What is Endometrial Cancer? Its signs, symptoms and causes.

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Dr. Heena Chawla
Gynecology

What is Endometrial Cancer? Its signs, symptoms, and causes. 

In this video, Dr. Heena Chawla, a Consultant Gynecologist at Apollo Clinic and CHD city Hospital, Chandigarh talks about:

  • What is endometrial cancer? 
  • What are its signs and symptoms? 
  • How do we know if we need further screening for cancer? 
  • What are its different stages? 

WHAT IS ENDOMETRIAL CANCER? 

Endometrial cancer, as the name suggests cancer of the endometrium. The endometrium is the innermost layer of the uterus, the middle layer of the uterus is the myometrium, and the outermost layer is the serous layer. 

For any reason, if there is an uncontrolled growth of cells in the innermost layer of the uterus, then we say it is endometrial or uterine cancer. It is prevalent cancer in females. 

Earlier its prevalence was more in the western world, but now a days, its incidence has drastically increased in developing countries like India. Due to lifestyle modification, lack of physical activity, and excessive hormonal imbalance, the incidence of endometrial cancer is more in Indian females. 

First, we will talk about the risk factors associated with endometrial cancer.

WHICH PATIENT COMES UNDER THE RISK CATEGORY?

Among high-risk patients are those who have:

  • a high concentration of estrogen in their body for any reason
  • are obese
  • a Body Mass Index of more than 25 
  • are suffering from diabetes or hypertension
  • never been pregnant
  • any baby 

are maximum at risk of endometrial cancer. 

Apart from this, if you have a history of breast cancer or doctors have prescribed you medicines that have a direct effect on the uterus lining may put you at risk of uterine cancer. Patients with lynch cancer, in which there is a combination of colon and endometrial cancer, are also at a very high risk of endometrial cancer. 

Often patients ask in OPD how they would know or what test they should undergo. What kind of signs and symptoms do we observe?

WHAT ARE ITS SIGNS AND SYMPTOMS?

Endometrial cancer, I would say, is one cancer in females that gives signs and symptoms of its onset in the form of uterine bleeding. We divide the menstrual cycle into three groups; In one group, we females are premenopausal with regular periods. Then we have the second group of perimenopause inclined towards the end of their periods, and the other group is at the menopause stage. The bleeding presentation in all three groups is different. 

Premenopause  

In the premenopausal group with regular periods, if you have heavy bleeding, which usually doesn’t occur. Or may start bleeding again after periods stop, which we call inter-menstrual bleeding, these two critical presentations or signs that one must consult a doctor. 

Perimenopause 

Those in the perimenopausal stage are at the end of their periods; if suddenly there is a reduced frequency of periods according to their age, or they are having delayed periods or have minor bleeding may also be at risk. But if you have heavy bleeding or periods start coming fast, you must consult our doctor. 

Abnormal bleeding

There may be other reasons associated with heavy bleeding or early periods. We can’t always relate them to endometrial cancer, there might be some other reason related to it, but we must evaluate ourselves with the doctor. Many times we diagnose cancer in simple things. On average, ten may get diagnosed with endometrial cancer among a hundred women with abnormal bleeding. Under these circumstances, we must consult our doctor. If they advise biopsy, we should go for a biopsy. 

Post menopause group 

Next, we are coming to the postmenopausal group, where periods have stopped for almost one year. If these patients have bleeding or spotting, we must consult our doctor immediately. We must examine ourselves properly, and if they advise ultrasound, we should go for an ultrasound. And suppose we should opt for biopsy after considering ultrasound. In that case, the thickness of the endometrial lining, or some other reason if the doctor has advised you for biopsy, then we must go for a biopsy test. This was all about the bleeding patterns. 

Signs and symptoms 

Many patients who have endometrial cancer may suffer from stomach aches, which we call pelvic pain, or they may have a bloating session. Apart from this, they feel the change in their urinary habits like the frequent urge to urinate, or there may be changes in bowel habits like they may suffer from diarrhea or constipation. Apart from that, they have general signs like losing appetite and weight loss, which are some common signs of endometrial cancer.

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