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Endometrial CancerBy Jamie LoberIt is important to know thefacts on endometrial cancer,sometimes referred toas uterine cancer. “Endometrialcancer is the most commongynecologic cancer inwomen accounting for aboutforty thousand cases eachyear,” informs Dr. Dwight Im,Director for The GynecologicOncology Center at MercyHospital in Baltimore. Thisoccurs when there is a thickeningof the uterine liningor excess of estrogen. “It isa case of having too much ofa good thing turn into a badthing,” says Im.If you are in tune to yourbody, you can detect endometrialcancer in its earliestand most curable stage.“Luckily, once the uterine liningbecomes thicker it givesyou a little warning signwhich is bleeding. This iswhy three quarters of endometrialcancers are typicallydetected in stage one whenit is more than ninety percentcurable,” tells Im. Theamount of blood is not indicativeof the seriousness ofthe cancer. “There is no correlationbetween the amountof bleeding and the degree ofcancer, so you can have a badcancer and only a little bit ofspotting,” explains Im. Anynew discharge from the vaginashould also be reportedto your gynecologist.Focus on the factors youcan control. “Obesity is amajor risk factor becauseyour body turns cholesterolinto estrogen and most of thework is done by your adrenalgland but fat cells also havethe capability of turningcholesterol into estrogen,”explains Im. Estrogen is ahormone produced by theovaries and may be takenby postmenopausal womenvia hormone therapy. It isimportant that hormonetherapy has estrogen andprogesterone because whentaken alone, estrogen canheighten the risk of endometrialcancer. According to theAmerican College of Obstetricsand Gynecology, otherrisk factors are irregularmenstrual periods, startingmenstrual periods before agetwelve, late menopause, infertility,never childbearing,personal history of ovarianor colon cancer, diabetes, hypertension,thyroid disease,smoking and use of tamoxifento prevent or treat breastcancer.Diagnosis is made in thegynecologist’s office. “It iscalled an endometrial biopsyand is usually a little moreinvolved than a pap smear,”describes Dr. Sarah Temkin,gynecologic oncologistat University of MarylandMarlene and Stewart GreenbaumCancer Center. A littletissue is removed from theuterine lining and evaluatedfor abnormal cells. A vaginalultrasound is sometimesused to determine the thicknessof the uterine lining andthe size of the uterus.Perimenopausal women,or women who are in theirmid to late forties and arestill menstruating occasionally,should put extra efforttoward listening to theirbodies. “If you miss a fewmonths and have a periodthat is heavier than a normalperiod, that is abnormal andyou should be checked outfurther. A period after skippinga few months shouldnever be heavier than a typicalperiod for that patient.This is how you miss cancer,”says Im.Typical treatment is a hysterectomy.“We can occasionallytreat young women whowant to get pregnant medicallyby giving them progesteronewhich is an antagonistof estrogen that makesthe lining thinner and canpotentially reverse all theeffects,” shares Im. For thosewho are candidates, there isanother alternative. “Overthe last few years, surgerycan be performed robotically,”reveals Temkin. Althoughthe cancer is in the uterus,some women choose to havetheir ovaries removed sincethere is an increased risk ofovarian cancer. Based on thestage of the disease, whichis determined during surgery,radiation is sometimesoffered to stop the growthof the cancer cells. Followupvisits are recommendedevery few months for at leastseveral years after diagnosis.Studies provide moreinformation about thiscondition. “There is a proportionatelink of women with24 Focus on Women Magazine