Endometrial Cancer

Diagnosis

• Endometrial cancer is often diagnosed in its early stages due to its characteristic symptom of abnormal vaginal bleeding. This can manifest as irregular menstruation or post-menopausal bleeding, prompting patients to seek medical attention.
• When endometrial cancer is suspected, a procedure called endometrial aspiration can be performed in the clinic to obtain endometrial tissue for examination.
• In cases where endometrial aspiration is not feasible or yields inconclusive results, patients may need to undergo hysteroscopy and endometrial biopsy for a more thorough evaluation.
• Regardless of the method used to obtain tissue samples, a definitive diagnosis of endometrial cancer requires histological examination to confirm the presence of cancerous cells.

Assessment

• Pre-operative assessment for endometrial cancer includes basic blood tests, tumour marker levels and chest X-rays.
• The grading of tumour cells should be known before surgery.
• Imaging studies can provide additional information about the depth of invasion into the uterine wall and any evidence of spread.
• Patients should be evaluated to determine the most appropriate surgical mode and approach.

• Surgery is the primary treatment for endometrial cancer.
• The specific surgical approach depends on the histological cell types, grading and extent of the tumour in the uterus.
• Many procedures can be performed laparoscopically, often with robotic assistance.
• Post-operative radiotherapy or chemotherapy may also be necessary depending on individual cases.

After completion of treatment, patients should be followed up regularly to 

• Deal with the side-effects and complications arising from the treatment
• Monitor the disease status 

Side-effects and Complications from Treatment 

• Extensive operation involves the removal of and insults to normal structures, e.g. lower limb oedema after pelvic lymphadenectomy
• Chemotherapy side-effects can be long-lasting, e.g. numbness over extremities after chemotherapy using platinum agents
• Patients who have received radiotherapy can also develop post-treatment complications 

Monitoring of Disease Status 

• Physical examination
• Vaginal cytology
• Blood test for tumour markers
• Repeated imaging studies if necessary. It helps pick up recurrent diseases