What is Endometrial Carcinoma?

Endometrial carcinoma, or uterine adenocarcinoma, is a cancer that begins in the uterine lining, or endometrium. The exact cause of uterine cancer is unknown; increased estrogen levels, however, appear to be a risk factor. Estrogen generally spurs the buildup of the lining of the uterus, which causes it to thicken. Endometrial thickening may be a risk factor in the development of endometrial carcinoma. Most cases of endometrial carcinoma occur between 60 and 70 years of age.

Cancer of the endometrium may be related to risk factors such as diabetes, estrogen replacement therapy, never being pregnant, and late menopause. Having colon or breast cancer also may increase the risk of uterine cancer. High levels of estrogen that are found in meat may result in excessive uterine thickening and subsequent uterine cancer.

Symptoms of endometrial carcinoma generally include abnormal vaginal or uterine bleeding, long and heavy episodes of vaginal bleeding that occur after the age of 40, abdominal pain or cramping, and vaginal discharge that is clear or thin and white. These symptoms also can be symptomatic of other, less serious medical conditions. This includes conditions such as a vaginal infection, local irritation, or allergic reactions.

Diagnostic tests for endometrial carcinoma may include a pelvic examination where the physician can check for abnormalities in the shape, size, or feel of the uterus; an endometrial biopsy where a sample of the endometrial tissue is analyzed for malignant cells; and a pap smear. If endometrial carcinoma is detected, further medical evaluation and testing may be performed to determine the extent of the disease, and whether the cancer has metastasized or spread to other body parts. This is referred to as staging.

Stages of endometrial carcinoma refer to the extent of the disease, ranging from the cancer being confined to the uterus, to the spreading of the malignancy to the abdomen, bowel, bladder, or other organs. Grades of endometrial cancer typically are used to identify aggressiveness. Grade 1 generally refers to the least aggressive, and grade 3 indicates the most aggressive.

Treatment for endometrial carcinoma may include a hysterectomy – which involves removing the uterus, fallopian tubes, and ovaries – radiation, and chemotherapy. Chemotherapy typically is used in cases of advanced or aggressive disease. Typically, an abdominal hysterectomy is preferred over a vaginal hysterectomy because it allows the surgeon to see inside the abdominal cavity and remove tissue for biopsy purposes.

Complications from treatments may include excessive blood loss during surgery, perforation of the uterus during an endometrial biopsy, and surgical infection. It also can include anemia, nausea, and vomiting related to chemotherapy. After surgery, the patient may experience symptoms related to menopause such as hot flashes, night sweats, and vaginal dryness as a result of ovary removal. If endometrial cancer is diagnosed when still in the early stages, the prognosis usually is favorable. Early stage endometrial cancer has not spread beyond the uterus, and therefore, distant organs and vital tissues are not affected by metastasis.