What Is Endometrial Cancer?
Endometrial cancer forms in the tissue lining of the uterus. Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).
According to the National Cancer Institute (NCI), uterine cancer is the most common type of gynecologic cancer. In the United States, approximately 37,000 cases are diagnosed and about 6,000 women die from the disease each year.
Incidence of uterine cancer increases after menopause and approximately 75 percent of cases are diagnosed in postmenopausal patients. The average age at diagnosis is about 60 years. In the United States, endometrial cancer is more common in Caucasian women and uterine cancer is more common in African American women.¹
What Are the Risk Factors of Cancer?
The cause of uterine cancer is unknown. Chronic exposure to estrogen increases the risk for developing the disease and estrogen often affects tumor growth. The following factors increase estrogen exposure:
Endometrial hyperplasia is a condition that increases the risk for uterine cancer. About one-third of patients with hyperplasia develop endometrial cancer. Symptoms of endometrial hyperplasia include heavy or prolonged menstrual periods, bleeding between menstrual periods, and prolonged amenorrhea (e.g., absence of menstruation for longer than 90 days). Postmenopausal women with hyperplasia may experience vaginal bleeding or spotting.²
Types of Surgical Treatment for Endometrial Cancer
Normal surgical treatment for endometrial cancer involves a hysterectomy (surgical removal of the uterus) and can include the removal of the ovaries and fallopian tubes (bilateral salpingo-oophorectomy). Your doctor will determine the stage and grade of the cancer by examining the tissues that are removed during a hysterectomy. Most cases of endometrial cancer are diagnosed during the earliest stage and can be cured if the tumor is contained within the uterus. Your surgery will depend on how much of your reproductive system may be affected by endometrial cancer.
A total hysterectomy is the removal of the uterus and cervix. A total hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes and ovaries. This is the most common surgery done for endometrial cancer.
A radical hysterectomy is the removal of the uterus, cervix, surrounding tissue, upper vagina and usually the pelvic lymph nodes.³
Why Radiation Therapy?
Radiation therapy is used postoperatively to reduce the recurrence rate of endometrial cancer. Vaginal brachytherapy decreases the recurrence rate at the most frequent site of recurrence, which is the vagina (vaginal cuff). External radiation is added if pelvic lymph nodes are involved or at high risk of being involved. Radiation therapy may also be used as the primary therapy for endometrial cancer, particularly in women who cannot have surgery.³
1 National Cancer Institute (General Information About Endometrial Cancer), accessed on October 9, 2009.
2 Oncology Channel (Endometrial Cancer – Causes and Risk Factors), accessed on October 9, 2009.
3 National Cancer Institute (Endometrial Cancer Treatment), accessed on October 9, 2009.
GYN eBx Treatment
Early menarche, Hormone replacement therapy with exogenous estrogen, late menopause, presence of an estrogen-secreting tumor and Nulliparity or low parity
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