How to perform surgery for endometrial cancer

Written by Liu Jian Wei
Obstetrics and Gynecology
Updated on September 09, 2024
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Surgical treatment for endometrial cancer needs to be determined based on the specific stage and type of the cancer, as well as the size of the lesions. If the lesions are small and the cancer is in an early stage, a complete hysterectomy including the removal of both fallopian tubes and ovaries can be performed. Intraoperative pathology assessment of the endometrium is also necessary to determine the specific pathological type. If it is a special type of endometrial cancer, it is also necessary to clear the pelvic lymph nodes. If the endometrial cancer is at a later stage and the lesions are larger, then in addition to the removal of the uterus and both fallopian tubes and ovaries, it is also necessary to clear the lymph nodes around the abdominal aorta in the pelvis.

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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 Liu Jian Wei
Obstetrics and Gynecology
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What to do about endometrial cancer pain?

Endometrial cancer, when cancerous tissues invade local nerves, can cause patients to experience pain. This type of pain is recommended to be alleviated by oral painkillers. Pain caused by cancer is an important factor affecting the quality of life of patients in the middle and late stages of the disease; therefore, in clinical practice, analgesic medications can be administered to relieve symptoms in patients with cancer pain. (Please take medications under the guidance of a doctor.)

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Written by Li Shun Hua
Obstetrics and Gynecology
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Is endometrial hyperplasia cancer?

Endometrial hyperplasia is not cancer; the normal endometrial lining is in a proliferative state. Endometrial hyperplasia occurs due to a lack of secretion of progesterone. If it continues to develop, it can progress to atypical endometrial hyperplasia, which is a precancerous condition of the endometrium. If not treated in time, it could develop into endometrial cancer. Thus, active treatment of endometrial hyperplasia is necessary. Large doses of progesterone can be used to promote the transformation of the endometrial lining. Once the endometrium transforms into the secretory phase, it indicates that the endometrial hyperplasia has been effectively treated and can prevent the progression to endometrial cancer.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Endometrial cancer B-ultrasound manifestations

Normally, the endometrium has a certain thickness. Patients with endometrial cancer usually show thickening of the endometrium, accompanied by irregular bleeding and abdominal pain. In severe cases, patients may experience excessive discharge from the half-vagina, accompanied by a fishy and foul odor. Typically, in cases of endometrial cancer, an ultrasound can reveal thickening of the endometrium and abnormal endometrial echoes, and some patients may show significant blood flow signals around the area according to reports. These signs generally suggest a high likelihood of endometrial cancer. The diagnosis of endometrial cancer typically involves undergoing a diagnostic curettage at the hospital. The tissue scrapped during this procedure is sent for pathology. Afterward, based on the pathology results, the type and nature of the endometrial cancer are determined. Therefore, the presence of endometrial cancer can generally be inferred from an ultrasound as well.