Endometrial Cancer: Diagnosis and Treatment

Endometrial Cancer: Diagnosis and Treatment
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  • 0:02 Endometrial Cancer
  • 0:54 Symptoms
  • 2:29 Diagnosis
  • 4:08 Treatment
  • 7:07 Lesson Summary
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Lesson Transcript
Instructor: Heather Adewale

Heather has taught reproductive biology and has researched neuro, repro and endocrinology. She has a PhD in Zoology/Biology.

Ever wonder how a doctor diagnoses cancer? Learn about some of the symptoms, tests and treatments a doctor considers when looking for cancer of the uterus, or endometrial cancer, in this lesson.

Endometrial Cancer

If you've been following our other lesson on endometrial cancer, then you're all caught up as to what endometrial cancer is. But for those of you who may have missed our other lesson or like to do things out of order, endometrial cancer is a cancer that occurs in the endometrial lining of the uterus. See, the uterus has three layers: outer, middle and inner.

The endometrium is the inner lining, or layer, of the uterine wall, the one that grows and sheds during menstruation. This one here:

The endometrium sheds during menstruation.
diagram of the endometrium

And, in case you haven't put two and two together, this is a cancer of the female reproductive tract, meaning that you guys don't have to worry about getting it, although you do have some male-specific cancers of your own to be aware of, but those are covered in other lessons.

Symptoms

So, Step 1: What is endometrial cancer? Check!

Step 2: How is it diagnosed? Well, just like most diseases, endometrial cancer comes with a set of symptoms that doctors look out for. The first one is any type of abnormal bleeding from the vaginal area. What do I mean by abnormal? Well, any bleeding that a patient doesn't normally see during their menstrual period. This could be:

  • Bleeding in between menstrual periods or excessive bleeding during menstruation.
  • Watery, blood-tinted fluid or discharge in between menstrual periods.
  • Bleeding after menopause.

Bleeding is usually the first symptom of endometrial cancer and occurs in the early stages of the disease. The good thing is that the early stages of endometrial cancer are slow-growing and, if caught early, the chances of a cure are good. However, if untreated, other symptoms can occur. Usually the bleeding is painless, but sometimes it can be associated with other symptoms, including:

  • Pelvic pain or cramping (That's the area where the uterus is located.)
  • Pain during intercourse
  • Pressure in the abdominal area
  • Enlarged lymph nodes (Lymph nodes are part of the body's immune system; they help fight off diseases, kind of like little tiny quarantine centers for infected cells and invading organisms.)

Diagnosis

But how does a doctor confirm that these symptoms are indeed signs of endometrial cancer? Many problems with the female reproductive tract can also include abnormal bleeding or pelvic pain.

To start, doctors can perform a routine pelvic exam just like they do during a woman's annual physical. This type of exam allows doctors to inspect the outer vaginal area and feel the inner cervix and uterus for any changes in size or shape. The next step to confirm endometrial cancer is inserting a small scope like a miniature camera or an ultrasound device into the vaginal canal to get a visual picture of the uterus. This will help the doctor view any abnormalities that may be present.

However, the best test is an endometrial biopsy. A biopsy is the removal of a small piece of tissue. Think of it like this: the word 'bio' means 'life,' and 'opsy' is kind of like the word 'optical.' And what do we think of when we hear 'optical?' Well, probably glasses or optics, all of which are associated with looking at things. So a biopsy is looking at a small piece of life, or in this case, live tissue from the human body.

In an endometrial biopsy, a piece of endometrial tissue is removed from the uterus and screened for cancer. This allows the doctor to examine the tissue directly to see if any cancer cells are present. This procedure identifies almost 80-90% of endometrial cancers.

Treatment

And that brings us to Step 3: Treatment options. Once a woman is diagnosed with endometrial cancer, the first step is to determine what stage the cancer is at. Like most other cancers, the stages of endometrial cancer are associated with how far along the disease has progressed.

In the early stages (Stages 1 and 2), the cancer is confined to the uterus and/or the cervix, these two areas here:

Early stages of cancer are usually confined to the uterus and/or cervix.
diagram of uterus and cervix

These are the stages where the chances of recovery are highest because the cancer is localized to one area. But once the cancer spreads out of the reproductive tract (Stages 3 and 4) to other parts of the body, its gets harder to treat. Treatment is similar to other cancers, and the three main pathways are:

  1. Surgery
  2. Radiation or chemotherapy
  3. Hormone therapy

These can be used together or separately. The earlier stages of endometrial cancer are better candidates for surgery or localized radiation therapy because the cancer is localized to the reproductive tract. However, radiation is not as effective by itself and is more effective when combined with surgery.

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