Finding out You have Endometrial Cancer: Making Treatment Decisions
Endometrial cancer originates in the inner lining of the uterus. It accounts
for about 90 percent of uterine cancer. It's the most common type of gynecological
cancer-cancer of the female reproductive system. According to the National Cancer
Institute, approximately 37,000 cases are diagnosed in the United States each
year. Endometrial cancer becomes more common after women go through menopause.
The average age at which a woman is diagnosed with endometrial cancer is 60.
The uterus is where a fetus grows when you're pregnant. In most women, the
uterus is about three inches long. (It becomes larger as it grows when you're
pregnant.) The opening of the uterus is called the cervix.
Signs of endometrial cancer
Common signs of endometrial cancer include
Unusual bleeding or discharge from the vagina
Painful urination, or other difficulty urinating
Pain during sexual intercourse
Pain in your pelvic area
To determine whether you have endometrial cancer, your doctor typically removes
samples of tissue from the inner lining of the uterus. This is done during what's
called an "endometrial biopsy," in which a thin flexible tube is inserted
through the cervix and into the uterus. The tube gently scrapes a small amount
of tissue. A pathologist views the sample under a microscope.
Sometime, the doctor performs what's called a dilatation and curettage, or
D&C, to get a tissue sample. The doctor dilates the opening of the cervix
and then inserts a curette (a spoon-shaped instrument) into the uterus to remove
tissue.
Treatment
Treatment is based on whether the cancer has stayed in the lining of the uterus,
spread to the muscle layer of the uterus, spread to the outer layer of the uterus,
or spread to other parts of the body, including the cervix, bladder, bowel or
lymph nodes. It also depends on whether the cancer cells are affected by the
hormone progesterone.
Surgery
The most common treatment is removal of the tumor through surgery. In many
cases, the surgeon removes the uterus, cervix, fallopian tubes and ovaries.
Sometimes the surgeon is able to perform the surgery through the vagina. In
other cases, an incision in the abdomen is necessary.
If you have surgery to remove an endometrial tumor, you're likely to stay in
the hospital from a few days up to a week. Most people are able to get back
to their normal activities in 4 to 8 weeks. Don't try to speed your recovery
too quickly. Take the time you need to rest. If you're in a lot of pain, tell
your doctor.
If your cancer was in an early stage, it's possible that you won't need further
treatment after your surgery. Regular follow-up visits will be necessary though.
Radiation
If your cancer has spread, or if it's not possible to operate to remove the
tumor, radiation and/or chemotherapy may be necessary. Radiation uses high-energy
X-rays to destroy cancer cells and shrink tumors. For endometrial cancer, external
or internal radiation may be used. External radiation is an outpatient procedure
in which you receive radiation from a machine that's outside your body. With
internal radiation, pellets containing radioactive material are inserted into
the upper vagina.
Side effects of radiation treatment can include
Diarrhea
Dryness, irritation, burning and tightening in the skin of the vagina
Painful and frequent urination
Hair loss
Loss of appetite
Extreme fatigue
Hormone therapy
Some endometrial tumors contain receptors that use the hormone estrogen to
grow. Hormone therapy can block or balance out the effects of estrogen and slow
down tumor growth. Side effects of hormone therapy can include
Fluid retention
Increase in appetite
Weight gain
Chemotherapy
Chemotherapy drugs travel throughout your body to slow down the growth of tumors
and to destroy cancer cells that may have spread. It can be used in addition
to surgery or to treat cancer that has metastasized, or spread. Side effects
of chemotherapy can include
Extreme fatigue
Fever
Hair loss
Infection
Low blood cell count
Nausea
If you are getting chemotherapy, it's extremely important to talk with your
doctor about your side effects and any other health issues or problems you're
having. Make sure you understand the answers to your questions, and if anything's
on your mind, talk to your healthcare team about it.
Source:
The American Cancer Society; The National Cancer Institute
www.mercyweb.org
