Endometrial Cancer (Uterine Cancer)

The endometrium is the mucous lining that covers the inner wall of the uterus.

Endometrial cancer primarily affects women after menopause, with the average age at diagnosis being 65 years.

The most common type is endometrioid adenocarcinoma, but there are other histopathological types, such as serous cancers, clear cell cancers, and carcinosarcomas, which are more aggressive in nature.

Common risk factors include high blood pressure, obesity, and diabetes.

Understanding Endometrial Cancer

Lynch syndrome is an inherited condition that increases the risk of developing certain cancers, particularly endometrial cancer and some digestive cancers.

Endometrial cancer is linked to a hereditary predisposition in 5–10% of patients.

A consultation in oncogenetics will be offered based on the patient’s personal and family history, as well as the histopathological and molecular characteristics of the disease.

The main symptom that may raise suspicion of an endometrial tumor is the recurrence of vaginal bleeding after menopause.

More rarely, before menopause, bleeding outside of the menstrual cycle or heavier-than-normal bleeding may indicate the presence of the disease.

There is no organized screening program for endometrial cancer, but regular gynecological follow-up and investigation at the first signs of symptoms often allow for early diagnosis.

In addition to a gynecological ultrasound, a hysteroscopy will be performed. A small camera is inserted through the vagina, and the suspicious area will be biopsied.

Depending on the type of tumor, other tests may be prescribed to assess the extent of the disease: a pelvic MRI and sometimes a PET scan.

Advanced molecular tests called next-generation sequencing (NGS) are performed on the biopsy to refine the diagnosis, better classify risk subgroups, and personalize treatments.

The main treatment for endometrial cancer is surgical removal of the uterus (hysterectomy). Sentinel lymph nodes (the first lymphatic relay nodes) are also removed in most cases. Minimally invasive surgical techniques avoid opening the abdominal wall, resulting in less pain and faster recovery after the procedure.

Depending on various prognostic factors, adjuvant treatment may be required after surgery to reduce the risk of recurrence. Pelvic radiotherapy and/or brachytherapy (internal radiotherapy) may be prescribed, sometimes in combination with chemotherapy, depending on the histological subtype and risk factors.

If endometrial cancer has spread throughout the body (metastases), several treatments are available: chemotherapy, immunotherapy, targeted therapy, and hormone therapy.