Getting the right diagnosis is the first step in making a treatment plan. Your doctor will check your symptoms and do a pelvic exam. They may also order a Pap test.
Some factors, like age or family history, can increase your risk of endometrial cancer. But most of the time doctors don’t know what causes it.
In the pelvic exam, your doctor will check your vulva and the opening of your vagina (called the cervix). He or she will look for redness, sores, irritation, abnormal discharge or inflammation. Your doctor may also examine the lining of your uterus and urethra for signs of cancer or other problems. Your doctor will want to know about your past health, symptoms and family history.
Your health care team will use an imaging test called an ultrasound to see the lining of your uterus and the structure of your cervix and fallopian tubes. For this test, you will lie on an exam table and place your feet in supports, called stirrups. A wand-like device (called an ultrasound transducer) sends out sound waves that echo off your body’s organs. A computer then turns the echoes into pictures.
Your health care team may also do a test called a transvaginal sonohysterography, or TVUS, to measure the thickness of your uterus’s lining and see if it is changing. This test is usually done after a biopsy to help decide whether you need another one. A new study led by researchers at Mayo Clinic suggests that TVUS may help diagnose endometrial cancer early because it can detect a type of cell that is more likely to grow into a tumor. The study was published in Gynecologic Oncology in 2023. In the study, women with a high cellular density were more than four times more likely to have endometrial cancer than those with lower cellular densities.
An ultrasound is a painless test that uses sound waves to look inside your pelvis. A doctor can use this to find a cyst or any unusual growths. It can also help to diagnose endometrial cancer by showing whether it has spread beyond the walls of your uterus. This test is usually done by a gynaecologist.
The ultrasound may be used to check for a type of endometrial cancer called uterine carcinosarcoma (CS). These tumours start in the tissues that line the uterus and have features of both endometrial carcinoma and sarcoma. They make up about 3% of all uterine cancers. Doctors sometimes mistakenly call them endometrial sarcomas, but they are actually an advanced form of endometrial carcinoma.
MRI scans are pictures that show how your body is working. They can find enlarged lymph nodes, which are often a sign of endometrial cancer. The MRI scan can also help to find if the cancer has spread to other parts of your body.
You might be given a special dye to help highlight any areas of abnormal cells. Then your doctor will take a small sample of cells from your uterus to confirm if you have endometrial cancer. This is often done with a thin tube, called a pipelle, inserted into your cervix. You can ask for some pain relief medicine before this test if you think it will be painful.
If your ob-gyn thinks you have Endometrial cancer, a biopsy is the best test to find out for sure. This involves removing a small sample of the endometrial lining to examine under a microscope. Your doctor may use a special tool, called a speculum, or a thin tube with a camera called a hysteroscope to get this tissue. You’ll lie on an examination table and your doctor will insert the tool into your cervix. The procedure takes less than 5 minutes.
The biopsied tissues can be used to diagnose a number of different conditions. They can also help determine what type of cancer you have. Most people with Endometrial cancer have a type of uterine cell called adenocarcinoma. This is when gland cells grow into the uterine lining (endometrium). Some types of this cell are clear-cell carcinoma, mucinous adenocarcinoma, undifferentiated carcinoma and serous adenocarcinoma. Other kinds of the adenocarcinoma include endometrioid cancer, which is when the cells look more like the normal lining of your uterus.
Other screening tests for Endometrial cancer can include a CA-125 assay, which measures how much of a protein called CA-125 is in your blood. This can tell if your cancer is spreading.
Other tests that may be ordered include a CT scan or an MRI, which can give your ob-gyn more information about the size of your tumor and its location. You might also need a blood test to measure your hormone levels.
If the biopsy doesn’t give your doctor enough information, or if it’s positive for endometrial cancer, you may need surgery. During a procedure called dilation and curettage (D&C), your ob-gyn scrapes tissue from the lining of your uterus and examines it under a microscope to look for cancer cells. This is done if your symptoms don’t improve with hormone therapy or other treatments.
Your doctor can use a blood test to check for high levels of a chemical called CA-125, which is released by many, but not all, endometrial cancers. When levels are high, it suggests the cancer has spread beyond your uterus. Your doctor can also check your DNA for mutations, such as dMMR and MSI-H. These are inherited and increase your risk of having endometrial cancer.
A MRI scan or CT scan can help your doctor stage your cancer. The staging system gives your cancer a number from 1 to 4, with 4 being the most advanced. Staging helps your doctor decide if you need more treatment, such as chemotherapy or radiation.
Your doctor may recommend surgery to remove your uterus and ovaries, as well as lymph nodes in your pelvis and abdomen. Surgical techniques have improved over the years. Some of them allow your doctor to perform surgery without large incisions. In some cases, your doctor might suggest surgery using a robot, which can reduce the risk of complications and speed up recovery time.
Many of the symptoms associated with Endometrial cancer can also be caused by other, noncancerous health conditions. However, it is important to see your doctor if you have any of these symptoms.
Risk factors can increase your chances of developing endometrial cancer. These include: being overweight; starting menopause at a later age; using estrogen-only hormone replacement therapy after menopause; and having certain genetic disorders, such as Lynch syndrome.
Cancer of the uterus, called endometrial cancer, starts in the inner lining of the uterus (endometrium). This is the pear-shaped organ above the pelvis where a fetus grows during pregnancy. Sometimes the cancer cells spread beyond the uterus, into other parts of the body. This can cause pain, bleeding and other symptoms in the abdomen.
Symptoms of endometrial cancer vary from woman to woman. If you have any of these symptoms, talk to your doctor right away. The sooner you get a diagnosis, the sooner you can start treatment.
Your health care team will check your overall health and do a physical exam. They may also ask about your family history of cancer. They will do tests to find out if you have endometrial cancer. Your GP will do some of the tests or refer you to a gynaecologist or a gynaecological oncologist.
A pelvic ultrasound to look at the lining of the uterus for signs of any unusual growths. A transvaginal ultrasound uses a small instrument to feel the lining of the uterus with an image on a screen. Your doctor may do a biopsy to check for cancer in the lining of the uterus. This is done by inserting a thin tube through your cervix. This can be painful, but you may take medicine to help with the pain.
Some women have a recurrence of endometrial cancer after having treatment. This is more common in premenopausal women. It can be difficult to know why this happens. Sometimes the cancer cells return because they grow faster than normal. Other times, the cells grow in places where there are scars from previous endometrial surgery.
The best way to prevent recurrence is to have regular screening exams with your gynaecologist. This includes a routine pelvic exam and a pap test.
You should also talk to your gynaecologist about ways to lower your risk for endometrial cancer. This can include leading an active lifestyle, eating a balanced diet and staying at a healthy weight (modifiable risk factors). You should also quit smoking and avoid alcohol.
Bleeding from the uterus (endometrium) is the most common symptom of Endometrial cancer. It’s different than a normal menstrual period, and is often more heavy or frequent. It can also be more painful, or come and go.
Abnormal vaginal bleeding as a result of Endometrial cancer can happen in nine out of 10 women who have the disease. This can include spotting or a heavy menstrual period. It can also mean bleeding between menstrual periods before or after a woman has had children, even after menopause. It is important to talk to your doctor about this because it’s a warning sign that something is wrong and needs to be looked into further.
The uterus is a pear-shaped organ that’s located above the pelvis. Cancer cells usually grow in the lining of this organ, but can sometimes spread to other areas of the pelvis. Endometrial cancer is the most common type of gynecologic cancer, but can also develop in the cervix or muscular wall of the uterus. The two types of uterine cancer are endometrial carcinoma and adenocarcinoma of the uterus.
If your doctor suspects that you have Endometrial cancer, he or she will do tests to check your symptoms. These may include blood tests and a pelvic exam. He or she will also ask about your family history of cancer.
A hysterosalpingogram (a test that looks at the inside of your uterus) and a transvaginal ultrasound can also be used to look for cancer cells. Your doctor might also want to do an endometrial biopsy. This is a small procedure that involves inserting a thin plastic tube into the uterus to take a sample of the lining. The doctor will then send this lining to a lab for testing. If you’re worried about pain, your doctor can give you a mild pain reliever before the biopsy.
A gynecologic oncologist will decide what treatment is right for you. At Siteman, a team of nationally renowned gynecologic cancer specialists meets every week to discuss each patient’s case and determine their best course of action.
A cancer cell can cause pain when it grows in the area of a tumor or spreads to nearby tissues. It can also cause pain when it presses on the nerves that surround the uterus, as can be the case with endometrial cancer, said Dr. Alison Schram, an attending physician in the early drug development and gynecologic medical oncology services at Memorial Sloan Kettering Cancer Center in New York City.
Uterine cancer is usually the result of an overgrowth of the lining of the uterus, which doctors call the endometrium. It happens most often after menopause. It is more common in women who have a history of obesity and who use estrogen-only hormone replacement therapy (menopausal hormone therapy, or HRT) for many years.
When cancer cells grow in the uterus, they can cause abnormal vaginal bleeding and pain in the pelvic area. They can also press on the ureters, which are the tubes that carry urine. This can lead to painful urination and a feeling that the bladder is full after urinating.
The uterus is the hollow, pear-shaped organ above the pelvis where a fetus grows during pregnancy. If cancer cells develop in the lining of the cervix at the bottom of the uterus, this is called cervical cancer and is less common than endometrial cancer.
Whether or not it is cancer, any new pain in the pelvic area should be evaluated by a doctor. This is especially true if a woman’s period has stopped or is irregular, like when she is in perimenopause or menopause.
Pain during sexual intercourse may be a sign of endometrial cancer, but only in advanced cases, when the cancer has already spread to the ovaries or other tissues and structures. This pain is more likely to occur when the tumor compresses nerves and other structures that surround the uterus, like the bladder or urethra.
Some types of treatment for endometrial cancer require removing the uterus. This can lead to early menopause or a return of symptoms for those who have not already gone through menopause. Some treatments can preserve the ovaries and uterus, however. A health care team will discuss options with each person.
If you have endometrial cancer, your tumor may grow around your bladder or urethra, which can cause pain when you urinate. Your doctor may also recommend a medication to help with this. Symptoms can sometimes return after your treatment is finished, especially if you had a complete hysterectomy or radiation to the pelvis.
Symptoms can vary from woman to woman, and they may occur for many different reasons. If you have any unusual vaginal bleeding or spotting, talk to your doctor right away.
You can reduce your risk of endometrial cancer by using the pill for at least five years, not smoking, staying physically active, and eating a healthy diet. If you’re at high risk, your doctor may recommend regular pelvic exams, Pap smears, or a vaginal ultrasound.
Some types of cancer, including endometrial cancer, use hormones to grow. Hormones are chemicals produced in the body that control many of your cell functions. They include oestrogen and progesterone, which are important for a woman’s health. Certain medical conditions, such as polycystic ovary syndrome, can increase your risk of endometrial cancer. Being overweight is a significant risk factor, too.
Most of the time, doctors don’t know what causes uterine cancer or how it starts. They can only tell you the symptoms of this condition. It’s very important to recognise any of these symptoms, especially abnormal vaginal bleeding after menopause or any change in your periods including heavier periods.
Symptoms of endometrial cancer can affect women at any age, but they are most common in women who have already reached menopause. In fact, they are more likely to be diagnosed with the disease than any other gynaecological cancer.
If a doctor finds endometrial cancer at its earliest stage, 95% of patients are alive five years later. However, it’s difficult to detect with current screening tests, such as Pap smears or pelvic ultrasound.
If you are at risk, your doctor may recommend regular pelvic examinations and a Pap test to screen for cervical cancer. They might also perform an endometrial biopsy or a transvaginal ultrasound. Depending on the type of cancer, your treatment plan may involve surgery or drugs that destroy cancer cells. Other options include hormone therapies, which are given as tablets or, if you haven’t had a hysterectomy, through a hormone-releasing intrauterine device (IUD).
The goal of colorectal cancer treatment is to destroy the tumor and stop it from spreading. You might need surgery, chemotherapy, radiation therapy, or other treatments.
The type of surgery you have depends on where the cancer is and how much it has spread. Your age, overall health, and other factors also affect your outlook.
A colonoscopy is an outpatient procedure that allows the doctor to examine the inside of the colon. The doctor can see if the lining is abnormal and remove polyps (abnormal growths). People with a family history of colorectal cancer should undergo a colonoscopy screening every 10 years, or more often if they have other risk factors.
The person lies on their back and the endoscopist inserts a long tube called a colonoscope into the rectum. The colonoscope has a light and video camera that transmits real-time images to a monitor so the doctor can see the lining of the colon. It also has a tube that pumps in air to help inflate the colon for a better view. The doctor can also use a tool in the tube to take small samples of tissue for testing, which is called a biopsy. The doctor can also remove any enlarged polyps that are found.
Before the procedure, the person will wear a hospital gown and may receive a painkiller or sedative. The sedative can be taken as a pill or injected directly into the bloodstream (intravenously). The painkiller will reduce discomfort during the test.
After the procedure, the doctor will discuss the results. The person will need to stay in the recovery room for an hour or so to make sure there are no immediate complications. The person will need someone to drive him or her home because the sedative may affect judgment and reflexes. Some people experience stomach cramping, bloating and gas pains after a colonoscopy. This is caused by the air introduced into the colon during the exam and will disappear when the person passes gas.
Colon cancer is most treatable when it’s localized to the large intestine (colon) or back passage (rectum). Surgery alone can cure it, but it may be combined with chemotherapy. If the colon cancer has spread to other organs or lymph nodes, treatment is different.
Doctors can use a procedure called a colonoscopy to examine the colon and rectum for signs of cancer. During this test, doctors use a long, flexible and slender tube that is attached to a video camera and monitor to see the entire area. They can also pass surgical tools through the tube to take tissue samples and remove polyps. The procedure is usually painless. But there is always some risk of complications, such as infection, too much bleeding or reaction to anesthesia.
The tissue samples are examined in a lab to find out if the cells are cancerous and how quickly they’re growing. The results help your health care team create a treatment plan.
If the colon cancer is at an early stage, doctors may remove it completely during surgery, called surgical resection. They may also remove nearby lymph nodes to check for cancer cells. This helps to reduce the chance of cancer recurrence.
For patients with advanced colon cancer, surgery may be used in combination with other treatments, such as chemotherapy or radiation therapy. In addition, a surgery called cytoreductive or debulking surgery and hyperthermic intraperitoneal chemotherapy can be beneficial for some patients with gastrointestinal stromal tumors (including mucinous, serrated and cribriform colon adenocarcinomas).
The five-year survival rate for people with colorectal cancer depends on the stage of the disease at the time of diagnosis. For example, 73% of people with colon cancer that hasn’t spread beyond the colon and its nearby lymph nodes were alive five years after being diagnosed. But that rate drops to 17% when the cancer has spread to distant organs or lymph nodes.
The use of chemotherapy drugs is often part of treatment for colon cancer. It is used to treat the tumor and reduce the chances of the cancer recurring after surgery or spreading to other parts of the body.
Chemotherapy for colorectal cancer may be given before or after surgery, or both. It can be given through a tube (catheter) that goes to your bloodstream in the abdomen or chest, a needle, or directly into the intestines. Sometimes, it is delivered into the cerebrospinal fluid through the spinal cord in a procedure called intrathecal chemotherapy. It may also be given in pill form, or injected under the skin in a process called intravenous (IV) chemotherapy.
In stage III colon cancer, the cancer has spread through the outer layer of the colon wall (the serosa) to the tissue that lines the organs in the abdomen (visceral peritoneum). It can also have spread to four or more nearby lymph nodes. It is possible to cure these stages of colon cancer with surgery plus chemotherapy.
Doctors can choose from 9 different antineoplastic classes and dozens of drug combinations to treat metastatic colorectal cancer. Several newer medicines that improve outcomes include fluorouracil, capecitabine, oxaliplatin, S-1, irinotecan, the tyrosine kinase inhibitors regorafenib and ramucirumab, the anti-EGFR drugs cetuximab and panitumumab, and others.
Several factors affect the results of chemotherapy for colon cancer, including your age, overall health, and other treatments you’ve had. You also have a chance of having side effects from the chemotherapy, such as nausea and vomiting. To help reduce the risk of side effects, doctors monitor patients closely during treatment with regular blood work and CT scans to measure their response to therapy. The doctors can then adjust your doses or medications as needed.
Radiation therapy uses high-energy radiation from x-rays, gamma rays, neutrons or protons to kill cancer cells and shrink tumors. It may come from a machine outside your body (external beam radiation therapy) or from a radioactive substance placed inside your colon near the cancer cells (brachytherapy). This treatment is usually given in addition to chemotherapy.
A doctor who specializes in treating cancer, called a radiation oncologist, performs this treatment. Before you have radiation, the team of doctors will study your medical records and scans to make sure it is the best option for you.
Colon cancer is a growth of abnormal cells in the large intestine, which is the last part of the digestive system that makes up most of the bowel. It starts as small clumps of cells, called polyps, that can develop into cancer over time. Most of the time, polyps aren’t cancerous and don’t cause any symptoms. However, some can become cancerous and start to grow and spread. Regular screening tests can find and remove polyps, which often can prevent colon cancer from getting worse.
Cancer that has spread beyond the colon to other organs or tissues is called metastatic colon cancer. In stage IV colon cancer, chemo and/or radiation therapy may be recommended to help reduce the chance of the cancer coming back after surgery.
The most common type of metastatic colon cancer is adenocarcinoma. It’s also possible to have squamous cell carcinoma, rectum cancer or undifferentiated colon cancer. Your doctor will recommend a treatment plan that is right for you based on the results of your scans, biopsy and other test results. They may also suggest other treatments, like a targeted therapy or immunotherapy.
With advances in treatment, most cancers are now found and treated when they are very early, before symptoms develop. Supportive care helps to reduce the effects of a serious illness and its treatment on patients and their families. It is offered at various points in the cancer journey and can be given alongside curative and life-prolonging treatment.
The goal of supportive care is to improve quality of life, reduce side effects and improve comfort. It is important for people with colorectal cancer and their family members. It may include preventing and managing problems like pain, nausea and vomiting, fatigue, anxiety and depression. It can also be helpful in helping people come to terms with a diagnosis and plan for the future.
Most people with stage 0 colon cancer are asymptomatic (have no symptoms). If they have symptomatic disease, they usually get surgery and chemotherapy to treat their colon cancer. Chemotherapy is used to prevent the cancer from recurring after surgery and to decrease symptoms such as rectal bleeding and abdominal pain.
In some cases, the doctor may decide to take out only part of the colon (partial colectomy). This can be done if the colon cancer is not too large and there are no signs of spreading. In other cases, the doctor might need to remove more of the colon (full colectomy) if the colon cancer is larger or spread to the surrounding tissues.
To help with the planning of the next steps in your treatment, a test called a carcinoembryonic antigen (CEA) assay might be used. This test measures the amount of CEA in the blood, which is released by both healthy cells and cancer cells. If the level of CEA is high, this can be a sign that the cancer has spread to nearby lymph nodes or other organs.
