•  Endometriosis

It's cancer of the lining of the uterus, a hollow pear-shaped organ in women in which a fetus can develop. (This lining is known as the endometrium.) Endometrial cancer is the most common cancer of the female reproductive tract, with an estimated 40,000 women diagnosed each year. Fortunately, it has a high cure rate. According to the American Cancer Society, about 84 percent of women are cancer-free five years after treatment.

Endometrial cancer is not the same as some other less common malignancies involving the uterus. For example, uterine sarcomas are malignancies arising from the wall of the uterus, not the lining. All in all, these other cancers make up less than 10 percent of the malignant tumors arising from the uterus. The remaining 90 percent are the endometrial cancers talked about here.

Women who get endometrial cancer tend to share certain characteristics. Having these risk factors doesn't mean you'll get the cancer, of course, just as being free of risk factors doesn't guarantee safety. But you're more likely to develop this cancer if:

•You're over the age of 50. Less than 5 percent of endometrial cancer cases are diagnosed in women under 40.

•You're on hormone replacement therapy. Both large doses of estrogen and long-term treatment with it seem to elevate the risk of endometrial cancer. Using both estrogen and progesterone appears to reduce the risk of taking estrogen by itself.

•You're overweight. If your weight is somewhat above the acceptable range for your height, you're twice as likely to get endometrial cancer as a woman at a lower weight. If you're obese, your risk is three to 10 times greater than that of those who aren't. Scientists believe this is because the more fat cells a woman has, the more estrogen she produces.

•You have diabetes or high blood pressure. Studies show these conditions may increase the risk of endometrial cancer, but scientists aren't sure whether this is a direct result of the diseases or because people who have these diseases tend to be overweight.

•You're taking tamoxifen. Using this drug to treat breast cancer raises your risk of developing endometrial cancer, perhaps because it affects the uterus much as estrogen does.

•You're white. White women are more likely to develop endometrial cancer than women of other races.

Other risk factors include having no biological children, going through menopause late in life, suffering from polycystic ovarian syndrome, and having a history of colon, rectal, or breast cancer. One thing that may lower your risk, according to some studies, is having used oral contraceptives containing both estrogen and progesterone.

Bleeding after menopause can be an indication of endometrial cancer. If that happens, you should see your doctor for a checkup as soon as possible. For women who haven't gone through menopause, bleeding between periods might signal either endometrial or cervical cancer (or other problems, such as vaginal infections). Other symptoms of endometrial cancer include pain during intercourse and painful or difficult urination.

Make an appointment promptly if you have any of the following symptoms:

•Unusual discharge or vaginal bleeding

•Difficult or painful urination

•A chronic ache in the pelvic area

•Pain during intercourse

These symptoms often have other causes, but your doctor can make sure your problem isn't an early sign of endometrial cancer.

If your doctor suspects you have endometrial cancer, she'll do a pap smear (take a sample of cells from your cervix to be inspected for abnormalities). She'll probably also do a biopsy of your uterine lining, removing a sample of tissue that will be examined for cancerous cells.

If cancer is detected, your doctor will then determine how far it has spread. There are four stages: Stage I means the cancer is confined to the uterus. In stage II, it has spread to the cervix. In stage III, it has spread to other reproductive organs. In stage IV, it's spread to elsewhere in the body. Endometrial cancer is usually diagnosed in the first stage.

A hysterectomy -- surgery to remove the uterus -- is typically the first line of treatment. (Although in Europe, the preferred treatment is generally radiology.)

The best approach depends on whether -- and how much -- the cancer has spread. Your doctor will probably suggest a hysterectomy and may want to remove your cervix, fallopian tubes, and ovaries along with your uterus. She may recommend a course of radiation as an adjunct therapy. Less common complementary treatments for this cancer include hormone therapy and chemotherapy. Discuss the advantages and side effects of the possibilities with your doctor or oncologist, and be sure to get a second opinion.

Some studies suggests that this surgery can lessen sexual desire, but others have found that it has no effect on libido or satisfaction. But if feelings of emotional loss detract from your sex life, counseling (either individual or for both you and your partner) may help.

In your reproductive years, try to maintain a normal weight through a healthy diet and regular exercise. If you have already gone through menopause and are worried about endometrial cancer, you might want to skip estrogen replacement therapy or take the kind that includes progesterone. If your doctor does recommend estrogen or tamoxifen, you should have regular follow-up visits during the treatment.

The National Cancer Institute has a wealth of booklets on cancer, including Eating Hints for Cancer Patients, Chemotherapy and You, Radiation Therapy and You, and Facing Forward: A Guide for Cancer Survivors. To order them, call the Cancer Information Service at (800) 4-CANCER, or (800) 422-6237.

The National Cancer Institute's Web site, offers materials on cancer treatment, screening, and clinical trials for health professionals and the public; it's at http://www.cancer.gov .

You can also read up on complementary approaches to the standard medical treatments. Special diets, yoga, herbal supplements, and "mind-body" techniques are among the alternative therapies that many cancer patients use in conjunction with conventional treatments. Michael Lerner's book Choices in Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer might be a good place to start your research.

Research has shown that cancer support groups can increase both the quality of life and long-term survival for people with cancer. The American Cancer Society (http://www.cancer.org ) can put you in touch with support groups in your area.

-- Kerry Nelson, M.L.S., is a library sciences specialist and freelance health writer based in Berkeley, California. Among other jobs, she has researched health issues for the Hesperian Foundation, which publishes Where There Is No Doctor.

References

First published September 24, 1999
Last updated March 5, 2008
Copyright © 1999 Consumer Health Interactive

Or Find More On:

Back to top of page