| Signs
and Symptoms
Endometrial cancers develop in the uterus, though most
develop in the endometrial glands that line the inner
wall of the uterine cavity rather than in the uterus'
muscular wall.
Although endometrial cancer usually occurs after menopause,
it also may occur around the time that menopause begins.
Abnormal vaginal bleeding is the most common symptom of
uterine cancer. Bleeding may start as a watery, blood-streaked
flow that gradually contains more blood. Women should
not assume that abnormal vaginal bleeding is part of menopause.
You should see your doctor if you have any of the following
symptoms:
•
Unusual vaginal bleeding or discharge
•
Difficult or painful urination
•
Pain during intercourse
•
Pain in the pelvic area
Diagnosis
If you have symptoms that suggest endometrial cancer,
your doctor may check general signs of your health and
order blood and urine tests. Your doctor also may perform
one or more of the exams or following tests:
•
A pelvic exam is done to check a woman's vagina, uterus,
bladder and rectum. The doctor feels these organs for
any lumps or changes in their shape or size. To see the
upper part of the vagina and the cervix, the doctor inserts
an instrument called a speculum into the vagina.
•
A Pap test is when the doctor collects cells from the
cervix and upper vagina. A medical laboratory checks for
abnormal cells. Although the Pap test can detect cancer
of the cervix, cells from inside the uterus usually do
not show up on a Pap test. This is why the doctor collects
samples of cells from inside the uterus in a procedure
called a biopsy.
•
Transvaginal ultrasound involves a doctor inserting an
instrument into the vagina. The instrument aims high-frequency
sound waves at the uterus. The pattern of the echoes they
produce creates a picture. If the endometrium looks too
thick, the doctor can do a biopsy.
•
Biopsy is when the doctor removes a sample of tissue from
the uterine lining. This usually can be done in the doctor's
office.
Treatment
There are a number of ways to treat endometrial cancer,
including:
•
Surgery -- Most women with uterine cancer
have surgery to remove the uterus through an incision
in the abdomen -- this procedure is called a hysterectomy.
If the doctor also removes the fallopian tubes and the
ovaries, this procedure is called a bilateral salpingo-oophorectomy.
•
Hormonal Therapy -- If the cancer has
spread to other parts of your body, synthetic progestin,
a form of the hormone progesterone, may stop it from growing.
The progestin used in treating endometrial cancer is in
different doses than the progestin used in hormone replacement
therapy for menopausal women. Some different medications
may be used as well. Treatment with progestin may be an
option for women with early endometrial cancer who want
to have children and therefore do not want to have a hysterectomy.
However, this approach is new and does not guarantee that
the cancer will not return.
•
Radiation Therapy -- Radiation therapy
uses high-energy rays to damage cancer cells and stop
them from growing. It is a localized treatment, which
means that it works to attack cancer cells in one area.
The radiation may come from a large machine, called external
radiation, or from radioactive materials placed directly
into the uterus, called implant radiation. Some patients
receive both types of radiation therapy.
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