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Don’t be in the dark about endometrial cancer

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We walk for breast cancer, wear bracelets to "Live Strong," and are reminded to get our annual colonoscopy, but what do we do for endometrial cancer?

"Women need more information about endometrial cancer," says Randolph Deger, MD, Virtua gynecologic oncologist. "Awareness is the first key to prevention, detection and treatment."

Not to be confused with endometriosis, a condition that involves non-cancerous growth of endometrial tissue outside the endometrium (the tissue that lines the uterus), endometrial cancer develops in the endometrium.

The good news is that when detected early and treated aggressively, most women with endometrial cancer have excellent outcomes.

"The challenge is in the symptoms," says Dr. Deger. For pre- or perimenopausal women, it can be difficult to distinguish between regular menstrual events and symptoms. "Symptoms like pelvic pain and abnormal vaginal bleeding may be mistaken for normal disruptions in a woman's menstrual cycle," he says. "Post-menopausal women may recognize there is a problem sooner."

Types and treatments
There are two different types of endometrial cancer. Type 1 endometrial cancer is usually localized and slow-spreading, seen in younger women, and readily managed by surgery. "After surgery, women may receive radiation treatment," says Dr. Deger. "It depends on the individual case."

Type 2 endometrial cancer is more aggressive and often occurs in post-menopausal women. After surgery to remove the cancer, usually a hysterectomy, women with type 2 often continue treatment with a radiation oncologist, like Deborah Butzbach, MD. According to Dr. Butzbach, every patient case is different. "Treatment decisions are made based on the stage and type of cells we see," she explains. "Biopsy results, surgery results, ultrasounds, and CT scans are factored into these decisions, as well as patient-specific factors, like age, medical history, and personal outcome goals."

"There are several types of radiation therapies that may be an option for women with type 2 endometrial cancer," says Dr. Butzbach. "Some also require chemotherapy or a combination of the two."

Starting the dialogue
While there may be more than one cause, studies suggest estrogen may play a part in the development of type 1 endometrial cancer.

"Fat helps the body produce estrogen, so women who are overweight or obese are at higher risk," says Dr. Deger. "Choosing estrogen-only oral contraceptives, and hormone replacement therapies may increase risk for type 1 endometrial cancer."

Also, there may be a genetic predisposition. "There's a much higher risk of endometrial and ovarian cancers for women who have a family history of colon cancer or a personal history of breast or ovarian cancers," says Dr. Deger. "Sharing your complete medical history with your doctor can help in defining your risk."