Endometrial Cancer Treatment

Endometrial Cancer

Endometrial cancer is a cancer that starts in the endometrium, the inner lining of the uterus

(womb). Nearly all uterine cancers start in the endometrium and are called endometrial

cancers. Most endometrial cancers are adenocarcinomas, and endometrioid adenocarcinoma

is the most common type. Uterine cancers can also start in the muscle layer or supporting

connective tissue of the uterus. These cancers belong to the group of sarcomas.

Endometrial cancer usually develops slowly and oftenly occurs in post-menopausal ages.

Although certain factors can increase a woman’s risk for endometrial cancer, they don’t always cause the disease. Many women with risk factors never develop endometrial cancer.

Many factors affect the risk of developing endometrial cancer, including:

Obesity
Things that affect hormone levels, like taking estrogen after menopause, tamoxifen; the number of menstrual cycles (over a lifetime), certain ovarian tumors, and polycystic ovarian syndrome (PCOS).
Age
Diet
Type 2 diabetes
Family history (having close relatives with endometrial or colorectal cancer)
Having had endometrial hyperplasia in the past
Treatment with radiation therapy to the pelvis to treat another cancer

Diagnosis

Diagnosis of endometrial cancer includes a review of your medical history, physical examination and pathologic evaluations. These include one or more of the following.

Pap smear: This test involves microscopic examination of cervical and vaginal cells, used to detect changes that may be cancer or may lead to cancer. This test may also show noncancerous conditions, such as infection . However, the Pap smear may not diagnose endometrial cancer.
Endometrial sampling: This procedure uses a thin, flexible tube that is put into the uterus to collect an endometrial tissue sample. The sample is examined microscopically to see if cancer or other abnormal cells are present. An endometrial biopsy procedure is often an outpatient office procedure.
Dilation and curettage: This is a minor procedure in which the cervix is dilated so that the cervical canal and uterine lining can be sampled with a curette (spoon-shaped instrument).

Treatment

Surgery is the basic treatment for most women with endometrial cancer. But in some cases, different treatment options may be chosen. The choice of treatment depends largely on the histologic type and stage. Other factors are; age, health status and other personal conditions.The operation includes removing the uterus, fallopian tubes, and ovaries. Lymph nodes from the pelvis and abdomen can also be removed. The tissues removed at surgery are tested and examined by the pathology unit. Some patients, depending on the stage and histologic type, may need additional therapy, such as radiation therapy, chemotherapy, or both.

Surgery (total abdominal hysterectomy) can be done by traditional methods. But, almost for all patients we perform through a minimally invasive approach (laparoscopic or robotic) that offers such benefits as reduced risk for infection and faster recovery.

With laparoscopy or robot-assisted techniques, we can remove the uterus and other tissues through the vagina using very small abdominal incisions.

With laparoscopic surgery, our expert surgeon examines the abdominal cavity with a laparoscope (a thin, lighted tube with a video camera) — which projects an image onto a screen. Guided by the laparoscope, the surgeon operates through tiny surgical incisions using special instruments to remove the uterus and other tissues through the vagina.

With robotic hysterectomy, our specially trained surgeons use the da Vinci Surgical System®. The surgeon is seated at a multifunctional console and views the operation field via a magnified, three-dimensional, high-definition visual system and performs the operation. The robot precisely copies surgeons finger movements.

Obesity is common among women with uterine carcinoma. In obese women, our gynecologic oncology surgeon can collaborate with plastic surgeons to combine hysterectomy with a reconstructive procedure known as panniculectomy. Also known as a tummy tuck, excess skin and underlying fat in the abdominal area can be removed.

Some younger patients with early stage endometrial cancer may have hysterectomy without removing the ovaries. This prevents menopause. This may be something that you want to discuss with your doctor.

For young women who still preserve her fertility, surgery may be postponed while progesterone therapy is used to treat the cancer. But, this treatment is experimental and should be discussed with the doctor.