thorough check up to see if cancer is limited to uterus or has spread to other body parts. This process is called staging and the treatment is decided on the basis of cancer stage. Cancer first spreads through tissues, then it starts travelling through lymph vessels and bloodstream. When the disease starts escalating through lymph, it's called metastasis.

Endometrial cancer has been divided into four stages.

Stage 3 and 4 come under high-risk treatment.
In the initial stages of cancer, hysterectomy is used to detect cancer. An operation is done for removal of the uterus. A thorough examination of the vagina, fallopian tubes, cervix, ovaries and rectum is done using the Pap test. The nurse/ doctor inserts two lubricated fingers, of first hand inside the vagina and another hand over the lower abdomen to detect the placement, shape and size of ovaries and uterus. Also, a gloved finger is put inside the rectum to figure out any lump growth or abnormality.

Presently, five types of treatments are available for this type of cancer:

It is the most common treatment used to cure cancer. The following methods can be used while surgery:

Post-surgery, the patient is given adjuvant therapy, which is to minimize the chances of cancer returning back to the source. Hormone treatment or radiation therapy might be used to eradicate the leftover cancer cells fully.

This therapy involves the use of powerful X-rays or other forms of radiation to eliminate cancer cells or curb their growth.

These therapies can also be used to provide relief from symptoms and give a healthier life.

Chemotherapy is effective in cancer treatment, by using drugs to either kill or inhibit the growth of cancer cells. When the drugs can travel through blood vessels to the cells within the entire body, it's called systematic chemotherapy. The drugs can be administered orally or through muscles and veins. Regional chemotherapy is used to directly affect the cancer cells in the cerebrospinal fluid, some organ, and the abdominal cavity.

This therapy stops the growth of tumour cells by removing hormones or preventing their flow around. Receptors, surgery, drugs or sometimes radiation is used to stop the hormones; the test results show the exact hormones that are attaching themselves to cancer cells.

In this therapy, the cancer cells are identified and then removed, without causing any harm to normal cells. There are three types within targeted therapy, which are used to treat endometrial cancer.

Endometrial cancer cannot be prevented completely, but sure minor lifestyle changes can lower the risk factors. A healthy lifestyle should be maintained, with consumption of timely diet. Less smoking, drinking can help reduce hypertension. Keeping a balanced diet and light exercise minimizes the chances of obesity and diabetes. Regular monthly health check-ups, even of vagina and uterus can assist in keeping track. If cancer is detected in early stages, it is much easier to completely get rid of it.

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