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Cancer

Endometrial Cancer

Cancer of the endometrium, a common kind of cancer in women, is a disease in which cancer (malignant) cells are found in the lining of the uterus (endometrium). The uterus is the hollow, pear-shaped organ where a baby grows during a woman’s pregnancy. Cancer of the endometrium is different from uterine cancer (called sarcoma of the uterus). In uterine cancer, the cancer cells grow in the muscles of the uterus, whereas endometrial cancer occurs in the uterine lining. You should see your health care provider if you have any of the following problems: bleeding or discharge not related to menstruation, difficult or painful urination, pain during intercourse, or pain in the pelvic areas.

Risk factors for endometrial cancer

One risk factor for endometrial cancer is an increase in the number of normal cells lining the uterus (endometrial hyperplasia). Any condition that elevates hormone levels and increases the number of endometrial cells may put women at increased risk. Estrogen replacement therapy, some ovarian tumors, obesity, having had few or no children and late menopause are all associated with elevated hormone levels.

Diagnosis

Your health care provider may use several tests to see if you have cancer, usually beginning with an internal (pelvic) examination. During the examination, your clinician will feel for any lumps or changes in the shape of the uterus. A Pap test will be performed using a piece of cotton, a brush, or a small wooden stick to gently scrape the outside of the cervix (opening of the uterus) and vagina to pick up cells for microscopic study.

Because cancer of the endometrium begins inside the uterus, it does not usually show up on a Pap test. For this reason, your clinician may also do a dilation and curettage (D&C) or similar test to remove pieces of the lining of the uterus. During a D&C, the opening of the cervix is stretched with a spoon-shaped instrument and the walls of the uterus are gently scraped to remove any growths. This tissue is then checked for cancer cells.

Common treatment for endometrial cancer

Surgery is the most common treatment for endometrial cancer. One of the following types of operations may be used:

Total abdominal hysterectomy and bilateral salpingo-oophorectomy, both of which involve removing the uterus, fallopian tubes and ovaries through a cut in the abdomen. Lymph nodes in the pelvis may also be removed (lymph node dissection). The lymph nodes are small, bean-shaped structures found throughout the body that produce and store infection-fighting cells, but may also contain cancer cells.

Radical hysterectomy involves removing the cervix, uterus, fallopian tubes, ovaries, and part of the vagina. Lymph nodes in the area may also be taken out.