What is endometrial cancer?
Endometrial cancer, also known as uterine cancer or womb cancer, is the fourth most common cancer diagnosed in Singaporean women. It is also rising in incidence, as Singapore’s urban environment exposes women to various risk factors. The endometrial lining of the uterus is shed during menstruation. As a result, endometrial tumors often present early as menstrual abnormalities. With awareness of signs and symptoms of endometrial cancer as well as timely treatment, it can be detected and cured.
What are the signs and symptoms of endometrial cancer?
- Vaginal bleeding more than once a month or throughout the month, unlike usual monthly menstruation
- Vaginal bleeding, after 12 or more months without usual monthly menstruation or after menopause
- Difficulty passing urine or painful urination
- Painful sexual intercourse
- Pain in pelvic area
- Abnormal vaginal discharge (may be bloody or watery)
Women who experience these symptom(s) should immediately consult their doctors.
What are the endometrial cancer risk factors?
- Increasing age (60+)
- Late menopause or starting period at a early-age
- Having never been pregnant
- Obesity
- Diabetes mellitus
- Hypertension
- Tamoxifan therapy or estrogen therapy
- Genetic factors (BCRA 1 and 2 gene mutations) or family history of breast cancer or other gynaecological cancers
How can I prevent endometrial cancer?
Endometrial cancer is a multifactorial disease. Preventing it involves being aware of the risk factors and controlling risk exposure. Women can do so by:
- Maintaining a healthy BMI and avoiding obesity, smoking and alcohol
- Seeking treatment for diabetes mellitus, hypertension
- Discussing risk/benefits of hormonal therapies and the risk of endometrial cancer with their doctors
How can I detect endometrial cancer early?
There are early signs of endometrial cancer that individuals can identify. It takes awareness, courage and initiative to approach your doctor, if you believe that you may be experiencing such symptoms.
As 75-90% of endometrial cancers are symptomatic, regular screening for endometrial cancer is typically not recommended. However, patients with genetic factors, such as Lynch syndrome, are at higher risk of developing endometrial cancer and may hence seek regular screening.
Endometrial cancer diagnosis and treatment
Endometrial cancer is typically diagnosed by examining a sample of endometrial tissue. Endometrial tissue can be obtained by:
- Endometrial biopsy: Short procedure carried out without anesthesia, whereby a thin instrument enters the uterine cavity to suck out a small uterine lining sample
- Dilation and curettage: Day surgical procedure performed under general anesthesia, whereby the cervix is gently widened to obtain uterine lining cells
Subsequently, treatment may involve surgery, radiation therapy, chemotherapy, and/or possibly immunotherapy.
- Surgery: Removal of uterus, ovaries and fallopian tubes may be sufficient to completely treat the cancer, especially in early stages
- Radiation therapy: Radiation kills cancer cells and reduces tumor sizes
- Chemotherapy: Drug treatments to kill rapidly multiplying cancerous cells
- Endocrine therapy: Oral medication to block hormonal stimulation and growth of cancer cells
- Immunotherapy: Harnessing the immune system to kill cancer cells
If you are looking for a endometrial/uterine cancer specialist in Singapore, you may wish to consult Dr Lynette Ngo.
Dr Lynette Ngo is a highly experienced medical oncologist specialising in women’s cancers. She began her oncology specialization in 2005 at the National Cancer Centre Singapore and is now part of the professional team of oncologists at Curie Oncology.