Endometrial cancer is the most common gynecologic cancer in the U.S., according to the American Cancer Society. An estimated 60,000 new cases of endometrial cancer – also known as uterine cancer – are diagnosed annually.
Endometrial cancer begins in the layer of cells lining the inside of the uterus. It often is detected at an early stage because it usually produces abnormal vaginal bleeding. However, more than 10,000 women die each year from this cancer.
Although endometrial cancer typically affects post-menopausal women, it can affect adult women at any age.
"Those at higher risk include women who are obese, have high blood pressure, diabetes or polycystic ovarian syndrome," says Dr. Jamie Bakkum-Gamez, gynecologic oncologist and surgeon with the Mayo Clinic Cancer Center. "We also know that tamoxifen use doubles the risk of endometrial cancer in postmenopausal women."
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In addition, about 5 percent of all cases are related to genetics, says Dr. Bakkum-Gamez. "Women who have a familial history suggestive of Lynch syndrome, which can include a history of colon, ovarian, stomach, urinary tract and pancreatic cancers are at higher risk also. Knowing your family history is important. If there is a strong family history of cancer, I recommend seeing a genetic counselor."
Journalists: Sound bites with Dr. Bakkum-Gamez are in the downloads.
Surgery is the primary form of treatment for women with endometrial cancer. If discovered early, removing the uterus surgically often cures endometrial cancer, says Dr. Bakkum-Gamez.
"The standard of care is to perform minimally invasive surgery ─ usually vaginal, laparoscopic, or robotic surgery. Robotic surgery has been a major advance in endometrial cancer management as it decreases complication rates," she notes.
Depending upon pathology and individual risk, chemotherapy is used to treat some patients. If lymph nodes are involved, patients also are treated with external radiation. "For some women with early-stage cancer who are at high risk of a vaginal recurrence, we also have a form of internal radiation ─ vaginal brachytherapy ─ that is available," Dr. Bakkum-Gamez says.
Screening tests and innovations
Currently, there is no screening test available for endometrial cancer but Dr. Bakkum-Gamez is working on research to address early detection and risk. She is leading a team from Mayo Clinic and the National Cancer Institute in the development of a new tampon-based test for endometrial cancer. She is also hoping to develop virus-based therapies to help destroy cancer cells in patients with metastatic endometrial cancer.
"Once endometrial cancer metastasizes, it is often very difficult to treat so it is important for us to identify it early and treat it most effectively," she says. "I tell women all the time: any abnormal uterine bleeding should be investigated."