Stage Four Endometrial Cancer

Understanding the signs and symptoms of cancer of the uterine lining
By Kathryn E. Vinson, MS, CCRC

In the world of cancer, there are some big names such as lung, breast, skin, and colon to name a few; however, there are some that don’t get quite as much attention, despite their devastating effect on people and their families. Among these lesser discussed cancers, is endometrial cancer, or cancer that starts in the lining of a woman’s uterus, which is the most common gynecological cancer in the United States. This disease was projected to account for over 65,000 new diagnoses in 2020 and take as many as 12,590 lives. Let’s take some time today to learn about late-stage endometrial cancer, its risk factors and symptoms, treatments, and what new research is telling us about this dreaded disease.

Risk factors for endometrial cancer

Endometrial cancer has a somewhat complicated list of factors that influence its development – some are true risk factors, while others help prevent it.

FactorRisk FactorPreventative FactorIncreased Age

X

Early onset of menstruation

X

Late onset of menstruation

X

Early menopause

X

Late menopause

X

Previous cervical or breast cancer

X

Use of Tamoxifen

X

Use of oral contraceptive pills

X

Use of non-hormonal IUDS

X

Diabetes

X

Obesity

X

Family history of endometrial or colon cancer

X

Increased number of pregnancies

X

One thing that research has shown is that the number of periods that a woman experiences in her lifetime has an influence on the development of endometrial cancer. The higher the number of periods, the higher the risk. While this is something that we ladies really can’t control, the knowledge of an early menarche (when a young woman gets her first period) or a late menopause gives us the proverbial heads up that we are at an increased risk, and to be aware of warning signs. Interestingly, the more pregnancies that a woman experiences, the lower her risk of endometrial cancer. The progesterone produced during pregnancies has been found to be protective against this type of cancer. Likewise, the hormones found in oral contraceptives and in combination (estrogen and progesterone) hormone replacement therapy (HRT) appear to be protective as well. It should be noted that estrogen only HRT is not protective against endometrial cancer and may increase the risk.

From a standpoint of ethnic background, Caucasian women are more likely to be diagnosed with endometrial cancer than Black ladies; however, Black ladies are more likely to succumb to endometrial cancer than Caucasian, due to the fact that they tend to be diagnosed at later, more advanced stages.

Signs and Symptoms of Endometrial Cancer

If there can be said to be a good thing about endometrial cancer, it is that its signs and symptoms are fairly easy for ladies to notice. The most common symptom, appearing in about 90% of women with endometrial cancer, is abnormal vaginal bleeding or discharge. This could be bleeding between periods or after menopause. Other symptoms include pelvic pain, unexplained weight loss, and a noticeable lump or mass in the abdomen – all of which are indicative of more advanced or later stage disease.

Treating Stage Four Endometrial Cancer

While endometrial cancer is considered highly treatable if caught early (surgery may be the only treatment needed), when diagnosed at stage 4, endometrial cancer has spread into the bladder or the bowel, or to lymph nodes outside of the pelvic region. In most cases, a radical hysterectomy (removal of the uterus and cervix) and removal of both fallopian tubes and both ovaries will be performed. Although this surgery does not address the spread of the disease to other organs or areas of the body, it helps to prevent bleeding in the patient. After surgery radiation, chemotherapy, hormone therapy, and targeted immunotherapies are all common and are often used in combination. Clinical research trials are also an option for stage four endometrial cancer patients. Take a look at our page dedicated to clinical trial listings if you feel this option might be right for you or your loved one.

New Research into Endometrial Cancer

Some interesting new research came out of Sweden in late December 2020. Researchers at Uppsala University studied information from the UK Biobank on women that both used (termed “ever users”) and didn’t use (termed “never users”) oral birth control pills and their corresponding risk factors for endometrial, cervical, and breast cancers. What they found was quite fascinating. Looking at women that were ever users – meaning that they had used oral contraceptives ever in their lives – they found that this group of ladies were less likely to develop endometrial or cervical cancer. While the benefits increased with duration of use, they were present across the entire group. What this study also found is that the increased risk of breast cancer that is associated with birth control pills begins to drop off two years after discontinuing the pill.

As always, much love, many prayers, and abundant blessings to all of the warriors out there!!