How is endometrial cancer staged?

Written by Zhang Lu
Obstetrics
Updated on September 29, 2024
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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.

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How is endometrial cancer diagnosed?

In the clinical setting, when endometrial cancer is suspected, further pathological examination is required. Generally, endometrial tissue can be obtained through fractional curettage or hysteroscopic endometrial biopsy. The acquired endometrium is then subject to a pathological examination, observing the morphology of the endometrial cells under a microscope. If cancer cells are detected, a diagnosis of endometrial cancer can be made. Therefore, the confirmation of endometrial cancer in clinical practice must be based on pathological examination.

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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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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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What should not be eaten with endometrial cancer?

When suffering from endometrial cancer, it's important to pay attention to your diet. Avoid eating foods that cause flare-ups, such as seafood, lamb, dog meat, oysters, and other sea products. Additionally, refrain from consuming high-fat, high-cholesterol foods like fatty meats, cream, and animal fats. Also, avoid eating foods that contain estrogen, such as longan, durian, red dates, and honey. It is also advisable to avoid irritating foods such as chili peppers, and other stimulants like pepper powder and white liquor, as these can affect the body's immunity and exacerbate the condition.

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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.