GENERAL

Endometrioid also called endometrial cancer is a cancer of the inside of the uterus, the endometrium being the lining that lines the inside of the uterus. In women with cancer at this level, endometrial cells multiply abnormally. Endometrial cancer generally occurs after menopause, but 10 to 15% of cases affect premenopausal women, including 2 to 5% of women under 40 years old. Cancerous tumors of the ovary can invade and destroy surrounding tissue. They can also spread (metastasize) to other parts of the body. Cancerous tumors are also called malignant tumors. Ovarian cancerous tumors are classified according to the type of cells in which cancer appears. And the treatment depends on the stage. This does not prevent Dawabio, your phytotherapy center, from giving you adequate treatment for your ailment. Natural treatments without side effects and very effective. To discover this product click on the image below

Endometrial cancer is the second most common gynecological cancer in France, after breast cancer. It is in the 5 ^th most common cancer in women in terms of incidence with about 7300 new cases estimated in 2012. In Canada, it is the 4 ^th  in incidence in women (after breast, lung and colon), with 4,200 new cases in 2008 in Canada. Mortality is steadily decreasing for this type of cancer, which is increasingly being treated.

Symptoms of endometrial cancer

Because of a generally slow progression, cancer of the endometrium (or of the body of the uterus) does not present itself with very characteristic symptoms. Among the main signs that should alert you, we can mention:

· - vaginal bleeding after menopause;

· - In younger women, bleeding between periods, bloody discharge outside of periods, periods lasting more than seven days;

· - Smelly discharge;

· - Pain in the lower abdomen;

· - Unexplained weight loss.

When endometrial cancer is treated at its early stage (stage I), the survival rate is 95%, 5 years after treatment

The causes

A significant proportion of endometrial cancers are thought to be attributable to an excess of estrogenic hormones produced by the ovaries or supplied by the outside. The ovaries produce 2 types of hormones during the female cycle:  estrogen and progesterone. These hormones act on the endometrium throughout the cycle, stimulating its growth and then its expulsion during menstruation. An excess of estrogen hormones would create an imbalance conducive to the poorly controlled growth of endometrial cells.  

Several factors can increase estrogen levels, such as obesity or hormone therapy with estrogen alone. This type of hormone therapy is therefore reserved for women who have had the uterus removed or hysterectomy who are no longer at risk of endometrial cancer. For more information, see the People at risk and Risk factors sections.

For some women, however, endometrial cancer does not appear to be caused by a higher level of estrogen.

Other causes are involved in endometrial cancer, such as advanced age, overweight or obesity, genetics, hypertension, etc.

Sometimes cancer occurs without a risk factor being identified.

Fertility and  endometrioid 

 As the desire to become pregnant has become later than before, we see that the frequency of these pathologies is increasing in women planning to become pregnant, even if they remain rare. At the end of the sixties, the principle of conservative treatment emerged in these patients whose classic management was based on total hysterectomy with bilateral adnexectomy. Conservative treatment possibly of the possibilities of medically assisted procreation (AMP). The objective of such treatment consists of the carcinological level is to offer a protocol preserving the uterus, based on hormonal treatment allowing regression of the endometrial lesion associated with close monitoring verifying the absence of recurrence and 'aggravation of lesions. Conservative treatment is aimed at patients of a "reasonable" age, suggesting a real hope of pregnancy, taking into account the complete remission of endometrial lesions and in terms of fertility, in obtaining one (or more ) pregnancy (ies). Since the originator cases reported in 1968, several publications give an account of the merits of this treatment.

Diagnostic

There is no screening test for endometrial cancer. The doctor therefore performs examinations to detect this cancer in front of signs such as gynecological bleeding occurring after menopause.
The first exam to be done is a pelvic ultrasound where the probe is placed on the stomach and then into the vaginal space in order to visualize an abnormal thickening of the endometrium, the lining of the inside of the uterus.

In the event of an abnormality on the ultrasound, to detect endometrial cancer, the doctor does what is called an “endometrial biopsy”. This involves taking a little mucous membrane from inside the uterus. The endometrial biopsy can be done in the doctor's office without the need for anesthesia. A thin, flexible tube is inserted through the cervix and a small piece of tissue is removed by suction. This sample is very quick, but it can be a bit painful. It is normal to bleed a little afterward.

The diagnosis is then made in the laboratory by microscope observation of the area of ​​mucous membrane removed.

In the event of illness or medication, the doctor should be informed if he or she needs to perform this examination.

Treatments for endometrial carcinoma

There are 3 stages of this disease which are: early stage, advanced stage, and recurrent stage. Indeed, the treatment depends on the stage.

In the presence of early-stage, advanced stage, or recurrent endometrial carcinoma, the following treatment options may be used. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Early-stage endometrial carcinoma

The following treatments may be used for stage 1 and 2 endometrial carcinomas.

Surgery

Surgery is the main treatment for early-stage endometrial carcinoma.

To treat stage 1 endometrial carcinoma, a total hysterectomy (removal of the uterus and cervix) and bilateral salpingo-oophorectomy (removal of both fallopian tubes and both ovaries) are usually performed. . The surgeon may also remove lymph nodes in the pelvis and around the aorta (lymph node dissection, or lymphadenectomy). In some young women, the uterus is sometimes removed without removing the ovaries.

To treat stage 2 endometrial carcinoma, you can perform the total hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection to remove lymph nodes in the pelvis and around the aorta. A radical hysterectomy can also be performed to remove the cervix, uterus, some of the tissues and structures near the cervix, and the upper part of the vagina. During a total hysterectomy, the surgeon sometimes also removes lymph nodes in the pelvis and around the aorta.

Radiotherapy

After surgery for early-stage endometrial carcinoma, you may be offered radiation therapy to reduce your risk of recurrence. In stage 2 carcinoma, radiation therapy is sometimes also given before surgery.

Radiation therapy can also be used as the main treatment in women who cannot have surgery because of other medical conditions.

You may be given external beam radiation therapy, brachytherapy, or both.

Chemotherapy

You may be offered chemotherapy after surgery for early-stage, high-grade endometrial carcinoma (such as serous adenocarcinoma or clear cell adenocarcinoma). Carcinosarcoma can also be treated with chemotherapy after surgery.

Advanced endometrial carcinoma

The following treatments may be used for stage 3 and 4 endometrial carcinomas. Treatment for stage 4 endometrial carcinoma is aimed at controlling the disease and relieving symptoms.

Surgery

Staging is done during the operation. The surgeon does a pelvic exam, which is done under general anesthesia. Then he makes an incision (cut) in the abdomen to examine the organs and see if cancer has spread to them. This is called an exploration of the abdomen (laparotomy). The surgeon might take samples of tissue and lymph nodes. They might also rinse the abdomen with saline solution and keep a sample of the flushing fluid (pelvic lavage). Samples of tissue, lymph nodes, and pelvic lavage fluid are sent to a lab where they are examined under a microscope to determine if they contain cancer cells. laparoscopy or robotic surgery.

Radiotherapy

Radiation therapy may be offered to treat advanced endometrial carcinoma. You may be given external beam radiation therapy, brachytherapy, or both. Radiation therapy can be given:

• if you cannot have surgery because of other medical conditions
• after surgery
• to treat extensive pelvic disease
• to control symptoms such as heavy vaginal bleeding
• before surgery (in some cases)

Hormone therapy

You may be offered hormone therapy to treat stage 3 endometrial carcinoma if you cannot have surgery or receive radiation therapy. Hormone therapy may also be given to help relieve symptoms caused by distant metastasis from stage 4 endometrial carcinoma.

Chemotherapy

You may be offered chemotherapy after surgery for high-grade stage 3 endometrial carcinoma (such as serous adenocarcinoma or clear cell adenocarcinoma). Advanced carcinosarcoma can also be treated with chemotherapy after surgery. The chemotherapy drugs used to treat stage 3 and high-grade carcinosarcoma or endometrial carcinoma are the same as those used to treat the early stages. As with the treatment of early-stage and high-grade carcinosarcoma or endometrial carcinoma, chemoradiotherapy or sandwich therapy may be used.

Recurrent endometrial carcinoma

The following treatment options may be available for recurrent endometrial carcinoma. Recurrence of endometrial carcinoma means cancer comes back after being treated. Treatment depends on the location of the recurrence and its extent in the body.

Radiotherapy

You may be offered radiation therapy after tumor reduction surgery if endometrial carcinoma only comes back in the pelvis (locoregional recurrence). Radiation therapy may also be offered if you have an extensive pelvic disease and cannot have surgery due to other medical conditions.

You may be given external beam radiation therapy, brachytherapy, or both.

Surgery

You may be offered one of the following types of surgery to treat recurrent endometrial carcinoma.

A  pelvic exenteration is done to treat a local recurrence when the rectum or bladder is damaged and you have already received radiation therapy.

It uses the debulking if you suffer from the pelvic extensive disease. This surgery helps relieve the pain and symptoms caused by the tumor.

Hormone therapy

Hormonal therapy may be offered to control the growth of recurrent endometrial carcinoma or to help relieve symptoms caused by distant metastases. If you cannot have surgery, hormone therapy may be combined with radiation therapy.

The types of hormone therapy used are the same as those used to treat advanced endometrial carcinoma.

Chemotherapy

Chemotherapy may be offered to control the growth of recurrent endometrial carcinoma or to help relieve symptoms caused by distant metastases. Combinations of chemotherapy drugs used include:

• cisplatin and doxorubicin, with or without paclitaxel
• carboplatin and paclitaxel
• carboplatin and docetaxel

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From all of the above, it is remembered that, endometrial cancer is easier to treat. But in the absence of characteristic symptoms, diagnosis is often late. The symptoms that should alert you and the tests allowing you to make a definite diagnosis have been established for you above.