endometrial cancer

What is Endometrial Cancer?

Endometrial cancer, also known as corpus uterine cancer or corpus cancer, is a type of cancer that affects the inner lining of the uterus (womb). It starts in the endometrium, which is the layer of tissue that lines the interior of the uterus.

Types of Endometrial Cancer

There are two types of cancer that affect the uterus: endometrial cancer and uterine sarcoma. Endometrial cancer is more common than uterine sarcoma, which is a rare type of cancer.

Symptoms of Endometrial Cancer

The symptoms of endometrial cancer may include:

• Vaginal bleeding after menopause
• Bleeding between periods
• Abnormal vaginal discharge or spotting
• Extremely long, heavy, or frequent menstrual periods

Causes and Risk Factors

Obesity and having metabolic syndrome are risk factors for developing endometrial cancer. Other risk factors include a family history of the disease, early onset of menstruation, and never having been pregnant.

Prevention and Treatment

While there is no surefire way to prevent endometrial cancer, maintaining a healthy weight through diet and exercise can reduce the risk. Treatment options for endometrial cancer may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.

References:

• [1] Symptoms of endometrial cancer may include vaginal bleeding after menopause (Search Result 1).
• [2] Endometrial cancer starts in the endometrium, the inner lining of the uterus (Search Result 2).
• [3] Uterine cancer includes two types of cancer: endometrial cancer and uterine sarcoma (Search Result 4).
• [4] Symptoms of endometrial cancer may include abnormal bleeding from the vagina (Search Result 6).
• [5] Endometrial cancer is the most common cancer of the female reproductive organs (Search Result 7).
• [6] Obesity and having metabolic syndrome are risk factors for developing endometrial cancer (Search Result 5).

Common Signs and Symptoms of Endometrial Cancer

Endometrial cancer, also known as uterine cancer, can cause a range of symptoms that may vary from person to person. Here are some common signs and symptoms associated with this type of cancer:

• Abnormal Vaginal Bleeding: This is the most common symptom of endometrial cancer, accounting for about 90% of cases [1]. Abnormal bleeding can include:
  • Vaginal bleeding after menopause
  • Bleeding between periods (in women who are still menstruating)
  • Heavy or prolonged menstrual bleeding
• Pelvic Pain: Endometrial cancer can cause pain in the pelvic area, which may be a dull ache or a sharp pain [2].
• Unusual Vaginal Discharge: Some women with endometrial cancer may experience unusual vaginal discharge that is foul-smelling, pus-like, or blood-tinged [3].
• Weight Loss: Unexplained weight loss can also be a symptom of endometrial cancer [4].

It's essential to note that these symptoms can also be caused by other conditions, and not all women with endometrial cancer will experience them. If you're experiencing any unusual vaginal bleeding or pelvic pain, it's crucial to consult your healthcare provider for proper evaluation and diagnosis.

References:

[1] Aug 11, 2023 - Symptoms (Context #1) [2] Mar 27, 2019 - Signs and Symptoms of Endometrial Cancer (Context #2) [3] Jun 6, 2024 - Symptoms of uterine cancer (Context #6) [4] Oct 16, 2023 - The most common symptom of endometrial cancer is abnormal vaginal bleeding. (Context #5)

Diagnostic Tests for Endometrial Cancer

Endometrial cancer diagnosis involves various tests to confirm the presence of cancer cells in the uterus. Here are some diagnostic tests used to diagnose endometrial cancer:

• Pelvic Exam: A pelvic exam is usually the first step in diagnosing endometrial cancer. It helps check for abnormal areas or lumps around the vagina, cervix, uterus, and fallopian tubes [3].
• Endometrial Biopsy: An endometrial biopsy involves removing a tissue sample from the lining of the uterus (endometrium) to examine under a microscope for cancer cells [2]. This is often performed during a D&C (dilation and curettage) procedure.
• Transvaginal Ultrasound: A transvaginal ultrasound uses sound waves to create images of the uterus, which can help identify abnormal growths or tumors [7].
• Blood Tests: Blood tests may be ordered to check for certain substances in the blood that can indicate endometrial cancer. These include:
  • CA 125: This test measures the level of a protein called CA 125 in the blood, which can be elevated in some cases of endometrial cancer [6].
  • Complete Blood Count (CBC) and Complete Metabolic Panel (CMP): These tests can help identify any abnormalities in blood cells or metabolic functions that may indicate cancer [6].

Additional Tests

Other diagnostic tests may also be performed to confirm the diagnosis, including:

• Endoscopy: This involves inserting a flexible tube with a camera into the uterus to visually examine the lining and surrounding tissues.
• Blood Chemistry Tests: These tests can help identify any abnormalities in blood chemistry that may indicate cancer.

It's essential to note that there is no standard or routine screening test for endometrial cancer [4]. However, if symptoms are present, these diagnostic tests can be used to help diagnose or rule out the condition.

Treatment Options for Endometrial Cancer

Endometrial cancer, also known as uterine cancer, can be treated with various drug therapies in addition to surgery. The goal of treatment is to remove or destroy the cancer cells and prevent recurrence.

• Chemotherapy: Chemotherapy involves using medications to kill cancer cells. For endometrial cancer, chemotherapy may be used alone or in combination with other treatments. Common chemotherapy drugs include:
  • Carboplatin
  • Paclitaxel
  • Doxorubicin
  • Cisplatin
• Hormonal Therapy: Hormonal therapy involves using medications to block the effects of hormones that can fuel cancer growth. For endometrial cancer, hormonal therapies such as tamoxifen may be used.
• Targeted Therapy: Targeted therapy involves using medications that specifically target cancer cells and their blood vessels. For endometrial cancer, targeted therapies such as pembrolizumab and dostarlimab have been approved for treatment.

Combination Therapies

In many cases, a combination of treatments is used to treat endometrial cancer. This may include:

• Carboplatin/Paclitaxel: A combination of carboplatin and paclitaxel is often used as first-line chemotherapy for advanced endometrial cancer.
• Cisplatin/Doxorubicin: A combination of cisplatin and doxorubicin is also commonly used to treat endometrial cancer.

Newer Treatment Options

Recent advances in treatment options include:

• Vitrakvi (larotrectinib): Approved for the treatment of advanced endometrial cancer that has worsened despite previous treatments.
• Antibody-Drug Conjugates: Research is ongoing to develop antibody-drug conjugates, which combine a monoclonal antibody with a chemotherapy drug to target and kill cancer cells.

References

1. The most common are medroxyprogesterone acetate (Provera) and megestrol acetate (Megace). Tamoxifen: This drug helps prevent any estrogens that may be fueling the growth of endometrial cancer [2].
2. Treatment usually involves surgery to remove the cancer, but chemotherapy is often used in combination with other treatments [5].
3. A combination of carboplatin and paclitaxel is often used as first-line chemotherapy for advanced endometrial cancer [4].
4. Vitrakvi (larotrectinib) has been approved for treatment of endometrial cancer that is metastatic or cannot be removed with surgery and has worsened despite previous treatments [7].

The differential diagnosis of endometrial cancer involves distinguishing it from other conditions that can cause abnormal uterine bleeding and endometrial thickening on imaging studies.

According to the medical literature, the differential diagnosis of endometrial cancer includes:

• Benign ciliary change: This is a condition where the cilia in the endometrium become overgrown, leading to abnormal uterine bleeding. [1]
• Uterine lymphoma: A rare type of cancer that can cause abnormal uterine bleeding and endometrial thickening. [6]
• Cervical cancer with uterine invasion: In this condition, cervical cancer spreads to the uterus, causing symptoms similar to endometrial cancer. [6]
• Metastasis to the uterus from a distant primary site: Cancer cells can spread to the uterus from other parts of the body, such as the breast or colon. [6]

To make an accurate diagnosis, it is essential to consider these differential diagnoses and perform further investigations, such as:

• Physical examination
• Laboratory tests (e.g., Pap smear, endometrial biopsy)
• Imaging studies (e.g., ultrasound, MRI)

A definitive diagnosis of endometrial cancer requires an endometrial tissue sample, which can be obtained through procedures like curettage. [5]

References: [1] SG Silverberg · 2000 · Cited by 278 [5] MM BRAUN · 2016 · Cited by 501 [6] Jul 20, 2023