Endometrial Cancer / Uterine Cancer

When you develop cancer in your uterus, this condition doesn't only stand a chance of making you incapable of bearing children; it could also kill you. While uterine cancer only accounts for 6 percent of the instances of cancer that affect American women, this condition can be devastating to the women who experience it and their loved ones. To protect yourself against the dangers of endometrial cancer and uterine cancer, you'll need to learn more about these types of conditions, their causes, and their risk factors.

What are the Uterus and Endometrium?

The uterus is the organ in which a baby grows when you are pregnant. This organ is hollow, and it is usually relatively small. When you become pregnant, however, your uterus becomes much larger and also hosts the placenta, which is the organ that provides your fetus with nourishment. The uterus is divided into two parts:

  • Cervix: The cervix is the organ through which a baby is pushed during the birth process. It connects the uterus to the vagina.
  • Corpus: The corpus is the area where the baby livesin utero. It is the main part of the uterus.

The corpus of the uterus is divided into two layers. The endometrium is the permeable inner lining of the uterus, and this endometrial lining is where a fertilized egg comes to rest after it is released through the fallopian tubes. The myometrium is the outer muscular section of the uterus, and this part of the organ contracts to push a baby out during birth.

During the initial stages of a woman's menstrual cycle, the ovaries release estrogen into the uterus, which causes the endometrium to thicken and prepare itself to receive an egg. If a fertilized egg is not released into the uterus, the ovaries start sending progesterone into this reproductive organ, which causes the uterus to shed the endometrium. This fertile inner layer is then excreted through the cervix and vagina during the cumulative stages of the menstrual process. 

What Is Uterine Cancer?

If cancer cells begin growing in the muscular myometrium, this type of condition is referred to as uterine cancer. This type of cancer is relatively rare, and the technical term for uterine cancer is "uterine sarcoma." There are a few different types of uterine sarcomas, and examples of these cancer subtypes include leiomyosarcomas and endometrial stromal sarcomas. While these cancers begin in the myometrium, they can quickly spread to other parts of the uterus and the surrounding tissues.

What Is Endometrial Cancer?

If you develop cancer in your uterus, chances are that you have a form of endometrial cancer. Cancer cells are much more likely to appear in the permeable endometrium than in the relatively solid myometrium, and cancers that appear in the endometrium are called endometrial carcinomas. While these cancers all have their origin in the endometrium, different types of endometrial carcinomas take on very different appearances under the microscope. Depending on the results of your biopsy, your doctor may inform you that you have one of the following types of endometrial carcinomas:

  • Squamous cell carcinoma
  • Small cell carcinoma
  • Transitional carcinoma
  • Adenocarcinoma
  • Carcinosarcoma
  • Undifferentiated carcinoma

Out of all of the different types of carcinomas that can appear in your endometrium, adenocarcinoma is, by far, the most common. In addition, there are various types of adenocarcinomas, and endometrioid cancer is the most common of these further subtypes. These types of carcinomas can be relatively difficult to diagnose because they look very similar to the healthy tissues that surround them, but they are often accompanied by squamous cells, which are telltale signs of cancer that look very different from healthy cells.

Some types of endometrioid cancers, such as clear-cell carcinoma, mucinous adenocarcinoma, and papillary serous adenocarcinoma are much more aggressive than other types of conditions within this subclass, and they spread very quickly. The best way to determine which subtype of endometrial cancer you have after you've received a diagnosis is to perform a biopsy or an investigative surgery.

What Are the Symptoms of Uterine Cancer and Endometrial Cancer?

In some cases, endometrial or uterine cancer may not cause any noticeable symptoms for quite some time. If you have a history of irregular or painful menstrual periods, for instance, you may not recognize the symptoms of these conditions among the usual symptoms that you experience when you menstruate. However, if you experience any of the following symptoms, you should check in with your doctor right away:

  • Vaginal bleeding between periods: If you are healthy, you will only discharge blood from your vagina during your normal menstrual period or after giving birth. However, if your vagina starts discharging blood between periods and you don't experience any other symptoms of menstruation, you may have uterine or endometrial cancer.
  • Vaginal bleeding after menopause: After you go through menopause, you will only discharge blood out of your vagina if something is wrong.
  • Abnormal vaginal discharge: If you start noticing a persistent vaginal discharge that is watery or blood-tinged, you should consult with a doctor immediately.
  • Pelvic or abdominal pain: Uterine and endometrial cancer may be indicated by pain in your pelvis. In most cases, pelvic pain is caused by cervical cancer, but pain higher in your abdominal area may be a sign of uterine or endometrial cancer.

What Causes These Types of Cancers?

While the exact causes of uterine and endometrial cancers are unknown, scientists suspect that hormonal issues may cause these conditions under some circumstances. For instance, the hormones estrogen and progesterone are responsible for maintaining the delicate balance of nutrients and tissues within the endometrium, and if this hormonal balance shifts, it's possible that cancerous growths could ensue.

For instance, if increased levels of estrogen cause the endometrium to thicken without there being a corresponding increase in progesterone, the likelihood of developing endometrial cancer appears to increase. With this apparent correlation in mind, it's important to point out that the environment is becoming increasingly flooded with xenoestrogens, which are unnatural sources of estrogen that come from outside the human body.

Xenoestrogens are sometimes called estrogen mimickers because they are often not exact chemical replicas of estrogen. However, your body believes that these external sources of estrogen are identical to the estrogen that it produces, and increased levels of estrogen in either males or females can cause serious medical complications. Xenoestrogens are increasingly prevalent in skin care products, industrial products, and even food, and common pesticides, such as atrazine, are also xenoestrogens. 

Atrazine, in particular, finds its way into the water supply quite commonly, and it's possible that these foreign estrogens are causing women to develop uterine and endometrial cancers at an increasing rate. Unfortunately, no scientific consensus has been reached regarding the role that xenoestrogens may play in the development of reproductive cancer in women.

What Are the Risk Factors for Uterine Cancer and Endometrial Cancer?

A variety of factors may make you more at risk of developing either uterine or endometrial cancer:

  • Age: The vast majority of cases of endometrial cancer occur in women who are over 60 years old. If you fall into this age group, you are much more likely to develop some form of uterine cancer.
  • Hormone Replacement Therapy (HRT): Some women choose to use HRT to alleviate the symptoms of menopause. However, if your doctor doesn't perfectly calibrate the levels of hormones that are introduced into your system, you could experience a hormonal imbalance that leads to the development of cancer.
  • Late menopause: If you go through menopause later than average, you may be at a greater risk of developing endometrial cancer due to your extended exposure to estrogen.
  • Early menstruation: Since exposure to estrogen has been linked to the development of endometrial and other uterine cancers, if you started menstruating earlier than other girls, you are more at risk of developing these conditions.
  • Hormonal imbalance: A variety of conditions can cause your hormonal levels to fluctuate. For instance, if you have polycystic ovarian syndrome or benign growths in your endometrium, the hormones in your uterus might be out of whack. In addition, a type of drug called tamoxifen is sometimes used to treat breast cancer, and this artificial hormone can also cause your hormonal system to be imbalanced.
  • Obesity: Scientific research has determined that you are two to four times more likely to develop endometrial cancer if you are overweight or obese. Some researchers believe that fatty tissues release more estrogen than other tissues, which could be the underlying cause of this trend.
  • Diabetes: Diabetes can independently cause endometrial and uterine cancer whether or not you are overweight or obese.

How Do Doctors Determine the Grade of Your Cancer?

Your oncologist may determine the grade of your endometrial cancer to find out whether or not it is likely to spread. In oncology, the grade of this type of cancer is determined by how many of the cancer cells in your tumor display the glands that are usually found on healthy endometrial cells. For instance, at least 95 percent of the cells in grade 1 endometrial cancer display glands, and endometrial tumors that display between 50 and 94 percent glandular cells are considered grade 2.

If your endometrial tumors are grade 1 or grade 2, you have type 1 endometrial cancer. This type of cancer is not very aggressive, and it is unlikely to spread to other tissues over a short period of time. Type 1 endometrial cancer is generally easy to treat, and you will usually have a good prognosis if a doctor determines that you have this type of cancer.

Grade 3 tumors, on the other hand, display less than 50 percent glandular cells, and if you have a grade 3 tumor, your doctor will diagnose you with type 2 endometrial cancer. This type of cancer is much more likely to spread outside of your uterus, and if you have type 2 endometrial cancer, it's unlikely that your prognosis will be optimistic.

Unlike type 1 endometrial cancer, it doesn't appear that type 2 endometrial cancer is caused by exposure to estrogen. Your doctor will take a more aggressive approach if you have this type of endometrial cancer, and surgery may or may not be useful in this application.

How Are Endometrial and Uterine Cancer Diagnosed?

To determine whether or not you have either endometrial cancer, uterine cancer, or both, your doctor will perform a number of tests as part of a physical exam:

  • Pelvic exam: Your doctor will begin with a pelvic exam. They will feel your pelvic organs in an attempt to detect the presence of a tumor.
  • Pap smear: While a pap smear isn't always effective in detecting these types of cancer, your doctor will still use this test, which checks for atypical cells in your cervix and vagina.
  • Ultrasound: Your doctor may also order an ultrasound to get a more detailed picture of what's going on inside of your uterus.
  • Biopsy: When your doctor takes a biopsy, they remove a tiny sample of tissue from a certain area of your body. In most cases, your doctor will use a small needle to remove a biopsy from your endometrium or uterus to test it for cancer cells.

How Do You Treat These Cancers?

If you develop any form of uterine cancer, your oncologist will most likely recommend a hysterectomy, which is the removal of the uterus. Your surgeon may also remove your ovaries and fallopian tubes, and once your surgery is complete, your oncologist will also recommend that you use radiation therapy and chemotherapy. Under certain circumstances, hormone therapy may also be recommended to increase your progesterone levels if your uterine or endometrial cancer is at an advanced stage.

Can You Reduce Your Risk of Developing These Cancers?

You'll have the best prognosis if a doctor diagnoses your endometrial or uterine cancer in its early stages. Make sure that you schedule a pap smear and a pelvic exam with a gynecologist at least once per year, and remember that any exposure to xenoestrogens can increase your risk of developing cancer in your uterus. If you are especially at risk for endometrial or uterine cancer, your doctor may want to perform pelvic exams and pap smears more than once per year.

According to some research, taking birth control pills may decrease your risk of developing endometrial cancer. Under ideal circumstances, birth control pills will balance your estrogen and progesterone levels. However, birth control pills may also cause side effects, and they may actually imbalance your hormonal system.

Contacting an Endometrial Cancer / Uterine Cancer Specialist Near Me

When dealing with or having symptoms of cancer it is important to meet with a specialist who is one of the premier doctors in the field. The right doctor will not only help you diagnose the problem but more importantly lead you through the right treatment for your specific case. Endometrial Cancer and Uterine Cancer are nothing to take lightly and it is crucial to have a specialist and team such as GYN LA to support you through this difficult time. We are always available to take on new patients who need our help and implore you to contact us at the first sign of any troubles. Please contact us at 310-375-8446 to schedule your consultation with our gynecological doctor.