How is endometrial cancer diagnosed?

Written by Tang Mei Xiang
Obstetrics and Gynecology
Updated on September 13, 2024
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Endometrial cancer often manifests as vaginal bleeding after menopause, and in women who have not experienced menopause, it often presents as menstrual irregularities. The diagnostic methods for endometrial cancer include the following: 1. Fractional curettage is the most important method for diagnosing endometrial cancer. First, scrape the cervical canal, then sequentially scrape the endometrial tissue from each part of the uterine body, label the specimens separately, and send them for pathological examination together. 2. Cytological examination is a method for screening for endometrial cancer. A specially made uterine cavity suction tube or brush is inserted into the uterine cavity to collect secretions for cytological culture. 3. Hysteroscopic examination allows direct observation of the growth of endometrial lesions and can also obtain live tissue for pathological examination. It involves pelvic ultrasound examination to understand the size of the lesion, surrounding infiltration, etc. 5. Other methods, such as lymphangiography, CT, MRI, and serum CA125 testing.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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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 Du Rui Xia
Obstetrics
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Can endometrial cancer patients become pregnant?

After the occurrence of endometrial cancer, it is not possible to become pregnant. This is because, after pregnancy, a woman's immunity decreases, and her resistance to illness declines. This will affect the woman's health and may exacerbate the condition of endometrial cancer. Additionally, women with endometrial cancer, even if they become pregnant, may experience miscarriages as the embryo cannot develop normally, and even many harmful symptoms might occur, affecting the woman's health. Therefore, women with endometrial cancer should take contraceptive measures to prevent unintended pregnancies.

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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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Written by Du Rui Xia
Obstetrics
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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.

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Written by Zhang Lu
Obstetrics
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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.