Endometrial Cancer:An Overview

[ktmonline]

Endometrial Cancer is the most common gynecological cancer and fourth common cancer in women .Fortunately ,early symptoms and easy accurate diagnosis modalities make endometrial cancer 3rd common causes of gynecological death (the most common causes being ovarian and cervical cancer ).Also known as "estrogen-dependent Neoplasm" , it has strong relation between unopposed estrogen exposure. Factors like obesity chronic an ovulation, low parity and late menopause lead to increase exposure to unexposed estrogen and subsequently to increase risk of endometrial cancer.

Endometrial cancer occurs in both pre-menopausal (25%) and post menopausal women (75%).The average age of diagnosis is 60 yrs and most affected groups being 50-59 age. Most tumors are caught early therefore overall prognosis for disease is good and overall mortality rate are declining.

Causes And Risk Factors:

The most common risk factor being history of unopposed estrogen exposure, including obesity (>30 lbs overweight),nulliparity or low parity, chronic anovulation ,menopause after 50 yrs or a history of unopposed exogenous estrogenuse,Conversely,oral contraceptive pills may help prevent endometrial cancer in women who have taken them for at least 12 months.
Despite this known risk factors, there are no effective mechanism for endometrial carcinoma. Neither annual Pap smear nor endometrial biopsies have been shown cost-effective screening test.

Common Sign and symptoms:
The most common symptoms of endometrial cancer is "irregular bleeding”. There is a saying if there is irregular bleeding is women aged more than 50 always suspect endometrial cancer. In case of pre-menopausal women there may be prolonged heavy periods or inter-menstrual spotting.

Some other causes of irregular bleeding might be the following:
Endometrial atrophy
Exogenous estrogen (Hormonal replacement therapy)
Endometrial or cervical polyps
Endometrial hyperplasia
Other causes like cervical cancers, uterine sarcoma, and trauma.

Treatment Plans for endometrial cancer:
Treatment plans differs with the staging. Fortunately, because it causes abnormal bleeding most women are diagnosed early with 75% of lesions being at stage I at the dime of diagnosis. In general treatment plan includes surgical staging, total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) and post operative radiation treatment.
High dose progestins are the first line of treatment for advanced and recurrent disease. Single-agent nonhormonal chemotherapy may be used in advanced cases but has low efficacy.
Because most endometrial cancers are diagnosed early at stage I, the overall survival rate is 65%.

Follow up care and prevention of cancer re-occurance

Almost 70% of endometrial carcinoma may re-occur with in 2 yrs after treatment and 85% at the end of third year. So follow up should be every 3 months for 2 yrs and then twice a year for 3 yrs the annually.

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[cancer hospital florida]

Endometrial cancer occurs when cells of the endometrium undergo a transformation and begin to grow and multiply without the control mechanisms that normally limit their growth. As the cells grow and multiply, they form a mass called a tumor. Cancer is dangerous because it overwhelms healthy cells by taking their space and the oxygen and nutrients they need to survive and function.