Late-stage symptoms of endometrial cancer

Written by Du Rui Xia
Obstetrics
Updated on October 21, 2024
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Endometrial cancer is a common malignant tumor in the female reproductive system. In advanced stages, patients often experience irregular vaginal bleeding. In addition, there may be bloody discharge from the vagina. If an infection is present or there are signs of necrosis due to the cancer, there may also be purulent discharge or other foul odors. Additionally, there are more apparent symptoms such as pain, abdominal masses, and in late stages, the cancer may invade blood vessels, causing swelling in the lower limbs, or spread to nearby organs, such as the ureters, leading to renal damage. Over time, this can also lead to cachexia, fever, and other signs of systemic failure.

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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.

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Stage IA endometrial cancer

Endometrial cancer is a group of epithelial malignant tumors that occur in the endometrium. Clinically, the surgical pathology staging revised by the World Health Organization in 2000 is mainly used, based on the severity of the lesion after surgery. Endometrial cancer can be divided into four stages, where, depending on the size and severity of the lesion, it can further be classified into sub-stages a, b, and c. Stage IA refers to cancer limited to the endometrium and is the earliest stage of endometrial cancer. Stage IA endometrial cancer can be completely cured with surgical treatment.

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Causes of Endometrial Cancer

Patients with endometrial cancer generally have factors such as hypertension, diabetes, and obesity that induce the condition. They are more prone to developing endometrial cancer. Furthermore, endometrial cancer is divided into hormone-dependent and non-hormone-dependent types. Hormone-dependent endometrial cancer occurs when there is an excess of estrogen produced in the body without sufficient counteraction by progesterone, leading to excessive growth and proliferation of the endometrial lining. When this growth becomes uncontrolled, it can lead to cancer. Non-hormone-dependent endometrial cancer is not caused by hormonal factors and its development is more complex. Additionally, the pathology type of non-hormone-dependent endometrial cancer is also quite unique.

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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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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.