Frequently Asked Questions About Endometrial Cancer
Q. What are the risk factors for endometrial cancer?
A. A risk factor is anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. The ovaries normally produce two main types of female hormones - estrogen and progesterone. The balance between these two hormones changes each month, producing a woman's monthly periods and helping to keep the endometrium healthy. When the balance of these two hormones shifts toward relatively more estrogen, a woman's risk for developing endometrial cancer increases. Many, but not all, of the known risk factors for endometrial cancer (such as early menarche, late menopause, infertility and obesity) are believed to be related to changes in hormone balance that increase a woman's risk for developing endometrial cancer.
Q. Do we know what causes endometrial cancer?
A. We do not know what causes most cases of endometrial cancer, but we do know many of the risk factors. A great deal of research is under way to learn more about the disease. Most known risk factors affect the balance between estrogen and progesterone in the body. Scientists have recently learned much about changes in the DNA of certain genes that occur when normal endometrial cells become cancerous.
Q. Can endometrial cancer be found early?
A. In most cases, being alert to any signs and symptoms of endometrial cancer and discussing them promptly with your healthcare provider permits diagnosis at an early stage. Unfortunately, some endometrial cancers may reach an advanced stage before recognizable signs and symptoms are present. Early detection improves the chances that your endometrial cancer will be treated successfully. Signs and symptoms of endometrial cancer include unusual bleeding, spotting or other discharge, and/or pelvic pain, feeling a mass in the abdomen of unexplained weight loss.
Q. How is endometrial cancer treated?
A. The choice of treatment depends largely on the type of cancer and stage of the disease at discovery. Other factors might play a part in choosing the best treatment plan. These might include your age, your overall state of health, whether you plan to have children, and other personal considerations. Be sure you understand all the risks and side effects of the various therapies before making a decision about treatment. There are four basic types of treatment for women with endometrial cancer - surgery, radiation therapy, hormonal therapy and chemotherapy. A combination of these treatments may also be used. Most patients with endometrial cancer are treated by surgery alone, which includes a hysterectomy (removal of the uterus and cervix) and removal of the ovaries and Fallopian tubes. The choice of treatment(s) will depend on the type and stage of your cancer, and your overall medical condition.
Q. What should you ask your physician about endometrial cancer?
A. It is important for you to have honest, open discussions with your physician. You should ask questions, no matter how trivial you may think they are. Some questions to consider:
- What type and grade of endometrial cancer do I have?
- Has my cancer spread beyond the uterus?
- What is the stage of my cancer and what does that mean in my case?
- What treatments are appropriate for me? What do you recommend? Why?
- What should I do to be ready for treatment?
- What risks or side effects should I expect?
- What are the chances of recurrence of my cancer with the treatment programs we have discussed?
- Should I follow a special diet?
- Will I be able to have children after my treatment?
- What is my expected prognosis, based on my cancer as you view it?
- Does this cancer prevent me from considering estrogen-replacement therapy?
- How can I preview disease recurrence?
Q. What's new in endometrial cancer research and treatment?
A. Molecular pathology of endometrial cancer: Recent research has improved our understanding of how changes in certain molecules can cause normal endometrial cells to become cancerous. It has been known for several years that mutations (damage or defects) to DNA can alter important genes that regulate cell growth. If these genes are damaged, excess growth may result in cancer formation. Sometimes, endometrial cancer and colon cancer may seem to "run in a family." We now know that some of these families have a higher risk for these cancers because their members have inherited a defect in certain genes that normally help repair damage to DNA. Molecular analysis of endometrial cancer may provide a new avenue for detection, prevention, or new therapeutic strategies.
Tumor markers: Molecules released by cancer cells can help detect recurrence of some types of cancer. Recent studies find that certain blood tests may also be helpful in detecting recurrent endometrial cancer, before tumor deposits are visible by imaging studies such as computed tomography (CT scans) or magnetic resonance imaging (MRI) scans.
Chemotherapy: Newer anticancer drugs appear promising for treating metastatic endometrial cancer.