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Endometrial Cancer

Endometrial cancer, or cancer of the lining of the uterus, is the most common gynecologic cancer. Most cases of endometrial cancer occur in women who have already gone through menopause. However, approximately one fourth of all cases occur in women who are premenopausal (are still having their periods). About three-quarters of women diagnosed with endometrial cancer are found in the early stage of the disease and cure rates are very high. Some of the risk factors for endometrial cancer include exposure to estrogens (either from one's own body or from taking estrogen medication without also taking a progesterone), obesity, diabetes, and high blood pressure.

Less common are cancers which start in the muscle or muscular wall of the uterus. These cancers are called uterine "sarcomas" and are treated somewhat differently than "endometrial" cancer. Diagnosis and staging are quite similar but treatment options and prognosis (whether the cancer is curable or able to be controlled) vary. This is because cancers from the uterine muscle behave differently than those which start in the uterine lining. The following inormation refers to the more common form of uterine cancer: endometrial cancer, arising from the lining of the uterus.

Diagnosis

Luckily, endometrial cancer usually has early warning signs, which make it easier to diagnose at more curable stages. Most women experience abnormal vaginal bleeding either after they have been through menopause or have bleeding that is different from that of their usual menstrual flow. A biopsy of the lining of the uterus is then done, usually in the doctor's office. Sometimes this cannot be done or the amount of tissue removed is not enough to make a diagnosis. At this point, a dilation & curettage (D&C) is done as an outpatient procedure in the operating room. An ultrasound test may also be ordered to try and see if the uterine lining is thicker than it should be, a condition known as "hyperplasia". The results of this biopsy will determine which treatment course is decided on. For example, simple hyperplasia is not concerning in regards to cancer unlike complex atypical hyperplasia, which is much more worrisome. If the biopsy shows cancer, then additional tests and surgery will also be ordered to help in choosing the best treatment for that stage of disease.

Treatment