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Endometrial cancer involves
cancerous growth of the endometrium (lining of the uterus). It mainly
occurs after menopause, and presents with vaginal bleeding. A hysterectomy
(surgical removal of the uterus) is generally performed.
It is the most common gynecologic cancer in the United States, with
over 35,000 women being diagnosed each year in the U.S. Because of
effective screening, it is only the third most common cause of gynecologic
cancer deaths (behind ovarian and cervical cancer).
The same risk factors for endometrial cancer predisposes women to
endometrial hyperplasia, which is a precursor lesion for endometrial
cancer. An atypical complex hyperplasia carries a 30% risk of developing
endometrial cancer while a typical simple hyperplasia only carries
a 2-3% risk.
Endometrial cancer is often referred to as uterine cancer, however
the uterus may harbor other malignacies, including cervical cancer,
sarcoma, and trophoblastic disease.
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Symtoms
• Abnormal uterine bleeding, abnormal menstrual
periods
• bleeding between normal periods in premenopausal women
• vaginal bleeding and/or spotting in postmenopausal women
in women older than 40: extremely long, heavy, or frequent episodes
of bleeding (may indicate premalignant changes)
• lower abdominal pain or pelvic cramping
thin white or clear vaginal discharge in postmenopausal women.
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 Treatment
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The
primary treatment is surgical. Surgical treatment should consist
of, at least, cytologic sampling of the peritoneal fluid,
abdominal exploration, palpation and biopsy of suspicious
lymph nodes, abdominal hysterectomy, and removal of both ovaries
(bilateral salpingo-oophorectomy). Lymphadenectomy, or removal
of pelvic and para-aortic lymph nodes, is sometimes performed
for tumors that have high risk features, such as pathologic
grade 3 serous or clear-cell tumors, invasion of more than
1/2 the myometrium, or extension to the cervix or adnexa.
Sometimes, removal of the omentum is also performed.
Abdominal hysterectomy is recommended over vaginal hysterectomy
because it affords the opportunity to examine and obtain washings
of the abdominal cavity to detect any further evidence of
cancer.
Women with stage 1 disease who are at increased risk for recurrence
and those with stage 2 disease are often offered surgery in
combination with radiation therapy. Chemotherapy may be considered
in some cases, especially for those with stage 3 and 4 disease.
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Facts
An atypical complex hyperplasia carries a 30% risk
of developing endometrial cancer while a typical simple hyperplasia
only carries a 2-3% risk.
Endometrial cancer is often referred to as uterine cancer, however
the uterus may harbor other malignacies, including cervical cancer,
sarcoma, and trophoblastic disease
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2007 Dreamers |
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