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Alternative namesEndometrial/uterine adenocarcinoma; Uterine cancer; Adenocarcinoma of the endometrium/uterus; Cancer - uterine; Cancer - endometrial
DefinitionEndometrial cancer involves cancerous growth of the endometrium (lining of the uterus).
Causes, incidence, and risk factors
Endometrial cancer is the most common type of uterine cancer. Although the exact cause of endometrial cancer is unknown, increased levels of estrogen appear to have a role. One of estrogen's normal functions is to stimulate the buildup of the epithelial lining of the uterus. Excess estrogen administered to laboratory animals produces endometrial hyperplasia and cancer .
The incidence of endometrial cancer in women in the U.S. is 1% to 2%. The incidence peaks between the ages of 60 and 70 years, but 2% to 5% of cases may occur before the age of 40 years. Increased risk of developing endometrial cancer has been noted in women with increased levels of natural estrogen.
Associated conditions include the following:
Increased risk is also associated with the following:
Women who have a history of endometrial polyps or other benign growths of the uterine lining, postmenopausal women who use estrogen-replacement therapy (specifically if not given in conjunction with periodic progestin) and those with diabetes are also at increased risk
Tamoxifen, a drug used to treat breast cancer, can also increase the risk of developing endometrial cancer.
Signs and testsA pelvic examination is frequently normal, especially in the early stages of disease. Changes in the size, shape or consistency of the uterus and/or its surrounding, supporting structures may exist when the disease is more advanced.
Women with the early stage 1 disease may be candidates for treatment with surgical hysterectomy , but removal of the tubes and ovaries (bilateral salpingo-oophorectomy) is also usually recommended for two reasons. Tumor cells can spread to the ovaries very early in the disease, and any dormant cancer cells that may be present could possibly be stimulated by estrogen production by the ovaries.
Abdominal hysterectomy is recommended over vaginal hysterectomy because it affords the opportunity to examine and obtain washings of the abdominal cavity to detect any further evidence of cancer.
Women with stage 1 disease who are at increased risk for recurrence and those with stage 2 disease are often offered surgery in combination with radiation therapy . Chemotherapy may be considered in some cases, especially for those with stage 3 and 4 disease.
Support GroupsThe stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .
Expectations (prognosis)Because endometrial cancer is usually diagnosed in the early stages (70% to 75% of cases are in stage 1 at diagnosis; 10% to 15% of cases are in stage 2; 10% to 15% of cases are in stage 3 or 4), there is a better probable outcome associated with it than with other types of gynecological cancers such as cervical or ovarian cancer .
The 5-year survival rate for endometrial cancer following appropriate treatment is:
Calling your health care providerCall for an appointment with your health care provider if any symptoms occur, particularly if you are a woman with associated risk factors or if you have not had women's health care examinations according to recommended schedules.
PreventionAll women should have regular pelvic exams and Pap smears (beginning at the onset of sexual activity or at the age of 20 if not sexually active) to help detect signs of any abnormal development.
Since conditions associated with increased risk have been identified, it is important for women with such conditions to be followed more closely by their physicians. Frequent pelvic examinations and screening tests, including a pap smear and endometrial biopsy , should be done.
Women who are taking estrogen replacement therapy should also take these precautions. Any of the following symptoms should be reported immediately to the doctor:
Update Date: 8/4/2002Kevin Knopf, M.D., M.P.H., Hematologist/Oncologist and Director of Clinical Research, Annapolis Oncology/Hematology Center, Annapolis, MD. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT