Is surgery necessary for endometrial cancer?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on September 15, 2024
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When a woman suffers from endometrial cancer, the primary treatment method is surgery, but there are some special circumstances. For example, if the lesion in the woman is relatively minor, it is atypical hyperplasia, which is a precancerous condition, or it is in the late stage of the disease, or in cases of recurrent endometrial cancer. At this time, treatment can be administered using progestogen drugs, applying high-dose long-term oral intake of effective progestogens, which can suppress the cancerous transformation of the endometrial lining and inhibit the further proliferation of cancer cells. Generally, it involves continuous oral administration for 12 weeks, which is three months, followed by a diagnostic curettage to evaluate the therapeutic effects of the drug. In addition, radiation therapy can also be considered.

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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 Xu Xiao Ming
Obstetrics and Gynecology
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Stage IB endometrial cancer treatment

Endometrial carcinoma Stage IB refers to tumors localized to the body of the uterus, where tumor infiltration is less than half of the myometrium. Surgical treatment is feasible for this stage and involves a slightly extensive total hysterectomy coupled with bilateral adnexectomy. During the surgery, a frozen section pathology test should be conducted. If the pathology report from the frozen section indicates special types of endometrial-like cancer, including papillary serous adenocarcinoma, clear cell carcinoma, squamous cell carcinoma, carcinosarcoma, and undifferentiated carcinoma, additional procedures are required. Moreover, if enlarged para-aortic or common iliac lymph nodes are palpated during the surgery, lymphadenectomy of the pelvic and para-aortic lymph nodes should be performed.

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Written by Li Lin
Obstetrics and Gynecology
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Are uterine cancer and endometrial cancer the same?

Uterine cancer is divided into cervical cancer and endometrial cancer. Cervical cancer is a malignant tumor that occurs in the epithelium and glandular tissue of the cervix, while endometrial cancer is a group of epithelial malignant tumors that occur in the endometrium. The two types of cancer differ due to their different sites of origin. Accordingly, the examination and treatment methods adopted are also not completely the same based on the different sites of origin. However, both cervical and endometrial cancers are primarily treated with surgery, followed by corresponding radiotherapy and chemotherapy.

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Written by Shen Li Wen
Obstetrics and Gynecology
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How is endometrial cancer detected?

When women experience irregular vaginal bleeding, or vaginal bleeding reoccurs after menopause, and uterine endometrial cancer is suspected, the first step is to conduct a routine gynecological examination to identify whether the bleeding originates from the uterine cavity or the cervix. Additionally, an ultrasound examination can be conducted to observe the condition inside the uterine cavity, the thickness of the endometrium, whether the thickness is uniform, and whether there are any abnormal growths, to understand whether the woman might have uterine endometrial cancer. However, these methods usually cannot provide a diagnosis and only serve to assess or suggest the possibility of endometrial cancer. For a definitive diagnosis, a hysteroscopy or diagnostic curettage can be performed, and the results of the pathological examination can confirm the diagnosis.

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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.