Early stage endometrial cancer

Endometrial cancer is a group of epithelial cell malignant tumors that occur in the wall of the uterus and is more common in menopausal and postmenopausal women. Endometrial cancer is one of the most common female urinary tract cancers, with nearly 200,000 new cases each year, and is the third most common cause of death among gynecological malignancies (after ovarian cancer and cervical cancer).

Its onset is closely related to lifestyle, and its prevalence varies in different regions. In North America and Europe, its incidence rate is second only to breast cancer, lung cancer, and colorectal cancer, ranking first among female urinary system cancers. In China, with the development of society and the improvement of economic development standards, the incidence of endometrial cancer has gradually increased. It is currently second only to cervical cancer among malignant tumors of the female urinary system.

Causes of Endometrial Cancer

The cause of endometrial cancer has not yet been determined. It is generally believed that endometrial cancer can be divided into estrogen-dependent (type I) and non-estrogen-dependent (type II) based on its pathogenesis and ecological behavior characteristics. The vast majority of estrogen-dependent endometrial cancers are mural carcinomas, and a small portion are mucinous adenocarcinomas; estrogen-independent endometrial cancers include plasma cell carcinomas, clear cell carcinomas, etc.

Clinical symptoms of endometrial cancer

1. Symptoms

Patients in the very early stages may have no obvious symptoms and are only discovered accidentally during investigations or gynecological examinations. Once symptoms occur, they are usually manifested as:

(1) Irregular bleeding Vaginal bleeding is a clinical symptom of endometrial cancer, usually with small to moderate amounts of bleeding. In young ladies or menopausal women, it is often mistaken for irregular menstruation and ignored. In postmenopausal women, the main symptoms are continuous or intermittent vaginal bleeding. Some patients only present with a small amount of pink vaginal discharge after menopause. Terminally ill patients may have rotten flesh-like tissue in their bleeding.

(2) Vaginal discharge Some patients have varying degrees of vaginal discharge. In the early stage, it may be manifested as a thinner white discharge or a small amount of bloody leucorrhea. If it is combined with infection or necrosis of the cancer, there may be purulent discharge with a foul odor. Sometimes tissue-like material may be present in vaginal discharge.

(3) Painful cancer and the bleeding or infection it causes can stimulate uterine contractions and cause intermittent lower abdominal pain. Postmenopausal women have difficulty draining secretions from the uterine cavity due to the narrow cervical canal, and secondary infection causes uterine cavity pyometra. Patients may experience severe lower abdominal pain accompanied by fever. In the late stage of the tumor, cancerous tissue infiltrates through the uterine cell layer, or invades the parauterine connective tissue, paracervical cruciate ligament, bladder, intestines, or invades the compressed pelvic wall tissue or nerves, which can cause persistent and gradually increasing pain, which may be accompanied by lumbar pain or radiate to the lower limbs in the same direction.

(4) Abdominal masses In the early stages of endometrial cancer, abdominal masses should generally not be touched. For example, if endometrial cancer is combined with a large uterine fibroid, or if pyometra forms in the late stage and migrates to the pelvis and abdomen to form a large mass (such as when the uterus and ovaries migrate), the mass may be felt in the abdomen. It is usually solid, has poor mobility, and sometimes has a dull pain.