Endometrial carcinoma starts in the cells lining the uterus and includes endometrial adenocarcinomas. Once endometrial carcinoma is diagnosed, it is staged. Staging involves using a standardized classification to describe the spread and extent of disease; and also helps guide treatment options and prognosis. Stages of endometrial carcinoma range from Stage 0, noninvasive cancer; to Stage IV, the most advanced stage of disease.
Significance
In 2009 in the United States, approximately 42,160 new cases of endometrial cancer were diagnosed, and 7,780 women died from the disease, according to the National Cancer Institute.
Features
The American Cancer Society describes Stage IV endometrial cancer as having two substages. Stage IVA describes cancer that has invaded the inner lining of the rectum or bladder. Lymph nodes might be cancerous, but distant organs are cancer free. Stage IVB endometrial cancer is diagnosed when the cancer has spread to organs far away from the uterus, such as the bones. Cancer may or may not be in the lymph nodes.
Diagnosis
If a health care professional suspects endometrial cancer, several procedures may be done to help definitively diagnose a woman. An endometrial biopsy is the most common procedure, according to the American Cancer Society, and can be done in a doctor's office. This entails inserting a flexible tube into the uterus and removing a small amount of uterine lining, which is then sent to a laboratory to be further examined for cancer. If the results are not definitive or not enough tissue was taken, a procedure called dilation and curretage, or D&C, might be performed. This is an outpatient surgical procedure in which the cervix is dilated and an instrument helps scrape the endometrium from inside the uterus. The endometrium is then sent to a lab for testing.
Treatment
The National Cancer Institute lists treatment options for Stage IV endometrial cancer, including radiation therapy, both internal and external; hormone therapy; or clinical trials of experimental chemotherapy drugs. Radiation therapy uses high energy rays to kill cancer cells. In internal radiation therapy, radioactive pellets are placed near the cancer and then removed; in external radiation therapy, the radiation is aimed at the affected area from a machine outside the body. Hormone therapy for endometrial cancer can consist of anti-estrogen drugs like tamoxifen, which is used in advanced endometrial cancer, and progestin, which mimics a hormone called progesterone. Clinical trials are carefully monitored studies in which new treatments for cancer are given to see how effective the treatment is. Talking to a health care professional can clarify whether a clinical trial is an option.
Time Frame
Survival in cancer is described in five-year survival rates, which are the percentage of individuals alive five years post-diagnosis. For endometrial carcinoma, the five-year survival rate for Stage IVA is 17 percent, and for Stage IVB it is 15 percent, according to the American Cancer Society.
