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Endometrial (Womb) Cancer in Elderly Women

What is Endometrial Cancer?

Endometrial cancer is the cancer of the womb (uterus) that occurs mostly in post-menopausal women between the age of 50 and 65 years. Obese women are at a higher risk of developing endometrial cancer. Endometrial cancer can be diagnosed at early stages and treated successfully. Therefore, it is important for post-menopausal women and women who are at risk to undergo regular Pap tests and pay attention to any symptoms that might indicate endometrial cancer. It is one of the most significant causes of vaginal bleeding after menopause in elderly women.

Endometrial Cancer Symptoms

Most women with endometrial cancer have abnormal post-menopausal vaginal bleeding accompanied by pelvic pain. There may also be an abnormal white or watery discharge from the vagina that begins before the onset of bleeding. If a routine Papanicolaou (Pap) test shows the presence of abnormal uterine cells, endometrial cancer might be suspected.

In pre-menopausal women, excessive menstrual bleeding (menorrhagia), irregular periods, and bleeding between periods (metrorrhagia) accompanied by lower abdominal or pelvic pain could indicate endometrial cancer. The diagnosis of endometrial cancer is done by endometrial biopsy in which a small sample of cells from the inner lining of the uterus (endometrium) is taken and checked for the presence of abnormal cancerous cells.

Causes of Endometrial Cancer

The main cause of endometrial cancer in post-menopausal women is thought to be high levels of circulating estrogen accompanied by a lack of progesterone. Estrogen stimulates the growth of the inner lining of the uterus – the endometrium. Progesterone is required for the shedding of the overgrown endometrial lining during periods. Lack of progesterone in post-menopausal women leads to unopposed growth of the endometrium (stimulated by estrogen) and provides the conditions for the development of endometrial cancer.

Other risk factors for developing endometrial cancer include obesity, diabetes, infertility, estrogen replacement therapy, infrequent periods, precocious onset of periods before age 12, polycystic ovarian syndrome, and treatment with tamoxifen (an anti-cancer drug used for treatment of breast cancer). In a minority of cases, endometrial cancer might be hereditary (especially in case of families with hereditary non-polyposis colorectal cancer) and run in families.

Treatment of Endometrial Cancer

Endometrial cancer can be cured if diagnosed during the early stages of the disease. The aim of the treatment at this early stage is to remove all non-vital organs that are affected by cancer so that the cancerous cells do not spread to the rest of the body. Surgical removal of uterus (hysterectomy), cervix, ovaries and the fallopian tube is recommended. Lymph nodes in the pelvis and around the aorta could also be surgically removed to prevent the spread of the cancer via lymph or bloodstream.

Radiation therapy is used to support surgery. Radiation can be given before the surgery to shrink the cancer before its removal. It can also be given after the surgery to kill any leftover cancerous cells and prevent the recurrence of cancer. If the cancer has spread to other parts of the body and surgery will not be effective in the removal of cancer, hormonal therapy with progesterone can be attempted. Chemotherapy with toxic anti-cancer drugs is the treatment of choice in the advanced stage.


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