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Gynecology and Obstetrics
Endometrium Cancer
Endometrium cancer is a malignant tumor originating from the inner lining of the uterus (endometrium) and is commonly known as uterine cancer. It is frequently diagnosed in postmenopausal women.
ℹWhat is Endometrium Cancer?
Endometrium cancer originates from the endometrial layer that lines the inner surface of the uterus and renews itself every month with the menstrual cycle. Its development can be triggered by a disruption in the balance between the hormones estrogen and progesterone.
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Type 1 (Endometrioid): The most common type; it is associated with estrogen excess and generally has a better prognosis.
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Type 2 (Non-endometrioid): These include serous or clear cell types; they follow a more aggressive course.
Common Symptoms
Abnormal Vaginal Bleeding
The most typical symptom. Any bleeding after menopause should be investigated under suspicion of cancer until proven otherwise. In premenopausal individuals, it may appear as intermenstrual bleeding or menorrhagia (heavy periods).
Pelvic Pain
A feeling of fullness or pain in the lower abdominal region.
Vaginal Discharge
Pink, watery, or foul-smelling discharge.
Weight Loss and Fatigue
Usually a sign of systemic spread in advanced-stage patients.
Diagnosis Methods
Transvaginal Ultrasonography (TVUS)
Endometrial thickness is measured. Thickness >4-5 mm in postmenopausal women is suspicious.
Endometrial Biopsy
An intrauterine tissue sample is obtained with a thin pipette for histopathological examination.
Dilation and Curettage (D/C)
Uterine curettage for tissue sampling when biopsy is insufficient.
Pelvic MRI
The "gold standard" for staging which shows the depth of invasion and lymph node involvement.
Treatments
Surgical Treatment
The primary treatment. Hysterectomy with bilateral salpingo-oophorectomy is performed. Sentinel lymph node mapping identifies at-risk nodes. Applicable via robotic and laparoscopic techniques.
Radiotherapy
Vaginal brachytherapy or external beam radiotherapy to reduce recurrence risk after surgery.
Chemotherapy
Preferred in advanced or Type 2 disease. Carboplatin + Paclitaxel (Carbo-Taxol) is the most common regimen.
Hormonal Therapy
Used to block estrogen effects or balance with progesterone in hormone receptor-positive tumors.
Immunotherapy
Pembrolizumab or Dostarlimab for dMMR/MSI-H positive patients. Pembrolizumab + Lenvatinib combination for pMMR patients.