Endometrial Cancer - Treatment, Symptoms, Causes
What is Endometrial Cancer?
Endometrial cancer is the general name for cancers that start in the uterus. Uterus, is the female reproductive organ, which is hollow and where the fetus completes its development. The lower part of the uterus ends with the part called the cervix and unites with the vagina. The uterus is located between the bowel (sigmoid colon) and the bladder. It is approximately 7.5 cm in size. The thickness of this organ is about 3 cm. It has three layers.
Endometrium: It is the innermost layer and is the functional part where the menstrual cycle develops. In addition, it is the part associated with the placenta, where the vascular structures that meet the oxygen and nutritional needs for the fetus during pregnancy develop. Uterine cancers most commonly develop from the endometrium layer, and therefore, when "uterine cancer" is mentioned, "endometrial cancer" is often meant and these two terms are used as synonyms. This article is about endometrial cancer in general.
Myometrium: The muscle layer of the uterus.
Perimetrium: It is the part of the uterus that covers the outer surface of the uterus like a sheet. It consists of a layer of the peritoneum.
Cancer that develops from the endometrium is the most common cancer of the female reproductive (gynecological) organs.
What are the Symptoms of Uterine Cancer?
75% of patients who develop uterine cancer are women over the age of 50 and in the menopausal period.
The most common symptom of endometrial cancer is vaginal bleeding. In case of bleeding between menstrual periods, bleeding again after menopause, and excessive bleeding during the menstrual period, you should definitely consult a doctor. Since bleeding is a complaint encountered in the early period, 75% of the patients are at an early stage at diagnosis and the 5-year survival rate of these patients is 90%.
Unusual Bleeding, Spotting, or Discharge in Endometrial Cancer
The most common sign of Endometrial cancer: on average 90% of patients diagnosed with uterine cancer have abnormal vaginal bleeding, such as a change in menstrual periods or bleeding between periods or after menopause. These symptoms may also occur from time to time in some noncancerous conditions. However, in such cases, it is important to have a doctor's control without delay. It would be beneficial for women who have gone through the menopause to share their vaginal bleeding, spotting or abnormal discharge with their doctor.
Bloodless vaginal discharge can also be a sign of endometrial cancer. The absence of blood in the discharge does not mean that you do not have cancer. About 10% of the discharge cases due to uterine cancer are bloodless. Any abnormal discharge that occurs should be checked by a doctor.
Uterine Cancer Surgery
In uterine cancer, the first option is to perform surgery in patients who do not have an obstacle to surgery in the preoperative examinations. Only 5-10% of patients are not suitable for surgery at diagnosis. In the rest, the operation is considered first. Uterine cancer surgery is important in terms of showing the extent of the disease. In the patient whose general condition is suitable for surgery, both ovaries (ovaries) and tubes (fallopian tubes) together with the uterus are removed by operation and the surrounding lymph nodes are removed during the operation.
Chemotherapy in Uterine Cancer
Chemotherapy with radiotherapy
The aim of chemotherapy given together with radiation therapy is to increase the effectiveness of the beam and reduce the possibility of spreading to the body. Platinum (cisplatin or carboplatin) group chemotherapy is used together with radiotherapy.
Preventive chemotherapy in high-risk disease
In uterine cancer, chemotherapy is usually given 4-6 weeks after surgery. The recovery period is expected to be completed. Preventive chemotherapy is preferred to be given as a combination of chemotherapy drugs once in 21 days. The most commonly preferred paclitaxel and carboplatin chemotherapy drugs are given together.
Chemotherapy in newly diagnosed metastatic disease
The concomitant use of paclitaxel and carboplatin chemotherapies, which are dual chemotherapy drugs, is the first treatment option in patients who have not received chemotherapy before. Other possible treatment options; It is the concomitant use of cisplatin, doxorubucin and paclitaxel triple drug. Although both treatment combinations are equal in terms of efficacy, paclitaxel-carboplatin combination regimen is more commonly preferred today because of less side effects.
The benefit rate of paclitaxel and carcarboplatin drug combination in newly diagnosed uterine cancer that has not received chemotherapy before, was evaluated as an average of 13 months for the disease to be under control, and an average life span of 37 months, and the rate of benefit from treatment was 51%.
Targeted Therapy – Smart Drugs
Some targeted therapies block the growth signal from reaching the cancer cell; some of them reduce the nutrition of the cancer cell through the blood, while others recognize and attack the cancer cells by strengthening the immune system.
