What is Uterine (Endometrial) Cancer?
Uterine cancer is the most common gynecological cancer in the world and in Turkey. It is the fourth most common cancer among women. Uterine (uterus, endometrium) cancer arises from the cells of the layer lining the inside of the uterus. It is not known exactly what triggers endometrial cancer. But; Age, obesity, hormonal disorders and genetic predisposition are risk factors. There is no specific procedure for endometrial cancer screening.
What are the Risk Factors for Uterine (Endometrium) Cancer?
Obesity: The source of estrogen is not only the ovaries. Fat tissue also secretes estrogen. Due to the increase in body fat in obesity, estrogen levels also increase, thus putting women in the risk group for endometrial cancer. The risk of endometrial cancer increases 3 times in obese women. However, cancer can also be seen in thin women.
Long period of menstruation: If menstruation begins at an early age (before the age of 12) or menopause occurs at a late age, the risk of endometrial cancer increases. The more periods a woman has, the more estrogen the endometrium is exposed to.
Having never been pregnant: Pregnancy reduces the risk of endometrial cancer. During pregnancy, more estrogen is released, but more progesterone is also secreted. Increased progesterone production can compensate for the effect of increased estrogen.
Ovulation irregularity: Ovulation means the monthly release of the egg from the ovary. This cycle is regulated by estrogen. Irregular ovulation or lack of ovulation increases exposure to estrogen. Causes of ovulation irregularities include; obesity and polycystic ovary syndrome (PCOS). In the treatment of obesity and PCOS, monthly ovulation and menstruation are regulated again. Thus, efforts are being made to reduce the risk of endometrial cancer.
Fat diet: This type of diet habit may increase the risk of endometrial cancer because it leads to obesity, or fatty foods may directly affect estrogen metabolism and lead to the same result.
Diabetes: Endometrial cancer is more common in women with diabetes, because obesity and diabetes often occur together. However, cancer risk is also high in thin women with diabetes.
Estrogen replacement therapy: Estrogen stimulates the growth of the endometrium, and giving only estrogen therapy after menopause increases the risk of cancer. Combined administration of estrogen with progesterone hormone causes thinning and shedding of the endometrium and a decrease in the risk of endometrial cancer.
Ovarian tumors: Some tumors of the ovary are a source of estrogen and increase estrogen levels.
Advanced age. : Most endometrial cancers occur after the age of 55.
Having a history of breast or ovarian cancer.
Using tamoxifen: One in every 500 women with breast cancer who receive tamoxifen treatment has endometrial cancer. Tamoxifen has an estrogen-like effect on the endometrium and causes thickening of the endometrium. For this reason, everyone who uses tamoxifen should have an annual periodic pelvic examination, as it increases the risk of endometrial cancer.
Hereditary Nonpolyposis Colorectal Cancer (HNPCC): In this hereditary disease, there is a defect in an important DNA repair gene. People with this hereditary disease have an increased risk of colon cancer and endometrial cancer. Having these risk factors does not mean that you will get endometrial cancer. However, it should not be forgotten that one is at risk due to these factors and should be sensitive to possible signs and symptoms.
Symptoms
Many women have complaints in the early stages of the disease. Postmenopausal bleeding, defined as vaginal bleeding in the postmenopausal period, is the most common symptom of uterine cancer. Postmenopausal bleeding can occur in any amount. Bleeding can occur at any time during the natural menopause process. Regardless of the time or amount of occurrence, postmenopausal bleeding should never be considered a normal occurrence. During the premenopausal period, irregular or heavy menstrual bleeding may be a symptom of endometrial cancer, although it is often explained by non-cancerous causes. Less common symptoms of endometrial cancer are pelvic pain, bloating and cramping. As a result, uterine cancer is detected at an early stage in many cases and offers definitive treatment.
What are the Diagnostic Methods?
First of all, the patient's history is taken and a physical/pelvic examination is performed. structure and transvaginal USG is performed. Here, endometrium thickness and structure are evaluated. Biopsy must be performed later for definitive diagnosis; It can be performed in the form of endometrial biopsy, under office conditions, without requiring anesthesia.
If sufficient tissue cannot be obtained, dilation and curettage are applied. However, operating room conditions may be required for this intervention. In this method; A sample is taken by scraping the entire endometrial layer and sent for pathological examination.
The definitive diagnosis is made after examining these tissues under a microscope. The specialist to whom patients diagnosed with cancer are referred is a gynecological oncologist. Later, if necessary, further tests may be requested to evaluate the spread of the disease.
What are the Treatment Options?
Endometrial cancer treatment options include surgery, chemotherapy, radiotherapy, hormonal therapy. treatments or combinations thereof. The exact treatment recommendation depends on many factors. The most important of these recommendations are the stage of the cancer, the woman's health, and whether she wants children in the future.
Surgical treatment
Surgery is the most common treatment for endometrial cancer. It is a form of treatment. Surgery both eliminates uterine cancer and determines the stage. Patients can undergo surgery using the laparoscopic (closed) method.
Finally, uterine cancer can be diagnosed early and early diagnosis saves lives.
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