Endometrial cancer, also known as uterine cancer, is a type of cancer that starts inside the uterus, known as endometrial cancer. It is the most common type of cancer that affects the female reproductive system.

What are the types of endometrial cancer?

The two main types of endometrial cancer are:

Endometrioid carcinoma: This is the most common type of endometrial cancer, accounting for about 75% to 80% of all cases. It grows from the cells that make up the inside of the uterus and is often diagnosed at an early stage.

Non-endometrioid carcinoma: This type of endometrial cancer is less common, accounting for about 20% to 25% of cases. It includes several subtypes, including serous carcinoma, transmucosal carcinoma and carcinosarcoma. Non-endometrioid carcinomas tend to be more aggressive and may be more difficult to treat than endometrioid carcinomas. There are also several other rare types of endometrial cancer, such as mucinous adenocarcinoma and squamous cell carcinoma, but these make up a very small proportion of cases. The type of endometrial cancer a person has can affect treatment options and outlook, so it is important to have an accurate diagnosis.

What are the risk factors for developing endometrial cancer?

There are several factors that can increase a person's risk of developing endometrial cancer. These include:

• Age: Endometrial cancer is most commonly diagnosed in postmenopausal women, usually between 50 and 70 years old.
• Hormonal imbalances: Women who have higher levels of oestrogen than progesterone are at greater risk of developing endometrial cancer. This can happen due to factors such as obesity, diabetes or certain hormonal treatments.
• Obesity: Women who are overweight or obese are at higher risk of developing endometrial cancer, probably due to increased production of oestrogen in fatty tissues.
• Personal history of cancer: Women who have had breast or ovarian cancer may have an increased risk of developing endometrial cancer.
• Family history: Women with a family history of endometrial, ovarian or colorectal cancer may be at greater risk of developing endometrial cancer themselves.
• Certain medical conditions: Women with a history of certain medical conditions, such as polycystic ovary syndrome (PCOS) or Lynch syndrome, may be at increased risk of developing endometrial cancer.
• Tamoxifen use: Tamoxifen, a drug used to treat breast cancer, has been associated with an increased risk of developing endometrial cancer.

It is important to note that the presence of one or more risk factors does not necessarily mean that a person will develop endometrial cancer and some women who develop endometrial cancer have no known risk factors. If you are concerned about your risk of endometrial cancer, talk to your doctor about screening and prevention strategies.

What are the most common symptoms caused by endometrial cancer?

The most common symptom of endometrial cancer is abnormal vaginal bleeding, which may include:

• Bleeding between periods
• Heavier or longer periods than usual
• Bleeding after menopause

Other symptoms that may occur include:

• Pelvic pain or discomfort
• Pain during sex
• Involuntary weight loss
• Abnormal vaginal discharge
• Fatigue

It is important to note that these symptoms can be caused by a variety of conditions and having one or more of these symptoms does not necessarily mean that a person has endometrial cancer.

How is endometrial cancer diagnosed?

Endometrial cancer can be diagnosed through a variety of tests and procedures, including:

Transvaginal ultrasound: This type of ultrasound involves inserting a small head into the vagina to create images of the uterus and ovaries, which may give rise to the suspicion of endometrial cancer.

Endometrial biopsy at the level of the clinic: It involves taking a small sample of tissue from the inside of the uterus to be examined under a microscope for signs of cancer.

Hysteroscopy: This involves inserting a thin camera through the vagina and cervix to view the inside of the uterus.

Αcuring (D&C): This involves dilating the cervix and using a special instrument to scrape tissue from inside the uterus for examination. If endometrial cancer is diagnosed, further tests may be needed to determine the stage and extent of the cancer, including imaging tests such as CT or MRI.

How is endometrial cancer treated?

Treatment of endometrial cancer depends on the stage and severity of the cancer, as well as other factors such as the age and general health of the person. Treatment options may include:

→ Surgery: The most common treatment for endometrial cancer is surgery to remove the uterus and cervix, known as a hysterectomy. In some cases, the ovaries and fallopian tubes may also be removed. Lymph nodes in the pelvis and abdomen may also be removed and examined for signs of cancer.

→ Radiotherapy: It involves using high-energy radiation to kill cancer cells. It can be used alone or in combination with surgery and/or chemotherapy.

→ Chemotherapy: It involves the use of drugs to kill cancer cells. It may be used alone or in combination with surgery and/or radiotherapy.

→ Hormonotherapy: It involves the use of drugs that affect hormone levels in the body to slow or stop the growth of cancer cells. It may be used in women with advanced or recurrent endometrial cancer. The choice of treatment depends on the stage and extent of the cancer, as well as other factors such as the age and general health of the person. 

What does surgery for endometrial cancer involve?

Surgery for endometrial cancer usually involves the removal of the uterus, cervix and appendages (fallopian tubes - ovaries). The operation performed depends on the stage of the cancer and whether it has spread beyond the uterus. In addition to hysterectomy, other surgical procedures may be performed to treat endometrial cancer. These include lymphadenectomy for the removal of lymph nodes and additionalablation (fatty tissue covering the abdominal organs). Endometrial cancer surgery can be performed using minimally invasive techniques, such as laparoscopy or robotic surgery, which involve smaller incisions and faster recovery time compared to traditional open surgery.