Endometrium cancer is the most common cancer of the female reproductive organs in developed countries. It originates from the endometrium layer in the uterus. It occurs in late reproductive and menopausal years. The average age of onset is 63 years and most patients are between 50-59 years old.

What symptoms do patients present with?

It usually presents with unexpected vaginal bleeding in menopausal patients and excessive, irregular vaginal bleeding in women who have not reached menopause. Therefore, a uterine biopsy should be performed for every bleeding in menopause. The cancer rate in postmenopausal bleeding is approximately 15%. In pre-menopausal women, if the patient’s age is over 45, a uterine biopsy should be taken in irregular, abundant bleeding. In women younger than 45 years of age, a sample should be taken if there are additional conditions such as obesity, hypertension, infertility history, not having given birth to a child, polycystic ovary disease.

What is the general prognosis of endometrial cancer?

Endometrial cancer is diagnosed at an earlier stage than other gynecologic cancers. Patients consult a doctor earlier because of heavy or unexpected bleeding during menopause. Therefore, the prognosis is better than other cancers. Up to 90% of stage 1 patients are cured. 10-20% of endometrial cancer has a different cellular structure. It tends to occur in advanced ages. It metastasizes early and life expectancy is shorter.

Who is more likely to have endometrial cancer?

Endometrium cancer is more common in Caucasians than in blacks. It is more common in obese, hypertensive and women who have never given birth. It is more common in polycystic ovary patients, women with infrequent menstruation (oligoanovulation), women with a history of infertility, women who use tamoxifen for breast cancer, women who use hormone drugs containing estrogen without progesterone, women who start menstruating at an early age and women who enter menopause late. The incidence of endometrial cancer increases in patients with Lynch syndrome, which is seen in familial bowel cancer patients.

What are the treatment options?

The main treatment for endometrial cancer is surgery. 5% of endometrial cancer patients are under the age of 40 and have a desire for children. In these patients, if it can be understood that it is very early stage, in vitro fertilization is recommended after 6 months of drug treatment. After delivery, surgery is performed again. Surgery should be performed in 98% of patients unless it is a very advanced stage. Surgery should include removal of the uterus and ovaries in the first stage. Removal of the lymph nodes can be decided by frozen (fast) pathology performed during surgery. The other method, which has been frequently used all over the world for the last decade, is sentinel lymph node evaluation. In this method, various dyes are injected into the uterus. With these dyes, the first lymph node with lymph flow is found and removed. It is known that tumor cells will follow this path. Depending on the condition of the stained lymph node, radiotherapy treatment is also considered after the operation. Sentinel lymph node application shortens the operation time. The rate of complications such as leg swelling and bleeding decreases.

What are the postoperative treatment options?

If deemed necessary, radiotherapy and/or chemotherapy can be applied after surgery. The choice of additional treatments is based on the parameters obtained by pathologic examination of the fragments removed during the operation. In some patients, no additional treatment is applied.