Endometrial cance_PTP

Although “endometrial cancer” is one of the common gynecological cancers, especially in postmenopausal women, in practice, there is still limited understanding of this disease among the general public. This results in many overlooking abnormal symptoms or warning signs, leading to diagnosis at an advanced stage. Having a basic understanding of this disease is therefore a key to monitoring, preventing risks, and helping detect the disease at an early stage.
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<h2>What is endometrial cancer?</h2>
The endometrium is the tissue lining the inside of the uterine cavity. It consists of layers of epithelial cells that change throughout the menstrual cycle under the influence of female sex hormones, especially estrogen and progesterone, to prepare for embryo implantation in case of fertilization. If pregnancy does not occur, this lining sheds as menstruation, which is a natural process in women of reproductive age.
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<h2>What causes endometrial cancer and who is at risk?</h2>
Endometrial cancer occurs when the cells of the endometrium grow abnormally and continuously, with excessive cell division. These cells can spread outside the uterus and to other parts of the body, developing into malignant tumors. In the early stages, the cancer may be confined to the uterus, but if not diagnosed or treated promptly, cancer cells can spread to adjacent organs such as the cervix, ovaries, fallopian tubes, or metastasize to lymph nodes and other organs through the bloodstream and lymphatic system.
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Epidemiological data indicate that endometrial cancer is common in women aged 50 and above or postmenopausal women. Knowing these risk factors helps you assess your own risk and seek timely screening.
<ul>
<li>Older age, especially women aged 50 and above or those in the postmenopausal period.</li>
<li>Being overweight or obese, which results in higher than normal estrogen levels in the body.</li>
<li>Use of hormone replacement therapy in menopause with estrogen alone without progesterone (Unopposed Estrogen Therapy), which stimulates thickening of the endometrium and increases cancer risk.</li>
<li>Chronic anovulation, such as in patients with polycystic ovary syndrome (PCOS), who have high estrogen levels but insufficient progesterone.</li>
<li>Early onset of menstruation or late menopause and prolonged absence of menstruation. Having a longer continuous menstrual cycle increases the time the endometrium is exposed to estrogen more than usual.</li>
<li>Infertility or never having been pregnant may cause continuous estrogen stimulation of the endometrium without interruption, unlike during pregnancy when progesterone levels are higher.</li>
<li>Certain chronic diseases such as diabetes, insulin resistance, and hypertension, often associated with obesity, which may cause hormonal imbalance.</li>
<li>Use of Tamoxifen, which is used in breast cancer patients and may increase the risk of endometrial cancer.</li>
</ul>
<ul>
<li>A family history of direct relatives with endometrial cancer or certain genetic disorders such as Lynch syndrome, a genetic condition that increases the risk of colorectal cancer and other cancers, including endometrial cancer.</li>
</ul>
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<h2>Warning signs of endometrial cancer that every woman should not ignore</h2>
Endometrial cancer can be detected early, so you should see a doctor promptly if you experience any of the following symptoms:
<ul>
<li>Abnormal vaginal bleeding, which is the most important symptom, especially bleeding after menopause, whether spotting or heavy bleeding, including bleeding between periods in premenopausal women.</li>
<li>Excessive or prolonged menstrual bleeding in premenopausal women.</li>
</ul>
<ul>
<li>Chronic lower abdominal pain, dull pain, or lower abdominal pain accompanied by abnormal vaginal bleeding.</li>
</ul>
<ul>
<li>Abnormal vaginal discharge, such as blood-tinged, foul-smelling, or mucous with blood.</li>
<li>Other symptoms that may occur in advanced stages include pain during intercourse, frequent urination or pain during urination, unexplained weight loss, palpable abdominal mass or abnormal abdominal enlargement, fatigue, easy tiredness, or anemia due to chronic blood loss from abnormal vaginal bleeding.</li>
</ul>
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<h2>Endometrial cancer screening is not as scary as you think</h2>
If you are at risk or have the abnormal symptoms mentioned, you should see a gynecologist for screening. Early detection increases the chance of a cure. The doctor will consider appropriate tests as follows:
<ul>
<li style="font-weight: 400">Medical history taking physical examination, and pelvic exam to assess the uterus and adjacent organs.</li>
<li style="font-weight: 400">Transvaginal ultrasound is an initial screening test for uterine abnormalities. The doctor inserts a small probe into the vagina to visualize the uterine cavity, uterus, and ovaries, helping to assess the thickness of the endometrium and detect tumors or other abnormalities clearly. This procedure is simple and painless. If abnormalities are found, the doctor will consider further tests as appropriate.</li>
<li style="font-weight: 400">Endometrial biopsy is a procedure to collect endometrial tissue for pathological examination. Generally, anesthesia is not required, making it safe and less frightening than many fear.</li>
<li style="font-weight: 400">Dilatation and Curettage (D&amp;C) is a procedure that dilates the cervix and scrapes tissue from the uterine wall for laboratory examination. It is usually used when a biopsy sample cannot provide a definitive diagnosis or there are other indications such as severe abnormal bleeding or suspicion of other uterine abnormalities. This procedure is generally performed under anesthesia.</li>
</ul>
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<h2>Hysteroscopy </h2>
This involves using a camera inserted directly into the uterine cavity, allowing clear visualization of abnormalities inside the uterus. It can also be used to surgically remove polyps, tumors, and treat uterine abnormalities precisely, enhancing diagnostic accuracy and tissue sampling.
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<h2>Treatment guidelines for endometrial cancer</h2>
There are various treatment methods for endometrial cancer. Doctors will consider the stage of the disease, cancer cell type, overall health of the patient, and patient preferences. The main treatment approaches are as follows:
<ul>
<li style="font-weight: 400">Surgery is the primary and most important treatment. The doctor will remove the uterus, ovaries, and fallopian tubes entirely and may consider removing pelvic lymph nodes to better stage the disease and remove as many cancer cells as possible. Surgery can be performed via open abdominal surgery or laparoscopy, depending on suitability.</li>
<li style="font-weight: 400">Radiation therapy uses high-energy radiation to destroy remaining cancer cells after surgery or, in some cases where surgery is not possible, as the main treatment to control the disease and relieve symptoms. This includes vaginal brachytherapy, implant radiation, and external beam radiation depending on the disease stage.</li>
<li style="font-weight: 400">Hormone therapy is used in hormone-responsive cancers, especially in early-stage patients who are suitable and wish to preserve fertility, or in some patients with recurrent cancer.</li>
<li style="font-weight: 400">Chemotherapy is often used when cancer has spread beyond the uterus, in certain cell types, or in aggressive cancers to control cancer cell growth and reduce recurrence risk.</li>
<li style="font-weight: 400">Targeted Therapy uses drugs targeting abnormal mutated genes, given after surgery combined with chemotherapy or in some cases of recurrence.</li>
<li style="font-weight: 400">Combined Therapy considers using multiple treatment methods together, tailored to each patient’s condition.</li>
</ul>
After completing treatment, patients must follow up with their doctors regularly to evaluate treatment outcomes, chances of cure, and monitor for recurrence.
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<h2>Early detection and treatment increase survival chances from endometrial cancer</h2>
Endometrial cancer is a silent threat that every woman should be aware of. While there is no need to be overly anxious, vigilance and attention to abnormal body signs, especially in those with risk factors, are important. Regular screening and self-care will help you manage this disease promptly.
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At Phyathai Phaholyothin Hospital we have a specialized gynecologic oncology team equipped with modern medical tools and technology, providing services from initial screening, accurate diagnosis, to treatment planning tailored to each patient for the best outcomes.
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Do not neglect your health because “Endometrial cancer… if detected early, can be treated.” Let us be part of your healthcare team.

Understanding &quot;endometrial cancer&quot; covers every aspect, from the definition of the disease, causes and mechanisms of its occurrence, symptoms and warning signs that should not be overlooked, risk factors to watch out for, screening methods you should know, and appropriate treatment guidelines to increase the chances of cure and recovery.

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Endometrial cancer warning signs: a cancer that women should not ignore. Find out early and get treatment in time.

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