Endometrial Cancer Treatment in Noida, Delhi, India

Overview
Endometrial cancer involves the uncontrolled growth of cells in the lining of the uterus, known as the endometrium. It is the most common form of uterine cancer, primarily affecting women in their post-menopausal years, though it can occur at any age.

Associated Anatomy
Endometrial cancer specifically affects the endometrium, the inner lining of the uterus, which plays a vital role in the female reproductive system.

Alternate Name for Endometrial Cancer

• Endometrial Carcinoma

Symptoms of Endometrial Cancer

Early detection is crucial for effective treatment. Common symptoms include:

• Abnormal Vaginal Bleeding: Unusual bleeding or discharge not related to menstruation, including post-menopausal bleeding.
• Pelvic Pain: Continuous or recurring discomfort or pain in the pelvic area.
• Painful Urination: Discomfort and pain during urination.
• Pelvic Mass: A detectable, painful mass in the pelvic area.
• Dyspareunia: Pain during sexual intercourse.
• Menstrual Irregularities: Changes in menstrual flow or duration.
• Abdominal Pain: Widespread discomfort or pain throughout the abdominal area.
• Uterine Enlargement: Swelling or enlargement of the uterus.
• Unexplained Weight Loss: Rapid weight loss occurring without any identifiable reason.

Causes of Endometrial Cancer

While the exact causes of endometrial cancer are not fully understood, several factors contribute to its development:

• Hormonal Imbalance: Fluctuating levels of sex hormones, particularly high levels of estrogen without corresponding levels of progesterone, can lead to abnormal cell growth in the endometrium.
• Metabolic Syndrome: Conditions like obesity, high blood pressure, and high blood sugar levels can increase the risk.
• Type 2 Diabetes: Often associated with obesity, this can elevate cancer risk.
• Early Menarche: Onset of menstruation before age 12 increases risk.
• Late Menopause: Delayed menopause extends exposure to estrogen, increasing cancer risk.
• Endometrial Hyperplasia: Overgrowth of the endometrium can lead to cancer.
• Family History: A history of ovarian cysts, breast, or ovarian cancer can increase the risk.

Stages of Endometrial Cancer

Endometrial cancer is classified into stages based on its spread, which influences treatment options and prognosis:

• Stage I: The cancer remains localized within the uterus.
• Stage II: The cancer has extended from the uterus to involve the cervix.
• Stage III: Cancer has extended to nearby areas such as the lymph nodes, ovaries, fallopian tubes, and vagina.
• Stage IV: Cancer has spread to the bladder, rectum, or distant organs like the lungs or liver.

Treatment Options for Endometrial Cancer

Treatment for endometrial cancer depends on the stage of the disease, the patient’s overall health, and other factors. Options include:

• Surgery: The main treatment consists of surgically removing the uterus through a procedure known as a hysterectomy.In some cases, additional surgeries may be performed to remove the ovaries, fallopian tubes, or affected lymph nodes.
• Radiation Therapy: Often used after surgery or in conjunction with chemotherapy to target residual cancer cells. It can also be an option for treating larger tumors that are not suitable for surgery.
• Chemotherapy: This involves the use of powerful drugs administered orally or intravenously to kill cancer cells, especially in advanced stages or to reduce tumor size before surgery.
• Hormone Therapy: High doses of progesterone can help slow the growth of cancer by counteracting the effects of estrogen.
• Immunotherapy: This treatment boosts the body’s immune system to fight cancer more effectively, particularly by blocking proteins that prevent immune cells from attacking cancer cells.

Risk Factors for Endometrial Cancer

Several factors can increase the risk of developing endometrial cancer:

• Obesity: Excess body weight leads to higher levels of estrogen, which can increase the risk.
• Diet: A diet high in animal fat can elevate cancer risk.
• Nulliparity: Women who have never been pregnant are at higher risk.
• Tamoxifen Use: This breast cancer treatment drug can increase the risk of endometrial cancer.
• Genetic Factors: Conditions like Lynch syndrome significantly raise cancer risk.
• Hormone Replacement Therapy (HRT): Estrogen-only HRT increases the risk of endometrial cancer.
• Family History: A family history of endometrial cancer can be a significant risk factor.
• Age: Age: The risk of developing the condition rises with age, especially following menopause.

Complications of Endometrial Cancer

Endometrial cancer can lead to several complications if not treated promptly:

• Anemia: Caused by heavy vaginal bleeding, leading to a decrease in red blood cells.
• Metastasis: The spread of cancer to other parts of the body, such as the ovaries, fallopian tubes, lungs, or liver, can occur in advanced stages.
• Organ Involvement: Cancer may spread to the bladder, rectum, and distant organs in the later stages.

Diagnosis of Endometrial Cancer

Accurate diagnosis is crucial for effective treatment. Common diagnostic methods include:

• Transvaginal Ultrasound: Imaging to detect abnormalities in the uterine lining.
• Endometrial Biopsy: A tissue sample is taken from the uterine lining to confirm the presence of cancer cells.
• PET Scan: A specialized imaging technique to detect the spread of cancer throughout the body.

Prevention of Endometrial Cancer

While endometrial cancer cannot always be prevented, certain strategies can reduce the risk:

Primary Prevention:

• Maintain a Healthy Weight: Avoiding obesity through diet and exercise can significantly lower the risk.
• Understand HRT Risks: Avoiding or carefully managing hormone replacement therapy can reduce risk.
• Treat Abnormal Bleeding Promptly: Early treatment of irregular vaginal bleeding can prevent the development of cancer.
• Genetic Testing: Women with a family history of Lynch syndrome should consider genetic testing and, in some cases, preventive surgery.

Secondary Prevention:

• Healthy Lifestyle: Regular exercise and a balanced diet help prevent recurrence.
• Weight Management: Maintaining a healthy weight is crucial in preventing recurrence.
• Awareness of HRT Risks: Understanding and avoiding unnecessary hormone therapy can prevent recurrence.

Epidemiology of Endometrial Cancer

• Global Incidence: Endometrial cancer is the second most common gynecological cancer worldwide.
• Age Distribution: Most cases occur in post-menopausal women, with a median age of diagnosis around 60 years. It is uncommon in women younger than 45.

Prognosis of Endometrial Cancer

• Survival Rates: Early-stage endometrial cancer has a favorable prognosis, with a five-year survival rate of around 95% for localized cases.
• Disease Progression: Without treatment, endometrial cancer can spread to other reproductive organs and distant sites like the lungs and liver, significantly worsening the prognosis.

Pathophysiology of Endometrial Cancer

Research continues to explore the underlying causes of endometrial cancer, focusing on genetic mutations and hormonal imbalances. Excess estrogen relative to progesterone can lead to the thickening of the endometrium, creating an environment conducive to cancer cell growth.