What are the symptoms of endometrial cancer? How is endometrial cancer diagnosed?
1. What is Endometrial Cancer?
2. What are the causes of endometrial cancer?
3. What are the clinical symptoms of endometrial cancer?
4. How is endometrial cancer diagnosed?
5. The latest detection method for endometrial cancer - MPap® Test
6. Treatment of endometrial cancer
Endometrial cancer is one of the female cancers that is easily overlooked. However, with the changes in modern fast food culture, lifestyle habits, and hormone influences, the incidence of endometrial cancer is increasing yearly. It is now ranked as the fifth most common female cancer and has become the number one gynecological cancer in Taiwan since 2011!
With advancements in technology, our understanding of endometrial cancer has deepened. Today, through DNA molecular testing techniques, we can screen for endometrial cancer early and intervene in time, safeguarding women's health.
What is Endometrial Cancer?
The uterus is located in the center of the female pelvis, connected to the fallopian tubes and ovaries on both sides. It is one of the most important reproductive organs in women. The uterine cavity is lined with a membrane called the endometrium, where a fertilized egg implants and begins to grow. In non-pregnant women, the endometrium thickens and sheds cyclically due to the influence of estrogen and progesterone, forming menstruation. Common uterine diseases include fibroids, endometriosis, chocolate cysts, cervical cancer, and endometrial cancer.
The cause of endometrial cancer is abnormal proliferation of endometrial cells, with the potential to invade and metastasize to other organs and tissues. Based on tissue type, endometrial cancer is divided into two types: Type 1, accounting for 75-80%, is endometrioid adenocarcinoma arising from the endometrial gland cells, while Type 2, accounting for about 20%, includes highly malignant types such as serous or clear cell carcinoma, which are prone to metastasis. According to the International Federation of Gynecology and Obstetrics (FIGO) staging system, endometrial cancer is classified into four stages, further divided into grades 1 to 3 based on tumor differentiation. The higher the grade, the more serious the condition.
| Stage | Tumor Status | 5-Year Survival Rate |
|---|---|---|
| Stage IA | Confined to the endometrium. | 80% ~ 90% |
| Stage IB | Confined to the endometrium, with invasion into less than half of the myometrium. | 80% ~ 90% |
| Stage IC | Confined to the endometrium, with invasion into more than half of the myometrium. | 80% ~ 90% |
| Stage IIA | Tumor has invaded cervical glands but is still confined to the uterus. | 70% ~ 80% |
| Stage IIB | Tumor has invaded cervical stroma but remains confined to the uterus. | 70% ~ 80% |
| Stage IIIA | Tumor has spread beyond the uterus but is confined to the pelvic cavity, involving the serosa or ovaries/fallopian tubes. | 50% ~ 60% |
| Stage IIIB | Tumor has spread to the vagina. | 50% ~ 60% |
| Stage IIIC | Tumor has spread to pelvic or para-aortic lymph nodes. | 50% ~ 60% |
| Stage IVA | Tumor has invaded the bladder or rectal mucosa. | 20% ~ 25% |
| Stage IVB | Distant metastasis, possibly including peritoneal or inguinal lymph node involvement. | 20% ~ 25% |
Causes of Endometrial Cancer
Endometrial cancer is associated with several factors, especially hormonal imbalances and individual health conditions. Below are some common risk factors for endometrial cancer:
- Inappropriate estrogen supplementation: Postmenopausal women supplementing with estrogen without medical supervision are at increased risk of endometrial cancer.
- Obesity: Fat can convert hormones into estrogen, and excess estrogen increases the risk of endometrial cancer.
- Menstruation: Early menarche (before age 12) or late menopause (after age 52), or long-term irregular ovulation cycles.
- Reproductive history: Women who have not given birth or are infertile have longer exposure to estrogen.
- Diabetes and hypertension: These conditions, often related to obesity, can indirectly increase the risk.
- Related medical history: Women with hereditary non-polyposis colorectal cancer (HNPCC), polycystic ovary syndrome (PCOS), breast cancer, or a family history of colon cancer are at higher risk.
- Genetic mutations: Mutations in genes such as MLH1 and MSH2 are also associated with endometrial cancer.
In summary, aside from estrogen-related factors, lifestyle habits, genetic background, and chronic diseases can all increase the risk of endometrial cancer.
Symptoms of Endometrial Cancer
Abnormal vaginal bleeding is the most common clinical manifestation of endometrial cancer, especially in postmenopausal women. In addition to abnormal bleeding, there are other potential symptoms and risk factors. Below are some common symptoms of endometrial cancer:
- Abnormal vaginal bleeding: Over 90% of endometrial cancer patients experience irregular vaginal bleeding, especially postmenopausal women. Abnormal bleeding may also include post-coital bleeding, heavy periods, and pinkish spotting between periods.
- Abnormal menstruation: Irregular menstrual cycles or excessive bleeding during periods.
- Abnormal vaginal discharge: Tumors may cause abnormal vaginal discharge, sometimes accompanied by a foul odor.
- Difficulty urinating or painful intercourse: This may be related to tumor pressure or infiltration into adjacent tissues.
- Lower abdominal pain: As the tumor grows or nerves are compressed, pain may occur.
- Pyometra: A large tumor may block the cervix, preventing the drainage of cancerous secretions and causing a buildup of pus in the uterine cavity.
- Other symptoms: Rapid weight loss, chronic fatigue, and loss of appetite may be related to cancer progression and metastasis.
These symptoms are also common in other physiological conditions and may not necessarily be directly related to endometrial cancer. However, it is important to seek medical attention promptly if these symptoms occur to ensure health.
Diagnosis of Endometrial Cancer
When diagnosing endometrial cancer, doctors will conduct further examinations based on symptoms. The following are common diagnostic processes and tests:
- Medical history: The doctor will ask detailed questions about menstrual history, cycle irregularities, and assess endometrial cancer risk factors.
- Pelvic ultrasound: To check for abnormal thickening of the endometrium, which may indicate disease.
- Pelvic examination: A pelvic exam may be performed to check for the source of abnormal bleeding from the vagina or cervix.
- Hysteroscopy: A direct visual examination of the uterus using a scope allows for the collection of endometrial tissue samples from specific locations.
- Endometrial sampling (Pipelle): In certain cases, a surgical procedure is used to collect endometrial tissue for pathology to confirm abnormalities.
- Endometrial curettage (D&C): A surgical scraping of the uterine lining is used to gather tissue for pathological examination.
The Latest Detection Method for Endometrial Cancer - MPap® Test
In addition to the above methods, the MPap® Test, developed by Phalanx Biotech, uses PCR-based molecular technology to quickly and accurately screen high-risk individuals for all stages of endometrial cancer (including stage IV). This test has a 90% sensitivity and a 98% negative predictive value and is minimally invasive, making it increasingly favored by clinicians.
The MPap® Test has undergone rigorous clinical trials and has proven to be an effective and accurate method for screening high-risk cases of endometrial cancer. It has been certified by the Taiwan Food and Drug Administration (TFDA) as a class III in vitro diagnostic (IVD) reagent, and all testing procedures are performed in laboratories certified to ISO15189 and LDTS standards for precision molecular diagnostics.
👉👉 Learn more about the "MPap® Test"
Treatment of Endometrial Cancer
The treatment plan should be discussed in detail with a medical team based on individual conditions. Below is a brief introduction to common treatment methods for endometrial cancer:
- Surgery: This is the primary treatment for most patients, including traditional open surgery, laparoscopic surgery, and robotic surgery.
- Radiation therapy: Radiation therapy uses high-energy rays to kill cancer cells and is a common adjunct treatment. Common forms include external pelvic radiation and vaginal brachytherapy. Proton therapy is also being applied in recent years.
- Hormone therapy: Applicable for early-stage patients with fertility needs or for recurrent patients who cannot undergo surgery. Common medications include progestins and other hormone therapies.
- Chemotherapy: Chemotherapy drugs are used to kill cancer cells throughout the body, often in combination with surgery, radiation therapy, or hormone therapy.
- Targeted therapy: This method blocks specific mechanisms of cancer cell growth, often used to inhibit tumor angiogenesis.
- Immunotherapy: This method stimulates the immune system to attack cancer cells, mainly using PD-1 monoclonal antibody inhibitors in combination with other treatments to enhance efficacy.
Conclusion
Prevention and early detection are the best strategies for combating endometrial cancer. Advances in medical technology, including the MPap® Test, offer patients more diagnostic and treatment options. Women should pay close attention to their bodies and undergo regular checkups to detect problems at the earliest stage, thus improving the chances of recovery.