There are several changes that a woman’s body goes through during her lifetime. Menopause is one such event, which leads to a natural decline in the reproductive hormones in women between the age of 45 to 55. According to National Center for Biotechnology Information (NCBI) US, the risk of developing cancer increases as a woman ages. Two of the most common cancers that affect women post menopause is breast cancer and endometrial cancer.
“Endometrial cancer is a type of uterine cancer that occurs in the lining of the womb (endometrium). It mainly affects post-menopausal women. According to the National Cancer Institute, approximately 3 in 100 women are affected by endometrial cancer at some point in their lives. There are more than 1 million cases registered in India. If detected early and given proper treatment, then 80 per cent of those affected will get cured,” says Dr Sabhyata Gupta, Chairperson, Gynaecology and Gynae Oncology, Medanta.
Below, he suggests a few tips that will help women in diagnosis and treatment.
Risk factors to look for:
Many factors that puts one at risk of developing endometrial cancer are:
● Obesity: In comparison with women who stay at a healthy weight, endometrial cancer is twice as common in overweight women (BMI 25 to 29.9)
● Changes in hormones: Ovaries produces two hormones: estrogen and progesterone. Imbalance in these hormones can lead to changes in the endometrium. An increase in levels of estrogen can increase the risk of endometrial cancer.
● Not conceived: Women who have never conceived are at a higher risk of developing this type of cancer.
● Prolonged years of menstruation: Starting menstruation at an early age and experiencing delayed menopause can put you at risk of developing cancer. For instance, women who started menstruating before age 12 years or those who entered menopause post 55 years, are at a higher risk.
● PCOS: Women with a personal history or family history of Lynch syndrome (inherited cancer syndrome) or polycystic ovary syndrome (PCOS).
Endometrial cancer is often detected at an early stage because of frequent abnormal vaginal bleeding at unexpected intervals. Early detection is important for early treatment. Some of signs to look out for are:
● Abnormal vaginal bleeding: This occurs after a woman has reached menopause. The first two episodes of abnormal bleeding should not be ignored and consulted with the doctor for early treatment.
● Painful urination: This is one of the most common warning signs to look out for. Painful stool or urination needs to be attended
● Unexpected weight loss: Unexpected weight loss is one of the most common symptoms which is often overlooked due to its commonality. Unexpected weight loss without heavy exercising needs to be consulted.
While there are no screening tests or exams to find endometrial cancer early in women who are at average risk and have no symptoms, the following is recommended for diagnosis:
* Women who have or are likely to have Lynch syndrome should go for yearly testing with an endometrial biopsy starting at age 35. In this procedure, a sample of the endometrium is removed and looked at under a microscope.
* One should go for pap test.
* Transvaginal ultrasound exam: In this exam, the thickness of the endometrium and the size of the uterus are measured. A thickened endometrium (more than 4 mm) means that more testing is needed.
Post diagnosis, the woman needs to undergo surgery. The surgical method is known as total hysterectomy and salpingo-oophorectomy. In total hysterectomy the cervix and uterus are removed, and salpingo-oophorectomy involves removal of both ovaries and fallopian tubes. After surgery, the stage of cancer is determined. Staging helps determine if additional treatment such as chemotherapy or radiation therapy is needed.
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When to consult the doctor?
If the symptoms are detected early, it is advised to consult your doctor immediately for an early treatment. Early detection will help in determining the stage of cancer and providing treatment accordingly. At menopause, it is important to speak with your doctor about the risks and symptoms of endometrial cancer.
● Maintain a healthy body weight: Obesity is linked with endometrial cancer hence it is essential to maintain a healthy weight. Increase in physical activity and making lifestyle changes through food choices can reflect on your overall health
● Consider taking birth control pills: Using oral contraceptives for at least a year may reduce the overall risk of endometrial.
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