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Endometrial Cancer
Late-stage symptoms of endometrial cancer
Endometrial cancer is a common malignant tumor in the female reproductive system. In advanced stages, patients often experience irregular vaginal bleeding. In addition, there may be bloody discharge from the vagina. If an infection is present or there are signs of necrosis due to the cancer, there may also be purulent discharge or other foul odors. Additionally, there are more apparent symptoms such as pain, abdominal masses, and in late stages, the cancer may invade blood vessels, causing swelling in the lower limbs, or spread to nearby organs, such as the ureters, leading to renal damage. Over time, this can also lead to cachexia, fever, and other signs of systemic failure.
How is endometrial cancer staged?
Endometrial cancer is a common gynecological malignancy in women. Based on surgical and pathological results, endometrial cancer can be divided into four stages. Stage I is the mildest form of endometrial cancer, where the cancer is confined only within the endometrium and does not extend beyond the uterine serosa. Generally, stage 1a is when the cancer is less than half the width of the muscle, while stage 1b is when the cancer infiltrates more than half the width of the muscle. Stage II means the cancer has locally spread but only involves the cervix, without causing cervical stromal infiltration. Stage III involves local spread to the serosa and lymph nodes. Stage IV involves distant metastasis, such as to the liver and bones.
Early symptoms of endometrial cancer
When endometrial cancer occurs in women, it first manifests as abnormal proliferation of the endometrium, increased endometrial surface area, and increased secretions, which can increase the pressure inside the uterine cavity, leading to lower abdominal pain in women. Most women can tolerate this pain, but it tends to worsen during vigorous activities or sexual intercourse. Vaginal discharge may become watery and increase. Additionally, some women may experience increased menstrual flow or irregular vaginal bleeding. Over time, this can lead to blood loss anemia in women, manifesting as dizziness, fatigue, and changes in appetite.
What to do about endometrial cancer pain?
Endometrial cancer, when cancerous tissues invade local nerves, can cause patients to experience pain. This type of pain is recommended to be alleviated by oral painkillers. Pain caused by cancer is an important factor affecting the quality of life of patients in the middle and late stages of the disease; therefore, in clinical practice, analgesic medications can be administered to relieve symptoms in patients with cancer pain. (Please take medications under the guidance of a doctor.)
What should not be eaten with endometrial cancer?
When suffering from endometrial cancer, it's important to pay attention to your diet. Avoid eating foods that cause flare-ups, such as seafood, lamb, dog meat, oysters, and other sea products. Additionally, refrain from consuming high-fat, high-cholesterol foods like fatty meats, cream, and animal fats. Also, avoid eating foods that contain estrogen, such as longan, durian, red dates, and honey. It is also advisable to avoid irritating foods such as chili peppers, and other stimulants like pepper powder and white liquor, as these can affect the body's immunity and exacerbate the condition.
Is endometrial hyperplasia cancer?
Endometrial hyperplasia is not the same as endometrial cancer; it can be treated promptly. Endometrial cancer develops from ongoing endometrial hyperplasia, which can progress into atypical hyperplasia, a precancerous condition of the endometrium. Further development can lead to endometrial cancer. Therefore, it is crucial to treat endometrial hyperplasia actively to prevent its progression to endometrial cancer. Endometrial hyperplasia results from a lack of progesterone influence, causing the endometrium to remain in a proliferative state rather than transitioning to the secretory phase. With the influence of progesterone, the endometrium would not undergo hyperplasia; therefore, treating endometrial hyperplasia with progesterone is advisable.
Is surgery necessary for endometrial cancer?
For endometrial cancer, surgery is generally recommended as the first choice, because early-stage endometrial cancer can largely be cured through surgical treatment. Besides surgery, other options include medication, radiation therapy, and chemotherapy, which are used for mid to late stages or in conjunction with surgery in early stages. When treating endometrial cancer, the treatment method should be chosen based on the specific condition and stage of the patient. In early-stage endometrial cancer, surgery is the preferred treatment. Therefore, aside from surgical treatment, patients should choose medication, radiation therapy, or chemotherapy based on their specific conditions.
How is endometrial cancer diagnosed?
If it concerns endometrial cancer, postmenopausal vaginal bleeding and menstrual disorders during the menopausal transition should prompt an exclusion of endometrial cancer. The most common and valuable method for diagnosing endometrial cancer is through pathological examination results, especially via fractional curettage. The advantage of fractional curettage is that it can differentiate between endometrial cancer and cervical adenocarcinoma, and it can clarify whether the cervical canal is involved, providing a basis for formulating treatment plans. In addition, endometrial cancer can also be assessed using a B-mode ultrasound, but this is only used to provide reference values for clinical diagnosis and management. Another method is hysteroscopy, which allows direct observation of the uterine cavity and cervical canal for any lesions, and tissue can also be collected for biopsy, which is also a very good method.
Is endometrial hyperplasia cancer?
Endometrial hyperplasia is not cancer; the normal endometrial lining is in a proliferative state. Endometrial hyperplasia occurs due to a lack of secretion of progesterone. If it continues to develop, it can progress to atypical endometrial hyperplasia, which is a precancerous condition of the endometrium. If not treated in time, it could develop into endometrial cancer. Thus, active treatment of endometrial hyperplasia is necessary. Large doses of progesterone can be used to promote the transformation of the endometrial lining. Once the endometrium transforms into the secretory phase, it indicates that the endometrial hyperplasia has been effectively treated and can prevent the progression to endometrial cancer.
Stage IB endometrial cancer treatment
Endometrial carcinoma Stage IB refers to tumors localized to the body of the uterus, where tumor infiltration is less than half of the myometrium. Surgical treatment is feasible for this stage and involves a slightly extensive total hysterectomy coupled with bilateral adnexectomy. During the surgery, a frozen section pathology test should be conducted. If the pathology report from the frozen section indicates special types of endometrial-like cancer, including papillary serous adenocarcinoma, clear cell carcinoma, squamous cell carcinoma, carcinosarcoma, and undifferentiated carcinoma, additional procedures are required. Moreover, if enlarged para-aortic or common iliac lymph nodes are palpated during the surgery, lymphadenectomy of the pelvic and para-aortic lymph nodes should be performed.