Endometrial Cancer Treatment in Delhi NCR, India

Overview
Endometrial cancer is characterized by the uncontrolled growth of cells in the lining of the uterus, known as the endometrium. It is the most common type of uterine cancer and primarily affects women after menopause, although it can develop at any age.

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

Alternate Name for Endometrial Cancer

• Endometrial Carcinoma

Symptoms of Endometrial Cancer
Early detection is key to effective treatment. Common symptoms include:

• Abnormal Vaginal Bleeding: Unusual bleeding or discharge not related to menstruation, particularly post-menopausal bleeding.
• Pelvic Pain: Persistent or recurring discomfort in the pelvic region.
• Painful Urination: Experiencing discomfort or pain while urinating.
• Pelvic Mass: A painful mass detectable in the pelvic area.
• Dyspareunia: Pain during sexual intercourse.
• Menstrual Irregularities: Changes in menstrual flow or duration.
• Abdominal Pain: Generalized discomfort or pain in the abdomen.
• 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 remain unclear, several factors are known to contribute to the development of endometrial cancer:

• Hormonal Imbalance: Fluctuations in sex hormones, particularly elevated estrogen levels without corresponding progesterone, can stimulate abnormal cell growth in the endometrium.
• Metabolic Syndrome: Conditions like central obesity, hypertension, high blood sugar, and abnormal cholesterol levels increase risk.
• Type 2 Diabetes: Often linked to obesity, this condition raises cancer risk.
• Early Menarche: The start of menstruation before the age of 12.
• Late Menopause: Delayed onset of menopause prolongs exposure to estrogen.
• 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, which help determine treatment options and prognosis:

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

Treatment Options for Endometrial Cancer
Treatment is determined by the stage of the cancer, the patient’s overall health, and other individual factors:

• Surgery: The primary treatment typically involves the removal of the uterus through a hysterectomy. Additional surgeries may be performed to remove the ovaries, fallopian tubes, or affected lymph nodes if cancer has spread.
• Radiation Therapy: Often used post-surgery or alongside chemotherapy to target residual cancer cells. It can also treat larger tumors that are unsuitable for surgery.
• Chemotherapy: Utilizes powerful drugs administered orally or intravenously to kill cancer cells, particularly in advanced stages or to shrink tumors before surgery.
• Hormone Therapy: High doses of progesterone may slow the growth of cancer by counteracting the effects of estrogen.
• Immunotherapy: Boosts the body’s immune response to cancer, particularly by inhibiting proteins that prevent immune cells from attacking cancer cells.

Risk Factors for Endometrial Cancer
Several factors increase the likelihood of developing endometrial cancer:

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

Complications of Endometrial Cancer
If untreated, endometrial cancer can lead to several complications:

• Anemia: Heavy vaginal bleeding can cause 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, occurs in advanced stages.
• Organ Involvement: Cancer may spread to the bladder, rectum, and distant organs in 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 used to detect the spread of cancer throughout the body.

Prevention of Endometrial Cancer
While it may not be possible to prevent endometrial cancer entirely, 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: Avoid or carefully manage hormone replacement therapy to reduce risk.
  • Treat Abnormal Bleeding Promptly: Early treatment of irregular vaginal bleeding can prevent cancer development.
  • 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.
• 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.