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Endometrial CarcinomaEndometrial Carcinoma – General InformationEndometrial Carcinoma is a kind of disease that affects the lining of the uterus, also known as endometrium. This kind of cancer usually appears after a few years of menopause. It is also considered to occur after an exposure to excessive estrogens, and develops from the endometrial hyperplasia. The estrogen generally stimulates the uterine lining to proliferate, making it lush and thick. Usually, estrogen is in opposition with progesterone, which is a hormone produced by ovulation. This hormone has the effect of inhibiting the proliferative actions of the estrogen. It has the role to assure structural support to the endometrium which is generally soft and friable. At the end of the menstrual cycle, the progesterone hormone is not produced any longer and the structural support for the endometrium disappears, becoming thickened and weakened, leading to the shedding of the uterine lining. The main sign of Endometrial Carcinoma is the vaginal bleeding. After ovarian and cervical cancer, this kind of cancer is considered the third major gynecologic cancer. The Endometrial Carcinoma is classified in two types, I and II. The type I cancer appears in the pre menopausal period. It occurs in patients who have been exposed to estrogen or endometrial hyperplasia. This type of cancer is usually easy to treat. The type II cancer appears in older patients, in the post menopausal period and is more encountered in Africans. This type of cancer is generally a life threatening form and does not respond well to the available treatment.Endometrial Carcinoma – SymptomsThe main cause for the Endometrial Carcinoma is the high level of estrogen inside the uterus. But there are other causes in developing the disease and can include obesity, hypertension and polycystic ovary syndrome. There are cases in which the patient develops the cancer if she suffers from nulliparity, has never carried a pregnancy, infertility (the inability to become pregnant), early menarche, the onset of menstruation and late menopause, cessation of menstruation. The main signs and symptoms of Endometrial Carcinoma are vaginal staining and bleeding, which happens in the post menopausal patients. In most cases, the symptoms are obvious and the patient can go to a doctor and perform a biopsy. The biopsy procedure can diagnose the cancer in an early stage, increasing the chances of curing. But not only postmenopausal patients who have vaginal bleeding should see a doctor. If any patient in the pre menopausal period has the same vaginal bleeding she should also contact the doctor, to make a biopsy. There are many other specific signs and symptoms for the Endometrial Carcinoma and can include pain in the pelvic or abdominal area, back or legs, bladder or rectal pressure sensation, weight loss or general weakness, which are usually signs that the cancer had spread in the surrounding areas of the patient’s body. There are also cases in which the cancer can appear asymptomatic, making it more severe in the late stages. It is very important to treat the cancer in the early stages because this condition can become life threatening.Endometrial Carcinoma – TreatmentThe diagnosis for Endometrial Carcinoma is usually made by a microscopic test of the cells that exist in the uterine lining. The cells are elevated by a suction procedure called scraping biopsy. The endometrial biopsy consists in scraping the uterus. There are cases in which the diagnosis of the disease requires dilation and curettage procedures, because the female patient has a small cervical opening or discomfort. When a patient in whom Endometrial Carcinoma has affected a part of the differential, the hysteroscopy procedure is contraindicated because the fluid used to dilate the uterine cavity for the test, can disseminate the carcinoblastomas through the fallopian channels inside the peritoneal cavity. There is another procedure called pelvic sonogram, which shows the thickness of the uterus cavity, an important sign of the cancer. Generally, if the uterus walls are thin, 5 mm, the doctor can be sure that the patient does not suffer from Endometrial Carcinoma. Another sign of cancer presence is the unusual uterine bleeding. In most cases, the prescribed treatment depends on the stage of the cancer and on the age of the female patient. If the patient has no reproductive desires, the doctor can remove the both tubes and both ovaries by a procedure called abdominal hysterectomy. This kind of operation is usually made in postmenopausal patients. After they get rid of the reproductive organs, the doctors can also prescribe a treatment trial with progesterone, administered orally. Progesterones are types of hormones that have to be taken for more than two months to treat the uterine lining. After treatment ends, the patient has to make another biopsy to see if the treatment has worked. If the progesterone treatment is prescribed in the early stage of the Endometrial Carcinoma, the cancer can be cured. After this, the doctor prescribes medication for life to prevent cancer recurring. However, if the cancer has not been cured with the hormonal treatment, the doctor can make a third biopsy, or, in some cases, a hysterectomy, which is the main choice. The hysterectomy procedure consists in removing both the tubes and ovaries, leading to the appearance of a fluid from the uterus cavity, which contains the cancer cells. There are cases, in which the doctor diagnoses the patient with high grade cancer and can remove the whole uterus. This kind of procedure is considered risky, because it can lead to the appearance of severe complications such as infections, bleeding and injury in the bladder, rectum and ureter area. It can also cause the development of other conditions which can include pulmonary embolism, characterized by several blood clots on the legs that can travel to the lungs. There is another operation that can be applied in Endometrial Carcinoma called post operative radiation. This procedure consists in invisible external beam radiation, which is administered daily. The radiation therapy can develop several side effects such as diarrhea, nausea, intestinal obstruction, bleeding from the bladder, rectum or vagina and fistulas in the urinary tract. After these operations doctors can prescribe chemotherapy for full recovery. |
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