Endometrial cancer is a type of cancer that begins in the uterus, a hollow organ in the female reproductive system that is roughly the size and shape of a pear. The uterus is where a fetus will develop during pregnancy.
Endometrial cancer begins in the inner lining of the uterus, called the endometrium. This is the tissue where a fertilized egg attaches when a person becomes pregnant and the tissue that is shed during menstruation when a person is not pregnant.
As with other types of cancer, endometrial cancer begins with mutations to normal cells. These mutations change the cell’s DNA, which contains instructions for making new cells. This creates cancerous cells that divide more quickly and do not expire like normal cells.
As cancer cells grow in number, they will form tumors, tumors will grow in size, and cancer can spread to nearby or distant parts of the body.
Shared decision making
People with cancer are encouraged to work with their healthcare team to understand their treatment options and take an active role in making treatment decisions. People are also encouraged to educate themselves on the type of cancer they have and the different treatment options that are available.
What is considered when choosing a treatment?
Treatment for endometrial cancer often involves a combination of different therapies, which can include:
- Surgery to remove the tumor and affected organs
- Radiation therapy to shrink or destroy tumors
- Systemic therapies, such as chemotherapy, targeted therapy, and immunotherapy, which act on cancer cells throughout the body.
However, treatment for endometrial cancer is different for each person, and treatment recommendations will depend on different factors about the cancer and about the person being treated. The factors that a person will discuss when making treatment decisions can include:
Stage
The cancer will be assigned a stage based on factors like the size of the tumor, if it has invaded the muscular layers of the uterus, if it has invaded nearby tissues, if it has spread to lymph nodes, and if it has spread to other areas of the body (metastasized).
Histologic grade
Histologic grading refers to how abnormal cancer cells appear compared to normal cells when examined under a microscope. Cancers with a higher grade have more abnormalities and are generally more aggressive, meaning they are more likely to spread, spread quickly, and recur after treatment.
Molecular subgroups
Molecular subgroups are another way of categorizing endometrial cancers. It’s based on genetic changes to cancer cells. For example, the types of mutations, number of mutations, and what genes are affected by mutations.
Age, overall health, and medical history
The age and overall health of the person being treated are important considerations for the treatment of any cancer. This includes coexisting conditions and medical history. Endometrial cancer most often occurs between the ages of 65 and 75 years, though endometrial cancer does affect people at younger ages.
Fertility
Infertility is a side effect of treatment for endometrial cancer. For example, surgery to remove reproductive organs, chemotherapy, and radiation therapy can all cause infertility. If a person wishes to avoid infertility, they need to discuss fertility-sparing treatment options with a healthcare provider and should consult a fertility expert. Fertility-sparing treatment may be an option when treating early-stage endometrial cancers.
Previous cancer treatments
If a person has previously been treated for endometrial cancer (or another type of cancer), a healthcare team will need detailed information on what treatments were used and how the cancer responded to that treatment.
Preferences, priorities, and needs
A person’s preferences, priorities, and needs are other important factors to consider. For example, how will treatment affect day to day functioning, how will it impact personal finances, how much assistance from caregivers will a person need during treatment. Different people may prioritize different treatment goals and be willing to tolerate different side effects from treatment to pursue these treatment goals.
Spend time thinking about your preferences, priorities, and needs. Keep a list of topics and questions you want to discuss with your healthcare team. Consider participating in a support group where you can talk to other people who have endometrial cancer. Talk to your loved ones. Learn about your diagnosis and treatment options.
Sources: NCI Dictionary of Cancer Terms. Endometr... + 15
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