Endometrial cancer, also known as uterine cancer, is a malignant neoplasm that arises from the lining of the uterus, the endometrium. This disease is most common in postmenopausal women, but can also develop in younger women. Endometrial cancer is divided into several subtypes, the most common of which is adenocarcinoma. The main factors that contribute to the development of endometrial cancer include hormonal imbalances, obesity, diabetes, and hereditary predispositions.
History of the disease and interesting historical facts
Endometrial cancer was first described in medical literature in ancient times, but the incidence rate and diagnostics have significantly increased since then. In the 19th century, scientists began the first studies to identify the causes and consequences of this disease. It is noteworthy that the first successful operations to remove endometrial tumors were performed using primitive instruments and anesthesia methods. In the 1960s, significant research was conducted on hormone-dependent forms of cancer, which allowed the introduction of new approaches to understanding the pathogenesis of the disease.
Epidemiology
The incidence of endometrial cancer in the world varies depending on the region. According to statistics, in the United States, this type of cancer is the fourth most common among women, and in Russia it ranks fifth. In 2021, about 29,000 new cases of this pathology were registered in the country. One of the features is that endometrial cancer is most often diagnosed in women aged 55-65 years. The incidence rate is 25 cases per 100,000 women per year. Younger age groups are beyond the scope of these statistics, but predisposing factors can also be identified in younger patients.
Genetic predisposition to this disease
Genetic predisposition to endometrial cancer plays an important role, as certain mutations in genes can contribute to the development of the tumor. The most studied genes are MLH1, MSH2, MSH6 and PMS2, which are responsible for the DNA repair system. Hereditary syndromes, such as Lynch syndrome, significantly increase the risk of developing this disease. According to a number of studies, up to 30% cases of endometrial cancer are hereditary. It is important to note that genetic factors do not act in isolation; their influence is enhanced by the presence of other accompanying features and factors.
Risk factors for the development of this disease
Endometrial cancer is associated with a number of known risk factors, which can be divided into endogenous and exogenous. Endogenous factors include hormonal changes, such as:
- long-term use of estrogens without progesterone;
- various menstrual cycle disorders;
- obesity and associated diseases (eg, diabetes);
Exogenous factors include:
- age (over 50 years);
- family history of endometrial cancer;
- low level of physical activity;
- long-term use of certain contraceptives;
The combination of these factors significantly increases the likelihood of developing the disease.
Diagnosis of this disease
Diagnosis of endometrial cancer involves several stages and a variety of methods. The main symptoms to look out for include:
- abnormal bleeding;
- pain in the pelvic area;
- unexplained weight loss;
Laboratory tests, such as hormone levels and tumor markers, help determine the predisposition and stage of the disease. Radiological examinations, including ultrasound, MRI and CT, play a key role in assessing the extent of the process. Endometrial biopsies are also performed for histological analysis. It is important to carry out a differential diagnosis with other pathologies, such as uterine fibroids or polyps.
Treatment
Treatment for endometrial cancer depends on the stage of the disease and the patient's overall health. Treatment options include:
- surgical intervention (removal of the uterus, ovaries and lymph nodes);
- pharmacological treatment (hormonal therapy, chemotherapy);
- radiotherapy (external and internal);
- immunotherapy (use of special drugs to stimulate the immune system).
Each method has its own indications and contraindications and can be combined to achieve the best result.
List of medications used to treat this disease
Among the pharmacological agents used for endometrial cancer, the following stand out:
- Progestins (eg, megestrol);
- Estrogens (to correct hormonal levels);
- Cytostatics (for example, paclitaxel and docetaxel);
- Hormonal drugs that suppress estrogen receptors (eg, tamoxifen).
Each of these drugs has its own indications and should be prescribed individually.
Disease monitoring
Monitoring of patients after endometrial cancer treatment includes regular check-ups and examinations. Control stages include:
- annual gynecological examinations;
- periodic psychological monitoring;
- maintaining hormone and tumor marker levels.
The prognosis depends on the stage of the disease at diagnosis and the treatment provided. With early diagnosis, the survival rate is about 85%. Complications may include recurrence of the disease, metastasis, and concomitant diseases.
Age-related features of the disease
Endometrial cancer has its own characteristics depending on the age group. In women of reproductive age, the disease is less common, but its manifestations can be more aggressive. In postmenopausal patients, a higher incidence rate and a better predisposition to hormonal factors are stated. It is important to consider that the younger population has less awareness of the disease, which can lead to late diagnosis.
Questions and Answers
- What age is most susceptible to endometrial cancer? Women between the ages of 55 and 65 are most susceptible.
- How to prevent endometrial cancer? Increase physical activity, weight control and regular preventive examinations.
- What symptoms should you be wary of? Abnormal vaginal bleeding and severe pelvic pain require a doctor's consultation.
- Can endometrial cancer be cured? Yes, with timely diagnosis and staging, the probability of cure is high.
- How do hormones affect the development of endometrial cancer? Hormonal imbalances directly related to estrogens can increase the risk of the disease.
Advice from Dr. Oleg Korzhikov
Dr. Oleg Korzhikov recommends:
- Have regular gynecological examinations, especially after 40 years of age.
- Monitor your weight, as obesity increases the risk of disease.
- Pay attention to any changes in your menstrual cycle and report them to your doctor.
- Smoking and excessive alcohol consumption have negative health effects and may contribute to the development of cancer.
Timely medical attention and prevention can significantly reduce the risk of developing the disease.
