How endometrial cancer develops, spreads, and is diagnosed
Beginning in the lining of the womb (endometrium), endometrial cancer is one of the most common cancers in women.
In this article, consultant obstetrician and gynaecologist Mr Javaid Ahmad Muglu explores how endometrial cancer develops, spreads, and is diagnosed, highlighting the importance of early detection.
How endometrial cancer develops
Endometrial cancer primarily begins in the cells that make up the endometrium, the lining of the uterus. It develops when these cells grow uncontrollably, forming a tumour.
The exact cause of this abnormal cell growth is not always clear, but certain factors can increase the likelihood of developing endometrial cancer, including:
- Hormonal imbalances: an excess of oestrogen without enough progesterone (a hormone that helps balance oestrogen) can encourage the abnormal growth of the endometrial lining.
- Obesity: overweight women are more likely to develop endometrial cancer because adipose (fat) tissue produces excess oestrogen, contributing to hormonal imbalances.
- Age: the risk increases after menopause, as hormone levels fluctuate.
- Family history: a family history of endometrial cancer or inherited conditions like Lynch syndrome can increase the risk.
It is important to note that endometrial cancer can also occur in women without any known risk factors.
Where can endometrial cancer spread to?
If not detected early, endometrial cancer can spread (metastasise) to other parts of the body.
Understanding where the cancer may spread is important for determining treatment options and monitoring the disease.
Lymph nodes
The most common sites for cancer cells to spread first are the lymph nodes, small, bean-shaped structures that are part of the body’s immune system.
Cancer cells from the uterus can spread to nearby pelvic lymph nodes. In advanced stages, cancer may spread to lymph nodes in the abdomen or groin.
Nearby structures
Due to their proximity, cancer may extend into the cervix, vagina, bladder, or rectum, potentially leading to abnormal bleeding, urinary symptoms, or bowel changes.
Distant organs
In advanced stages, cancer cells may travel through the bloodstream, affecting:
- Lungs: the most common site for distant metastases, where it may cause persistent coughing, shortness of breath, or chest pain.
- Liver: resulting in symptoms like jaundice (yellowing of the skin and eyes), abdominal pain, and swelling.
- Peritoneum: spread to the peritoneal lining can lead to fluid buildup (ascites), bloating, discomfort, and loss of appetite.
How endometrial cancer is diagnosed
Early diagnosis is vital for improving treatment outcomes. Several methods are used to confirm the presence of endometrial cancer:
Medical assessment
The first step in diagnosis involves discussing your medical history and symptoms with your doctor.
Common signs of endometrial cancer include abnormal vaginal bleeding, pelvic pain, or unusual discharge.
Physical examination
A pelvic examination may be performed to check for any abnormalities in the uterus or ovaries.
While this can help detect potential issues, it is not definitive for diagnosing endometrial cancer.
Ultrasound
An ultrasound is often used to create an image of the uterus and check for abnormal thickening of the endometrial lining, which may be a sign of cancer.
Biopsy
The most definitive way to diagnose endometrial cancer is through a biopsy, where a small sample of tissue from the uterus is removed and examined under a microscope for cancer cells.
This procedure is usually done during a hysteroscopy, where a thin, lighted tube is inserted into the uterus to view the lining.
When to seek medical advice
You should see a doctor if you experience abnormal vaginal bleeding, especially after menopause or between periods.
Other warning signs include persistent pelvic pain, unusual vaginal discharge, pain during intercourse, or unexplained weight loss.
While these symptoms may have other causes, early evaluation is crucial for detecting and treating endometrial cancer effectively.
Understanding how endometrial cancer develops, spreads can help with early detection and better treatment outcomes.
If you experience symptoms like abnormal bleeding, consult with Mr Muglu via his Top Doctors profile to ensure the right tests and care for your health needs.