| Our Programs |
Endometrial Cancer |
||
The uterus is a hollow organ, about the size and shape of a medium-sized pear. It has 2 main parts. The lower part, which extends into the vagina, is called the cervix. The upper part is the body of the uterus, also known as the corpus. The lining is called the endometrium. Endometrial cancer is a cancer that develops from the inner lining of the womb (uterus). Nearly all endometrial cancers are cancers of the glandular cells found in the lining of the uterus. Less common uterine cancers that do not come from glandular tissue of the endometrium are called uterine sarcomas and can involve the endometrium. The exact cause of endometrial cancer is not known. There are, however, certain risk factors that are linked to the disease. The ovaries (sex glands on either side of the uterus that produce eggs) normally make two types of female hormones – estrogen and progesterone. The balance between these two hormones changes each month during a woman’s menstrual cycle. This produces a woman’s monthly period and keeps the endometrium healthy. A shift in the balance of these two hormones toward more estrogen increases a woman’s risk of developing endometrial cancer. In fact, most risk factors are linked to the balance between estrogen and progesterone in the body. Early menstruation (before age 12); late Menopause (after age 50); history of not being able to get pregnant, or having never given birth; obesity; use of Tamoxifen; Estrogen Replacement Therapy; Unusual bleeding, spotting or discharge (bloody or white), pelvic pain and/or mass, pain during intercourse and weight loss should be reported to a doctor. These symptoms can be caused by cancer or other less serious conditions. Often they are not cancer, but only a doctor can tell for sure. Women should have regular pelvic exams, including a Pap test. These tests should begin about 3 years after women start having sex, but no later than 21 years of age. If cancer is suspected, women should see a doctor with special training in diseases of the female reproductive system, a gynecological oncologist. The gynecological oncologist will remove some tissues to look at under a microscope. The tissue is obtained by endometrial biopsy or by a D & C (dilation and curettage). • Biopsy: A sample of tissue is obtained through a very thin flexible tube placed into the uterus through the cervix. The tube is used to remove a small amount of the endometrium using suction. The suction takes a minute or less. This discomfort is something like menstrual cramps and can be helped by taking a drug such as ibuprofen one hour before the test. • Dilation and Curettage (D & C): If the biopsy sample doesn’t provide enough tissue, or the doctor can’t tell for sure whether the sample is cancerous or not, a D & C must be used. To so this, the cervix is dilated (opened) and a special instrument is used to scrape tissue from inside the uterus. The test takes about an hour, and you may need general anesthesia or medicine to make you drowsy. Most women have little discomfort after this procedure. The tissue that has been removed is looked at under a microscope to see if cancer cells are present. If cancer is found, the cells will be studied to learn about the exact features of the cancer. The lab will also assign a grade to the cancer. If most of the cells look normal, it is given a grade 1. If more than half of the cells look very different from normal cells, it is given a grade 3. Grade 2 tumors fall somewhere in between. The grade is important because women with a lower grade cancer are less likely to have advanced disease or to have the cancer come back after treatment. The tissue can be tested to see if it has progesterone receptors. Tumors that have these receptors tend to grow and spread more slowly, giving the patient a better outlook. An ultrasound allows the doctor to see an image of the uterus. Saltwater might be placed into the uterus before the test in order to make the image clearer. Staging is the process of finding out how widespread the cancer is and whether it has spread to other parts of the body. This is very important because the treatment and the outlook for your recovery depend on the stage of the cancer. The system used is called the FIGO system of staging. This is a surgical staging system, which means it is based on an examination of tissue removed during the operation. Stages are labeled in Roman numerals I trough IV (1-4). In general the lower the number the less the cancer has spread. If a doctor finds that cancer is present, the next step is surgery to remove the uterus. Further imaging tests are done to determine if the cancer has spread to other organs. • Cytoscopy |
||