Endometrial cancer refers to several types of malignancy which arise from the endometrium, or lining of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States, with over 35,000 women diagnosed each year in the U.S. The most common subtype, endometrioid adenocarcinoma, typically occurs within a few decades of menopause, is associated with excessive estrogen exposure, often develops in the setting of endometrial hyperplasia, and presents most often with vaginal bleeding. Endometrial carcinoma is the third most common cause of gynecologic cancer death (behind ovarian and cervical cancer). A total abdominal hysterectomy (surgical removal of the uterus) with bilateral salpingo-oophorectomy is the most common therapeutic approach.
Endometrial cancer may sometimes be referred to as uterine cancer. However, different cancers may develop not only from the endometrium itself but also from other tissues of the uterus, including cervical cancer, sarcoma of the myometrium, and trophoblastic disease.
Classification
Most endometrial cancers are carcinomas (usually adenocarcinomas), meaning that they originate from the single layer of epithelial cells which line the endometrium and form the endometrial glands. There are many microscopic subtypes of endometrial carcinoma, including the common endometrioid type, in which the cancer cells grow in patterns reminiscent of normal endometrium, and the far more aggressive uterine papillary serous carcinoma|papillary serous carcinoma and clear cell endometrial carcinomas. Some authorities have proposed that endometrial carcinomas be classified into two pathogenetic groups:
* Type I: These cancers occur most commonly in pre- and peri-menopausal women, often with a history of unopposed estrogen exposure and/or endometrial hyperplasia. They are often minimally invasive into the underlying uterine wall, are of the low-grade endometrioid type, and carry a good prognosis.
* Type II: These cancers occur in older, post-menopausal women, are more common in African-Americans, are not associated with increased exposure to estrogen, and carry a poorer prognosis. They include:
* the high-grade endometrioid cancer,
* the uterine papillary serous carcinoma,
* the uterine clear cell carcinoma.
In contrast to endometrial carcinomas, the uncommon endometrial stromal sarcomas are cancers which originate in the non-glandular connective tissue of the endometrium. Uterine carcinosarcoma,formerly called Malignant mixed müllerian tumor, is a rare uterine cancer which contains cancerous cells of both glandular and sarcomatous appearance - in this case, the cell of origin is unknown.
Signs and symptoms
*Vaginal bleeding and/or spotting in postmenopausal women
* Abnormal uterine bleeding, abnormal menstrual periods
* Bleeding between normal periods in premenopausal women in women older than 40: extremely long, heavy, or frequent episodes of bleeding (may indicate premalignant changes)
* Anemia, caused by chronic loss of blood. (This may occur if the woman has ignored symptoms of prolonged or frequent abnormal menstrual bleeding.)
* Lower abdominal pain or pelvic cramping
* Thin white or clear vaginal discharge in postmenopausal women.
Risk factors
# high levels of estrogen
# endometrial hyperplasia
# obesity
# hypertension
# polycystic ovary syndrome
# nulliparity (never having carried a pregnancy)
# infertility (inability to become pregnant)
# early menarche (onset of menstruation)
# late menopause (cessation of menstruation)
# endometrial polyps or other benign growths of the uterine lining
# diabetes
# Tamoxifen
# hyperplasia
# high intake of animal fat
# pelvic radiation therapy
# breast cancer
# ovarian cancer
# heavy daily alcohol consumption (possibly a risk factor)
-References From Wikipedia-