Endometrial Cancer

Endometrial cancer is the fourth most common cancer among women in Singapore, but it is often detected early and has a good rate of successful treatment.

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Endometrial cancer usually begins in the endometrium, the lining of the womb. Most cases of endometrial cancer develop in postmenopausal women, whose periods have stopped. However, it can also affect women younger than 40. Because the disease frequently produces vaginal bleeding between menstrual periods or after menopause, these visible symptoms are often discovered early. If the cancer is confined to the uterus, removing the womb surgically often eliminates all of the cancer.

Endometrial Cancer Causes 

The exact cause is not entirely known. However, it is believed that high oestrogen levels play a role in the development of endometrial cancer.

Endometrial Cancer Symptoms 

Signs and symptoms of endometrial cancer may include:
Prolonged periods or bleeding between periods
More frequent vaginal bleeding or spotting during the years leading up to the menopause (perimenopause)
Any bleeding after menopause
A pink, watery or white discharge from your vagina
Pelvic pain, especially late in the disease
Pain during intercourse
Weight loss

Endometrial Cancer Risk Factors 

Factors that increase levels of oestrogen in the body include:
Late menopause (cessation of periods)
Irregular ovulation or failure to ovulate, which can increase your lifetime exposure to oestrogen. Ovulation irregularities are common in women with a condition known as polycystic ovary syndrome, or PCOS
Obesity. Fat tissue can change some hormones into oestrogen and being obese can increase levels of oestrogen in the body, increasing the risk of endometrial cancer
Oestrogen-only replacement therapy (ERT), which stimulates the lining of the womb and increases the risk of endometrial cancer
Ovarian tumours producing oestrogen
Personal history of breast cancer or ovarian cancer
Tamoxifen treatment for breast cancer
Race: Caucasian women are more likely to develop endometrial cancer
Hereditary nonpolyposis colorectal cancer (HNPCC) — women with HNPCC also have a significantly higher risk of endometrial cancer, as well as colon and other cancers

Pregnancy seems to offer protection against endometrial cancer.

Endometrial Cancer Tests and Diagnosis 

Tests include:
Endometrial biopsy to get a sample of cells from inside the womb for laboratory analysis
Dilation and curettage (D and C), a procedure in which tissue is scraped from the lining of the womb and examined for cancer cells
Transvaginal ultrasound. This test helps to look for abnormalities in the uterine lining
Imaging tests including chest X-ray and a computerised tomography (CT) scan

Endometrial Cancer Treatment 

Surgery is the most common treatment for endometrial cancer. This is either the surgical removal of the uterus alone (hysterectomy) or, more likely, the surgical removal of the uterus, fallopian tubes and ovaries (hysterectomy with bilateral salpingo-oophorectomy)
Radiation: radiation therapy involves the use of high-dose X-rays to kill cancer cells
Hormone therapy in the form of high-dose progestins may stop the growth of the tumour
Chemotherapy is the use of drugs to kill cancer cells

The usual treatment for endometrial cancer is the surgical removal of the uterus, fallopian tubes and ovaries, and includes draining lymphatics. This surgery also allows the doctors to assess the extent of the spread of the cancer (i.e. the stage of the cancer). Following the surgery, additional or adjuvant treatment such as radiotherapy, hormonal treatment or chemotherapy may or may not be required, depending on the stage, grade and subtype of the cancer.   

Endometrial Cancer Prevention 

Some factors can lower the risk of endometrial cancer. These include:
Maintaining a healthy weight. Obesity is one of the highest risk factors for the development of endometrial cancer in women. You can help prevent endometrial cancer by maintaining a healthy weight
Good control of diabetes can also reduce the risk of endometrial cancer
Taking hormone therapy (HT) with progestin. Synthetic progestin, a form of the hormone progesterone with oestrogen, lowers the risk of endometrial cancer
Using birth control pills. Use of oral contraceptives has shown to reduce endometrial cancer


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Endometrial Cancer

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