Endometrial Cancer

• February 18, 2022
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Endometrial Cancer is cancer of the uterine lining. Incidence is rising in urban women in India. The patient commonly presents with abnormal vaginal bleeding like heavy menstrual bleeding or postmenopausal bleeding and less commonly with abnormal vaginal discharge. These patients are usually obese, hypertensive, and/or diabetic but it can also develop in women with no co morbidities with some high-risk factors. Women with a history of polycystic ovarian disease (PCOD), postmenopausal patients on long-term estrogen therapy, patients with carcinoma breast on hormonal therapy are at risk of endometrial cancer. Endometrial cancer can occur in women with a family history of ovarian/ breast/ endometrial or colon cancer, as it is also inherited by genes in 5-10% of patients.

For early detection of endometrial cancer, women should not neglect the abnormal vaginal bleeding in the perimenopausal and postmenopausal age groups. Do not start any blind hormone therapy without D&C and biopsy report in case of abnormal bleeding in this age group. Annual ultrasonography after the age of 40 years in patients with a family history of endometrial, colon, and breast or ovarian cancer is helpful in screening so that patients can be diagnosed and treated at an early stage. Transabdominal /transvaginal ultrasound is the modality of choice to identify endometrial thickness. Endometrial thickness is 3mm in an asymptomatic postmenopausal lady who is suspicious of endometrial cancer and should undergo hysteroscopy and D&C to rule out carcinoma endometrium.

Surgery is the treatment of choice in endometrial cancer and is mandatory for surgical staging of uterine cancer. Postoperative management like observation/adjuvant radiotherapy and /or chemotherapy is decided according to the final histopathology report. After completion of treatment, all patient needs regular checkups once every three months for 2 years, once in every 6 months after 2 years till 5 years, and then annually for life long.

Endometrial cancer is good behaving cancer if treated in early-stage and worse when treated in late-stage, so should be diagnosed and treated early and should not be neglected in early stage.