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    Endometrial Cancer Care in Northwest Indiana

    Endometrial cancer is a type of gynecologic cancer that forms in the tissue lining of the uterus called the endometrium. Because of this, endometrial cancer is sometimes referred to as uterine cancer. Most endometrial cancers are adenocarcinomas (cancers that begin in the cells that make and release mucus and other fluids).

    The risk of developing endometrial cancer increases as women get older. The most common symptom of endometrial cancer is abnormal vaginal bleeding, ranging from a watery and blood-streaked flow to a flow that contains more blood. Vaginal bleeding during or after menopause is often a sign of a problem that you should talk about with your doctor.

    Discussing your options with a gynecologic cancer specialist is important to be informed about all of your options for treatment. At Northwest Cancer Centers, our oncologists work with each patient to recommend a personalized treatment plan.

    Learn more about how uterine cancer is detected and treated.

    cancer diagnosis

    Diagnosing Endometrial Cancer

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    staging cancer

    Stages of
    Endometrial Cancer

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    cancer treatment options

    Treatment for Endometrial Cancer

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    cancer diagnosis

    Diagnosing Endometrial Cancer

    If you have symptoms that suggest uterine cancer, your doctor will try to find out what’s causing the problems. They will likely perform a physical exam and blood tests. You may also have one or more of the following tests:

    • Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the pelvis. The echoes create a picture of your uterus and nearby tissues. The picture can show a uterine tumor. For a better view of the uterus, the device may be inserted into the vagina (transvaginal ultrasound).
    • Biopsy: The removal of tissue to look for cancer cells is a biopsy. A thin tube is inserted through the vagina into your uterus. Your doctor uses gentle scraping and suction to remove samples of tissue. A pathologist examines the tissue under a microscope to check for cancer cells. In most cases, a biopsy is the only sure way to tell whether cancer is present.
    • Biomarker testing of the tumor. Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This may also be called molecular testing of the tumor.

     

    staging cancer

    Stages of Endometrial Cancer

    If uterine cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on whether the cancer has invaded nearby tissues or spread to other parts of the body.

    When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if uterine cancer spreads to the lung, the cancer cells in the lung are actually uterine cancer cells. The disease is metastatic uterine cancer, not lung cancer. It’s treated as uterine cancer, not as lung cancer. Doctors sometimes call the new tumor a “distant” disease.

    To learn whether uterine cancer has spread, your doctor may order one or more tests:

    • Lab tests: A Pap test can show whether cancer cells have spread to the cervix, and blood tests can show how well the liver and kidneys are working. Also, your doctor may order a blood test for a substance known as CA-125. Cancer may cause a high level of CA-125.
    • Chest x-ray: An x-ray of the chest can show a tumor in the lung.
    • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pelvis, abdomen, or chest.
    • MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of your uterus and lymph nodes.

    In most cases, surgery is needed to learn the stage of uterine cancer. The surgeon removes the uterus and may take tissue samples from the pelvis and abdomen. After the uterus is removed, it is checked to see how deeply the tumor has grown. Also, the other tissue samples are checked for cancer cells.

    Stages of Endometrial Cancer

    Doctors assign the stage of endometrial cancer using the FIGO system. The stages of endometrial (uterine) cancer are as follows:

    Stage I

    The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.

    • Stage IA: The cancer is found only in the endometrium or less than one-half of the myometrium.
    • Stage IB: The tumor has spread to one-half or more of the myometrium.

    Stage II

    The tumor has spread from the uterus to the cervical stroma but not to other parts of the body.

    Stage III

    The cancer has spread beyond the uterus, but it is still only in the pelvic area.

    • Stage IIIA: The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.
    • Stage IIIB: The tumor has spread to the vagina or the tissue immediately next to the uterus called the parametrium.
    • Stage IIIC1: The cancer has spread to the regional pelvic lymph nodes. Lymph nodes are small, bean-shaped organs that help fight infection.
    • Stage IIIC2: The cancer has spread to the para-aortic lymph nodes with or without spread to the regional pelvic lymph nodes.

    Stage IV

    The cancer has metastasized to the rectum, bladder, and/or distant organs.

    • Stage IVA: The cancer has spread to the mucosa of the rectum or bladder.
    • Stage IVB: The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs.

    Recurrent

    Recurrent cancer is cancer that has come back after treatment. Endometrial (uterine) cancer may come back in the uterus, pelvis, lymph nodes in the abdomen, or other parts of the body.

    Grade

    If cancer is found, the pathologist studies tissue samples from the uterus under a microscope to learn the grade of the tumor. The grade tells how much the tumor tissue differs from normal uterine tissue. It may suggest how fast the tumor is likely to grow. Tumors with higher grades (also called “poorly differentiated”) tend to grow faster than those with lower grades (also called “differentiated”). Tumors with higher grades are also more likely to spread. Doctors use tumor grade along with other factors to suggest treatment options.

    The letter "G" is used to define a grade for uterine cancer:
    GX: The grade cannot be evaluated.
    G1: The cells are well differentiated.
    G2: The cells are moderately differentiated.
    G3: The cells are poorly differentiated.

     

    cancer treatment options

    Endometrial Cancer Treatment Options

    Treatment options for people with uterine cancer can include surgery, radiation therapy, chemotherapy, and hormone therapy. You may receive more than one type of treatment.

    Surgery

    Surgery is the most common treatment for women with uterine cancer. A gynecologic oncology surgeon will work with you to discuss the types of surgery (hysterectomy) and which may be right for you.

     

    The surgeon usually removes the uterus, cervix, and nearby tissues. The nearby tissues may include:

    • Ovaries
    • Fallopian tubes
    • Nearby lymph nodes
    • Part of the vagina

    Surgery to remove lymph nodes may cause lymphedema (swelling) in one or both legs. Your health care team can tell you how to prevent or relieve lymphedema.

    Radiation Therapy for Uterine Cancer

    Radiation therapy is an option for women with all stages of uterine cancer. Radiation therapy uses high-energy rays to kill cancer cells. It may be used before or after surgery. For women who can’t have surgery for other medical reasons, radiation therapy may be used instead to destroy cancer cells in the uterus. Women with cancer that invades tissue beyond the uterus may receive a combinaton of radiation therapy and chemotherapy.

     

    Doctors use two types of radiation therapy to treat uterine cancer. Some women receive both types:

    • External radiation therapy: A large machine directs radiation at your pelvis or other areas with cancer. The treatment is usually given in a hospital or clinic. You may receive external radiation 5 days a week for several weeks. Each session takes only a few minutes.
    • Internal radiation therapy(also called brachytherapy): A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. This common brachytherapy method may be repeated twice or more over several weeks. Once the radioactive substance is removed, no radioactivity is left in the body.

    Chemotherapy for Uterine Cancer Once It Has Affected Lymph Nodes

    Chemotherapy uses drugs to kill cancer cells. It may be used after surgery to treat uterine cancer that has an increased risk of returning after treatment. For example, uterine cancer that is a high grade or is Stage II, III, or IV may be more likely to return. Also, chemotherapy may be given to women whose uterine cancer can’t be completely removed by surgery. For advanced cancer, it may be used alone or with radiation therapy.

     

    Chemotherapy for uterine cancer is usually given by vein (intravenous). It’s usually given in cycles. Each cycle has a treatment period followed by a rest period.

    Hormone Therapy

    Some uterine tumors need hormones to grow. These tumors have hormone receptors for the hormones like estrogen, progesterone, or both. If lab tests show that the tumor in your uterus has these receptors, then hormone therapy may be an option.

     

    Hormone therapy may be used for women with advanced uterine cancer. Also, some women with Stage I uterine cancer who want to get pregnant and have children choose hormone therapy instead of surgery. The most common drug used for endometrial cancer hormone therapy is progesterone tablets however, estrogen-blocking medicines may be used depending on how well the progesterone therapy works and its side effects.

    Targeted Therapy

    Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells.

     

    Monoclonal antibodies, mTOR inhibitors, and signal transduction inhibitors are three types of targeted therapy used to treat endometrial cancer.

    Immunotherapy

    Immunotherapy, a type of biological therapy, uses the body's natural defenses to fight cancer by improving your immune system’s ability to attack cancer cells.

     

    Immune checkpoint inhibitors, which are drugs that block immune checkpoints, can be used to treat some endometrial cancers. These checkpoints are a normal part of the immune system and keep immune responses from being too strong. These drugs allow immune cells to respond more strongly to cancer by blocking them.

    Find Endometrial Cancer Care in Northwest Indiana

    The gynecologic oncologists at Northwest Cancer Centers specialize in the treatment of female cancers. They work with you to ensure you are recommended the most effective treatment plan for your endometrial cancer. We have locations in the northwest Indiana area, including Crown Point, Dyer, Hobart, Michigan City, and Valparaiso. We also offer second opinions on diagnosis and treatment plans for endometrial cancer. Take the time to evaluate your options and choose the cancer care team you feel most comfortable with.

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