Endometrial Cancer

 

 

OVERVIEW

Endometrial cancer is a type of gynecologic cancer. It is the most common cancer of the female reproductive organs in the United States. The American Cancer Society estimates that in 2007, 39,000 new cases of endometrial cancer will be diagnosed in the United States. Most endometrial cancers cannot be prevented but when detected and treated early, the five-year survival rate for women with localized endometrial cancer is 96 percent. The five-year survival rate at all stages is 84 percent.

Endometrial cancer develops from the endometrium, the inner lining of the uterus. Almost all endometrial cancers are adenocarcinomas, cancer of the glandular cells. Other rare types of endometrial cancer include stromal sarcomas, malignant mixed mesodermal sarcomas, and leiomyosarcomas.

The Cancer Center at Hackensack University Medical Center features many unique and innovative services to treat endometrial cancer. So if you are diagnosed with endometrial cancer, you can feel comfortable with the following:

  • a full-time board-certified gynecologic oncologist on site, who leads the Division of Gynecologic Oncology and is highly experienced in all medical and surgical treatments for endometrial cancer
  • board-certified medical oncologist and radiation oncologists, if your treatment requires chemotherapy or radiation therapy
  • minimally invasive laparoscopic surgical procedures
  • a twice-monthly gynecologic oncology clinic
  • sophisticated diagnostic testing and imaging studies
  • clinical trials to investigate new medications and treatment methods
  • monthly meetings of the Gynecologic Tumor Board, where cases are discussed and treatment plans are developed by a multidisciplinary team of cancer specialists
  • a full range of support services

 

RISK FACTORS

Most cases of endometrial cancer occur in women older than age 40. Risk factors for endometrial cancer include:

  • increased exposure to estrogen caused by beginning monthly periods before age 12
  • experiencing menopause after age 50
  • increased bleeding during the time just before menopause
  • a long total menstruation span
  • a history of infertility or never having given birth
  • obesity
  • the use of tamoxifen (a drug used to treat women with breast cancer)
  • a high-fat diet
  • diabetes
  • a history of breast or ovarian cancer
  • a family history of hereditary non-polyposis colon cancer
  • prior pelvic radiation
  • increased age (the average age at diagnosis is 60)
  • certain estrogen-producing tumors
  • polycystic ovaries

 

SYMPTOMS

Symptoms for endometrial cancer include unusual bleeding, spotting, or other discharge; pelvic pain and/or a pelvic mass; and weight loss, which usually occurs later in the disease.

 

TREATMENT SERVICES

The four methods most commonly used to treat endometrial cancer are surgery, radiation therapy, chemotherapy, and hormonal therapy. A combination of methods may be used.

Surgery

Your doctor will decide which is the best surgical method to use to treat your cancer depending on the stage, type, and grade of the cancer, any spread of the cancer, your overall health, your age, and other factors:

  • simple hysterectomy (removal of the body of the uterus and cervix; may be done abdominally or vaginally
  • radical hysterectomy (removal of the body of the uterus, the cervix, the parametria and uterosacral ligaments next to the uterus, and the upper part of the vagina; may be done abdominally or vaginally)
  • bilateral salpingo-oophorectomy (removal of both fallopian tubes and both ovaries in addition to a hysterectomy)
  • pelvic and para-aortic lymph node dissection (in addition to a hysterectomy, removal of some lymph nodes near the pelvis and the area next to the aorta to determine whether they contain cancer cells)
  • laparoscopic lymph node sampling with a hysterectomy

Radiation Therapy

Several different types of radiation therapy may be used to treat endometrial cancer:

  • external beam therapy (beams are directed to the cancer site from outside the body)
  • brachytherapy (pellets of radioactive materials are placed inside a special applicator that is placed into the vagina)
  • radioactive solution (introduced into the abdomen and pelvic cavities after surgery is complete)

External beam therapy and brachytherapy may be combined.

Chemotherapy

A combination of chemotherapeutic drugs may be given in conjunction with surgery and/or radiation therapy.

Hormonal Therapy

The hormone progesterone taken in pill form may be prescribed to slow the growth of endometrial cancer cells. Tamoxifen (an anti-estrogen) may be used to treat advanced or recurrent endometrial cancer.

The Hereditary Cancer Risk Assessment Program

If you have a personal or family history of colorectal, ovarian, or endometrial cancer, you may be at increased risk of developing breast cancer. Our Hereditary Cancer Risk Assessment Program offers genetic counseling and testing services to determine each patient's risk. A medical management plan is developed for each patient and may include various methods to reduce risk factors, including medication, prophylactic surgery, diet, exercise, smoking cessation, and other recommendations for a healthy lifestyle. Various issues are discussed, such as privacy, insurance, psychosocial, and family issues. We keep up to date on patients through our high-risk registry. For more information or to make an appointment, call (201) 996-5264.