How is endometrial cancer staged?

Written by Zhang Lu
Obstetrics
Updated on September 29, 2024
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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.

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Obstetrics and Gynecology
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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.

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Written by Li Shun Hua
Obstetrics and Gynecology
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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.

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Endometrial cancer requires chemotherapy.

If endometrial cancer has high-risk factors, chemotherapy is needed after surgery if these high-risk factors are found in the pathological staging. If it's early-stage endometrial cancer without these high-risk factors, chemotherapy might not be necessary after surgery because chemotherapy also serves to prevent recurrence and metastasis. Therefore, it is advised that patients with high-risk factors in endometrial cancer undergo chemotherapy. Although chemotherapy may have significant side effects, it can improve the survival time and quality of life for cancer patients. The decision to proceed with chemotherapy should be based on the postoperative pathological staging, biopsy results, and the presence or absence of factors like lymph node metastasis.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Endometrial cancer leukorrhea symptoms

The main manifestation of endometrial discharge is an increase in the amount of discharge, which can be watery or bloody. Sometimes, it can also appear as pus-blood-like discharge. Another main symptom of endometrial cancer is irregular vaginal bleeding. During an ultrasound, uneven echoes can be seen within the uterine cavity. The patient may also experience pain in the lower abdomen and increased menstrual flow. Therefore, if there are abnormalities in menstruation or unusual vaginal discharge, it is necessary to promptly go to the hospital for an ultrasound and gynecological examinations, and receive treatment based on the results of these tests.

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Written by Li Shun Hua
Obstetrics and Gynecology
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Is endometrial hyperplasia the same as cancer?

Endometrial hyperplasia is not cancer; it is caused by a prolonged absence of ovulation, which means there is no secretion of progesterone. This prevents the proliferative phase endometrium from transforming into the secretory phase, leading to hyperplasia. If the hyperplasia persists over an extended period, it may lead to precancerous changes in the endometrium, and in severe cases, it can cause endometrial cancer. Therefore, it is essential to treat endometrial hyperplasia with progesterone, which can transform the endometrium and allow it to shed completely, altering its condition and restoring it to normal. As long as there is ovulation, there is the production of progesterone, so promoting ovulation is crucial.