I’ve been told that I have endometrial cancer. What is it exactly?
Endometrial cancer or cancer of the womb, is when normal cells lining the womb change and form a cancer. It is the most common gynaecological malignancy, making up approximately 95% of all uterine cancers diagnosed. It accounts for 13% of all cancers in women and is most frequently found in women over the age of 50, following the menopause. In Ireland, about 300 women are diagnosed with womb cancer each year.
The survival rates for endometrial cancer are quite high and have steadily increased over the last 40 years. There is no known cause or routine screening test for this type of cancer, therefore recognition of early symptoms is vital. There are a number of risks which can increase your chances of developing endometrial cancer:
- Being overweight
- Hormone replacement therapy (HRT)
- Family history of faulty genes: hereditary nonpolyposis colorectal cancer (HNPCC)
- Never been pregnant and had children
- Polycystic ovaries
What are the symptoms of endometrial cancer ?
The main symptoms of endometrial cancer include:
- Bleeding following the menopause
- Bleeding between periods
- Heavier periods than normal
- Abnormal vaginal discharge
- Pain in your lower abdomen or back of legs
- Discomfort or pain during sex
How is endometrial cancer diagnosed?
How gynaecological cancer is diagnosed depends on what type of cancer is suspected. Pelvic exams, imaging tests, biopsies, colposcopy exam and possible diagnostic surgery are all methods of diagnosing gynaecological cancer. Once cancer is confirmed, the stage of the cancer is determined and a treatment plan is developed. Staging refers to how far the cancer has spread to nearby tissue or organs. Among each of the various types of gynaecological cancer, early detection is crucial. However, detection can be very difficult, especially in the early stages.
Tests such as the following may be used for diagnosis:
An ultrasound used to build up a picture of the tissues in your womb. During a transvaginal ultrasound a small metal ‘probe’, covered with a gel is inserted into the vagina. This generates the images in the scan. This test is not painful but may be a little uncomfortable.
A hysteroscope is a thin, flexible tube with a light at the end which is passed through the vagina and into the womb. This allows the doctor to look inside the womb and take tissue samples or a biopsy.
A small amount of tissue samples are taken from the womb during a hysteroscopy. Biopsies are sent to a laboratory and looked at under a microscope to detect if cancer cells are present.
D&C - Dilatation and curettage
During a D&C the cervix and entrance to the womb are gently opened. Samples of tissue from the inner lining of the womb are taken with an instrument shaped like a spoon called a curette. The samples are then sent to the laboratory to be examined.
What are the treatment options?
The options for treating endometrial cancer will depend on the characteristics of your cancer, such as the stage, your general health and your preferences. It could involve any one of the following treatments:
- Hormone therapy
Most women with endometrial cancer will be recommended a hysterectomy as the best form of treatment for this cancer. This involves the removal of the uterus. It may also be advised that the fallopian tubes and ovaries are removed in a procedure known as a salpingo-oophorectomy. Occasionally the lymph nodes will also be removed for testing. The aim of surgery is to remove the entire tumour. The extent of surgery carried out will depend on the type and size of the cancer and whether or not it has spread.