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Endometrial Cancer

Endometrial cancer is a rare disease that mostly strikes post-menopausal women with an average age of 60.

Endometrial cancer is a rare disease that mostly strikes post-menopausal women with an average age of 60.

Overview

There are over 600,000 endometrial cancer survivors living in the United States today1https://www.cancer.org/cancer/endometrial-cancer/about/key-statistics.html. Luckily, endometrial cancer is often caught early because it generally causes abnormal vaginal bleeding, leading women to get checkups2https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461.

In general, if an endometrial tumor is identified, doctors will often recommend a PET or CT scan for further evaluation3https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/diagnosis-treatment/drc-20352466. Both PET and CT scans, however, can expose you to potentially harmful radiation4https://www.mayoclinic.org/tests-procedures/pet-scan/about/pac-20385078 5https://www.fda.gov/radiation-emitting-products/medical-x-ray-imaging/what-are-radiation-risks-ct. Furthermore, a 2016 study showed that MRIs, which do not expose you to radiation, are more effective in evaluating local tumor extent than PET or CT scans6https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769723/.

Symptoms

Signs of endometrial cancer could include:

  • Bleeding in between menstrual periods
  • Pelvic pain
  • Vaginal bleeding after menopause
  • Abnormal, blood-tinged, or watery vaginal discharge

(Source)

If you are having any of the above symptoms you need to talk to a doctor about the appropriate diagnostic work up. The Ezra scan is a screening test for asymptomatic individuals and it is not designed to diagnose existing or suspected cancers.

Causes

Physicians have not yet pinpointed the exact causes of endometrial cancer, though they do know the culprit is some genetic mutation in the endometrium, or uterine lining. When healthy cells garner certain mutations, they grow and multiply with no abandon, and do not die when they should. Eventually, they accumulate and form a tumor, then invade tissues in the area. If left untreated, some tumor cells can separate from the original tumor and metastasize to other parts of the body.

There are, however, some known risk factors that increase your chances of developing endometrial cancer:

  • Never having been pregnant
  • Obesity
  • Older age
  • Having undergone breast cancer hormone therapy, such as Tamoxifen
  • Hereditary nonpolyposis colorectal cancer, an inherited colon cancer syndrome, increases your risk of endometrial cancer as well
  • Changes in the balance of estrogen/progesterone hormones in your body: if you have a disease or condition that only increases the amount of estrogen but not progesterone in your body, your chances of developing endometrial cancer increase
  • More years of menstruation: in other words, starting menstruation early or menopause late

(Source)

Detection

If your doctor is worried you could have endometrial cancer, they will likely begin by performing a physical pelvic examination on you. If they feel or see any abnormalities, they will likely perform a transvaginal ultrasound to rule out other potential endometrial conditions before making a beeline for cancer. They may also perform a hysteroscopy, in which a lighted tube is inserted into the uterus through the vagina for further examination, and a biopsy may be performed for further analysis7https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/diagnosis-treatment/drc-20352466.

Diagnosis

If a tumor is found, doctors will commonly use imaging tests such as CT and PET scans in addition to performing a biopsy, in order to stage endometrial cancer8https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/diagnosis-treatment/drc-20352466. These tests, however, have been shown to be less effective than MRIs in determining the extent of endometrial tumors9https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769723/. Staging cancers is useful for doctors because it helps them understand the extent of a given case, as well as formulate the best treatment plan possible.

Endometrial cancer is typically staged on a numerical scale, ranging from Roman numerals I through IV:

  • Stage I endometrial cancer is confined to the uterus.
  • Stage II endometrial cancer is found in both the uterus and cervix.
  • Stage III endometrial cancer has spread past the uterus and perhaps even the pelvic lymph nodes, but not the bladder or rectum.
  • Stage IV endometrial cancer has spread past the pelvic region and to distant body parts, such as the bladder, rectum, and beyond.

(Source)

Treatment

The best treatment for endometrial cancer depends on the nature of the disease and how far it has spread. Treatment options may include: radiation, hormone therapy, immunotherapy, surgery, targeted therapy, and chemotherapy10https://www.cancer.org/cancer/endometrial-cancer/treating.html.

Please consult with a physician on treatment options as necessary.

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