Causes, factors and ways to prevent endometrial cancer

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Article by Doctor Specialist I Nguyen Thi Minh Thuyen - Pathologist - Laboratory Department - Vinmec Danang International General Hospital
Endometrial cancer is a dangerous disease and currently tends to be younger in women. Knowing the causes and ways to prevent them will help you be more proactive in reducing the risk of disease.

1. Risk factors for endometrial cancer

A risk factor is anything that increases your chances of getting a disease like cancer. Different cancers have different risks. Some risk factors, like smoking or sun exposure, can be modified. Other factors, like old age or family history, cannot be changed.
Although certain factors can increase the risk of endometrial cancer, they are not always the cause. Many women with risk factors never develop endometrial cancer.
Some women with endometrial cancer do not have any risk factors. Currently, there are many factors that affect the risk of endometrial cancer, including:
Obesity Hormonal factors: estrogen use after menopause, oral contraceptives or tamoxifen, number of menstrual cycles ( throughout life), pregnancy, some ovarian tumors and polycystic ovary syndrome IUD use Age Diet and exercise Type 2 diabetes Family history (having a close relative with endometrial or colorectal cancer) History of breast or ovarian cancer History of endometrial hyperplasia Contraceptives and IUD use are associated with a lower risk of endometrial cancer, while other factors are associated with a higher risk.

2. Diagnosing the risk of endometrial cancer

2.1 Signs and symptoms There are a few symptoms that can indicate endometrial cancer. Some of the more common symptoms as the cancer progresses (grows and spreads)
Unusual vaginal bleeding, spotting, or other discharge About 90% of women with endometrial cancer have vaginal bleeding abnormal . It could be a change in menstrual cycle, bleeding between periods or after menopause. Noncancerous problems can also cause abnormal bleeding. But it's important to have a doctor check for any abnormal bleeding as soon as possible. If you've passed menopause, it's especially important to report any vaginal bleeding, or unusual discharge, to your doctor.
Pelvic pain, a lump and weight loss Pain in the pelvis, feeling a mass (tumor) and unintentional weight loss can also be symptoms of endometrial cancer. These symptoms are more common in the later stages of the disease. However, any delay in seeking medical help may further progress the disease. This reduces the success rate of treatment.
Although any of these symptoms can be caused by causes other than cancer, it is important to see a doctor.

2.1 Signs and symptoms There are a few symptoms that can indicate endometrial cancer. Some of the more common symptoms as the cancer progresses (grows and spreads)
Unusual vaginal bleeding, spotting, or other discharge About 90% of women with endometrial cancer have vaginal bleeding abnormal . It could be a change in menstrual cycle, bleeding between periods or after menopause. Noncancerous problems can also cause abnormal bleeding. But it's important to have a doctor check for any abnormal bleeding as soon as possible. If you've passed menopause, it's especially important to report any vaginal bleeding, or unusual discharge, to your doctor.
Pelvic pain, a lump and weight loss Pain in the pelvis, feeling a mass (tumor) and unintentional weight loss can also be symptoms of endometrial cancer. These symptoms are more common in the later stages of the disease. However, any delay in seeking medical help may further progress the disease. This reduces the success rate of treatment.
Although any of these symptoms can be caused by causes other than cancer, it is important to see a doctor.
2.2 Endometrial cancer screening and testing Endometrial cancer is usually diagnosed after a woman presents with symptoms.
Medical history and physical examination If there are any signs of endometrial cancer, you should see your doctor right away. Your doctor will ask about your symptoms, risk factors, and medical history, as well as a general and gynecological exam.
Ultrasound Ultrasound is usually one of the first tests done to look at the uterus, ovaries, and fallopian tubes in women who may have gynecological problems. Pelvic ultrasound requires drinking plenty of water before the test to get a clearer picture.
Transvaginal ultrasonography (TVUS) often provides a better view of the uterus, may show uterine fibroids or endometrium that is thicker than normal, which may be a sign of endometrial cancer, and can also help see if cancer is growing into the muscle layer of the uterus
Ultrasound can also see endometrial polyps, measure the thickness of the endometrium and can help doctors pinpoint Identify the area they want to biopsy.

Endometrial tissue sample To find out exactly what type of endometrial change is, the doctor must take some tissue for the pathologist to examine and look at under a microscope. Endometrial tissue can be obtained with endometrial biopsy or curettage with or without hysteroscopy.
Endometrial biopsy Endometrial biopsy is the most common test for diagnosing endometrial cancer and is very accurate in postmenopausal women. A very thin, mobile tube is inserted into the uterus through the cervix, suctioning a small amount of the endometrium through the tube. A local anesthetic of the cervix may be used to relieve pain.
Hysteroscopy The doctor places a small scope through the cervix. The uterus is filled with saline to get a better look at the lining of the uterus, allowing the doctor to look for and biopsy any unusual lesions, such as cancer or polyps. Hysteroscopy is usually under local anesthesia.
Dilation and curettage If the endometrial biopsy specimen is insufficient or if the biopsy results are inconclusive, dilation and curettage must be performed. The cervix is ​​dilated and a special instrument is used to scrape the tissue inside the uterus, with or without hysteroscopy. This procedure may require general anesthesia or local anesthesia of the cervix or spine.
Endometrial tissue test Samples of endometrial tissue are removed and then processed and viewed under a microscope to see if cancer is present. If cancerous, the pathology report will tell you what type of endometrial cancer is (such as endometrial or clear cell) and how much histology is (grades 1, 2, and 3). 3 based on how much it looks like a normal endometrium). Women with low-grade cancer are less likely to have cancer in other organs and are less likely to recur after treatment.
Test for changes in genes and proteins in cancer cells If your doctor suspects hereditary non-polyposis colon cancer (HNPCC) is the cause of endometrial cancer, tumor cells can be checked for changes proteins and genes, which may include:
Protein mismatch repair (MMR) Defect in mismatch repair gene (dMMR) DNA changes (satellite instability or MSI-H) If changes are present protein or DNA, your doctor may recommend genetic testing for the genes that cause HNPCC.
2.3 Tests for cancer spread If your doctor suspects the cancer has progressed, you will probably have to do other tests to look for the spread of the cancer.
Chest X-ray A chest X-ray may be done to see if the cancer has spread to the lungs.
Computed tomography (CT) CT is not used to diagnose endometrial cancer, but can help see if the cancer has spread to other organs and has come back after treatment.

Magnetic resonance imaging (MRI) MRI helps to assess how far endometrial cancer has invaded into the uterine muscle.
MRI is also useful for viewing the brain and spinal cord.
Positron emission tomography (PET) This test can help detect small lesions of cancer cells, combined with CT to more accurately identify areas of spread of cancer, often used for advanced cancer cases.
Cystoscopy and proctoscopy If cancer is suspected to have spread to the bladder or rectum, the doctor will look inside these organs to look for cancer, which can then give birth Suspicious tissue samples. These tricks have been applied a lot in the past, but are now very rarely used.
2.4 Blood tests Complete blood count Endometrial cancer can cause bleeding, which can lead to a low red blood cell count (anemia).
CA-125 blood test CA-125 is a substance that is released into the bloodstream in many (but not all) endometrial and ovarian cancer patients. If a woman has endometrial cancer, very high levels of CA-125 in the blood indicate the cancer has likely spread beyond the uterus. Some doctors test CA-125 levels before surgery or other treatment. If elevated, they can be retested to assess the effectiveness of treatment (the level will decrease after surgically removing all of the cancer).
CA-125 levels are not needed to diagnose endometrial cancer, so this test is not performed on all patients.
Vinmec International General Hospital is the first private hospital to achieve JCI global medical certificate, Vinmec always brings the best cancer screening and treatment services to customers, including cancer. Endometrial endometriosis with:
Top modern and advanced machine system The laparoscopic surgery methods are performed by a team of highly skilled doctors, providing good treatment effect while still ensuring the accuracy of the treatment. Aesthetics Always update the most optimal and effective methods in screening and treatment of endometrial cancer: cancer screening through genetic testing, robotic surgery with a success rate of up to 95%. Thanks to good medical quality, customers can completely trust the results of examination and treatment at the hospital.

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