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Endometriosis Cancer


OVERVIEW OF Endometriosis Cancer :

The cancer or malignant cells forms in the endometrial tissues.


STRUCTURE of Endometriosis Cancer :

The endometrium is the lining of the uterus, a hollow, muscular organ in a woman’s pelvis.

The uterus is where a foetus grows.

In most nonpregnant women, the uterus is about 3 inches long.

The lower, narrow end of the uterus is the cervix, which leads to the vagina


EPIDEMIOLOGY :

Mostly it occurs in women who has crossed 50 years of age.


CAUSES :

  • Taking tamoxifen to prevent or treat breast cancer
  • obesity
  • Having metabolic disease
  • Having type 2 diabetes
  • Exposure of endometrial tissue to estrogen made by the body. This may be caused by:
    • Never giving birth.
    • menstrurating at an early age.
    • Starting menopause at a later age.
  • Having polycystic ovarian disease
  • Hypertension
  • Age greater than 50 years
  • Ovulation dysfunction
  • Having a family history of endometrial cancer in a first degree relative (mother, sister, or daughter).
  • Having certain genetic conditions such as Lynch disease
  • Having endometrial hyperplasia


COMMON CLINICAL SIGNS AND SYMPTOMS :

  • Vaginal bleeding or discharge not related to menstruation (periods).
  • Vaginal bleeding after menopause.
  • Difficult or painful urination
  • Pain during sexual intercourse.
  • Pain in the pelvic area.


DIAGNOSTIC :

The physician might look for your history to come into the conclusions. It might includes the type of cancer suspected, signs and symptom of the individual, age and general health of the individual, results of previous medical tests.

Pelvic examination:

     The physician palpate the uterus, vagina, ovaries and rectum to check for any possible findings.

PAP test:

A PAP test is done to check for endometrial cancer in which the cells are removed from the cancer site and it is stained.

Endometrial biopsy:

A biopsy is the removal of a small amount of tissue for examination under the microscope. Other test can suggest the cancer is present or not but only the biopsy makes the greater difference between them. The pathologist inserts the tube into the uterus through the cervix and the tissue is removed from the endometrium. After the women might have uterine bleeding and vaginal cramps. It is very accurate measurement for diagnosis for cancer.

Dilatation and curettage(D&C):

  • It is the procedure used to remove the sample from uterus. This procedure is done under aneasthesia. This  D&C procedure is done after the hysteroscopy so that the doctor can clearly view the lining of the uterus. During a hysteroscopy, the doctor inserts a thin, flexible tube with a light on it through the cervix into the vagina and uterus. After endometrial tissue has been removed, during a biopsy or D&C, the sample is checked by a pathologist for cancer cells, endometrial hyperplasia, and other conditions.

Transvaginal ultrasound:

  • Sound waves are used to create the pictures of internal organs.in an transvaginal ultrasound an ultrasound wand is inserted into the vagina.

Computed tomography (CT or CAT) scan:

  • A  CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

Magnetic resonance imaging:

  • It uses a specific xray to see the uterus images. It is mainly used to treat the early stages of cancer.

Molecular testing of the tumor:

 Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor.

The following is the stage of the endometrial cancer:

          Stage 1: The cancer is only present in the uterus.

  • Stage 2: The cancer is present in the uterus and cervix.
  • Stage 3: The cancer has spread outside the uterus, but not as far as the rectum or bladder. It might be present in fallopian tube, vagina, ovaries and lymph node.
  • Stage 4: The cancer has spread beyond the pelvic area. It might be present in the bladder, rectum, and/or distant tissues or organs.

 

 


TREATMENT AND PROGNOSIS :

Treatment of endometrial cancer:

Hysterectomy:

It is the procdure wherein surgeon removes the uterus,cervic and vagina.

Bilateral salphingo oophorectomy:

It is the procedure wherein the surgeon removes the fallopian tube along with the ovary.

Chemotherapy:

A chemotherapy is after the sugery or before the surgery to shrink the cancer cells. A chemotherapy is nothing but the delivery of drug intravenously

Radiation therapy:

It uses powerful x rays or emission of protons to destroy the cells. The radiation therapy also aids  in shrinkage of the cells and also relief the symptoms caused by the cancer.

Internal radiotherapy: the rays are focused inside the uterus , fallopian tube and ovaries.

External radiation: the rays are focused externally.

Immunotherapy

it is a drug treatment that uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells from recognizing the cancer cells. This immunotherapy boos those cells and helps the body to fight against it.

Hormonal therapy:

This therapy uses hormones to slow down the cancer process.


PROGNOSIS :

The 20 year survival rate f the patient with endometrial cancer is  is 80%

 


PREVENTION :

 

To reduce your risk of endometrial cancer, you may wish to:

  • Talk to your doctor about the risks of hormone therapy after menopause. If you're considering hormone replacement therapy to help control menopause symptoms, talk to your doctor about the risks and benefits. Unless you've undergone a hysterectomy, replacing estrogen alone after menopause may increase your risk of endometrial cancer. Taking a combination of estrogen and progestin can reduce this risk. Hormone therapy carries other risks, so weigh the benefits and risks with your doctor.
  • Consider taking birth control pills. Using oral contraceptives for at least one year may reduce endometrial cancer risk. The risk reduction is thought to last for several years after you stop taking oral contraceptives. Oral contraceptives have side effects, though, so discuss the benefits and risks with your doctor.
  • Maintain a healthy weight. Obesity increases the risk of endometrial cancer, so work to achieve and maintain a healthy weight. If you need to lose weight, increase your physical activity and reduce the number of calories you eat each day.
  • Maintain the healthy lifestyle.

 


Medicines used in the Treatment :

Cisplastin

Carboplantin

Paclitaxel

doxorubicin