Endometrial cancer, also called uterus cancer, occurs when a tumor grows in the cells that form the lining (endometrium) of the uterus.
The most typical sign of endometrial cancer is abnormal vaginal bleeding. Other signs and symptoms may include, among others: unusual vaginal discharge, pelvic pain, painful urination, and weight loss.
To diagnose endometrial cancer, patients usually undergo a series of tests and procedures:
- A clinical and pelvic exam-inspecting the uterus and ovaries for any abnormalities.
- A pelvic ultrasound- the specialist checks the endometrium’s texture and thickness. Thus, detecting any irregularities in the uterine lining.
- Hysteroscopy-a specialist passes a hysteroscope through the vagina and cervix into the uterus. The hysteroscope is a slim, flexible device with a light and a camera. It allows seeing the inside of the uterus and the endometrium. Thus, examining them for any sign of disease. The specialist can use the scope to remove the abnormal tissue and, if needed, take a tissue sample (a biopsy) for further examination by a pathologist.
- Dilation and Curettage (D&C)–if the biopsy sample doesn’t provide enough tissue, or if the biopsy results are unclear, a doctor might need to perform this procedure. During the process, a specialist dilates the cervix and then uses a particular instrument to scrape tissue from the lining of the uterus.
- Blood tests- such as a complete blood count, and a tumor marker (CA-125).
Endometrial cancer can spread locally, regionally to nearby lymph nodes, and systemically to other organs. Common spreading might occur to the bladder, rectum, vagina, fallopian tubes, or ovaries. To learn whether cancer has spread, the doctor might recommend imaging tests. They may include CT, MRI, chest X-ray, or a PET CT scan. In some cases, the doctor might recommend other tests as well, to examine the bladder or the colon.
Most patients diagnosed with endometrial cancer will need to undergo surgery to remove the uterus. The operation to remove the uterus is called a hysterectomy. If necessary, the surgeon will also remove the cervix, ovaries, or fallopian tubes. Another type of surgical approach is called debulking. Debulking involves reducing the size of the tumor by removing as much cancer as possible. For some patients with advanced or metastatic endometrial cancer, there is also the option of clinical trials with newer drugs such as immunotherapy and target therapy.
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