Women in today’s world suffer from a number of gynecological cancers. One of the most important and common type of gynecological cancer is endometrial cancer.
Therefore, in today’s blog we will be discussing about endometrial cancer. Endometrial cancer develops from the lining of the uterus known as the endometrium. It is the most common gynecologic cancer and the fourth most common cancer amongst women. It usually affects women after menopause, commonly in the age group of 50–65 years.
Around, 1 in every 50 women is likely to get affected with the endometrial cancer. The most common symptom associated with endometrial cancer is abnormal uterine bleeding (AUB).
Based on the various degrees of anaplasia, cellular differentiation and glandular architecture; it is mainly of 3 grades:
• G1
• G2
• G3
PATHOGENETIC TYPES OF ENDOMETRIAL CANCER:
There are two distinct pathogenetic types of endometrial cancer:
• Type I: seen typically in younger perimenopausal women and is most common (80%). Occurs in the background of estrogen stimulation and endometrial hyperplasia.
• Type II: occurs in postmenopausal women who have atrophic endometrium seen in around 20% of the cases. These tumors are poorly differentiated and have worse prognosis.
ETIOLOGY:
• Nulliparous women
• Women suffering from diabetes or hypertension.
• Women undergoing hormonal replacement therapy without any guidance or under any supervision.
• Women who had taken tamoxifen for breast cancer.
• Women who encountered early menarche or late menopause.
Women suffering from endometrial cancer may present with the following symptoms:
• Bleeding abnormalities such as menorrhagia or post-menopausal bleeding.
• Pelvic pain
• Low extremity edema
• Postcoital bleeding
• Intermenstrual bleeding
INVESTIGATIONS:
Various diagnostic tests that should be performed include:
• Cytological examination
• Endometrial studies
• Transvaginal ultrasound
• Hysteroscopy
• Investigation for evaluating the spread of cancer.
TREATMENT:
The various treatment plans for the management of endometrial cancer depends upon the stage of cancer:
• Stage 0: Total abdominal hysterectomy with salpingo-oophorectomy.
• Stage I (grade 1,2, or 3): Extrafascial TAH and bilateral salpingo-oophorectomy with lymph node sampling.
• Stage II: radiation therapy followed by surgery.
• Stage III: Total abdominal hysterectomy with salpingo-oophorectomy with selective lymphadenectomy.
• Stage IV: Palliative therapy comprising of a combination of surgery,radiotherapy, hormone therapy or chemotherapy is required.
Jaypee Brothers Medical Publishers organises a course regarding MRCOG exam. For further information regarding the course, please visit our website www.crackingmrcog.com
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