Endometrial cancer, also called cancer of the uterine body, develops in the lining of the inside of the uterus. It is the most common gynaecological cancer after breast cancer, affecting mainly women after the menopause.
The majority of endometrial cancers develop from the glandular cells of the uterine lining. Several types are distinguished:
Endometrioid adenocarcinoma This is the most common form, accounting for around 80% of cases. It develops from the glandular cells of the endometrium. These cancers are generally diagnosed at an early stage, because they cause bleeding quickly, which often allows prompt treatment with a good prognosis.
Serous carcinoma Rarer but more aggressive, it accounts for around 10% of endometrial cancers. It requires specific management because it tends to spread more quickly than the endometrioid form.
Clear cell carcinoma This form is also uncommon (around 5% of cases). Like serous carcinoma, it is considered more aggressive and requires adapted management.
Mixed forms Some cancers may show the characteristics of several types. The treatment is then adapted according to the components present.
This classification is important, because it guides treatment decisions. Each type of cancer may require a different approach in terms of surgery and complementary treatments.
Several factors can increase the risk:
Treatment is personalised according to:
The main warning sign is vaginal bleeding:
The diagnosis relies on several examinations:
Total hysterectomy: This is the complete removal of the uterus and cervix. This operation can be performed by different routes depending on your situation:
Removal of the ovaries and fallopian tubes: Called bilateral adnexectomy, this operation is generally performed at the same time as the hysterectomy. It is recommended because the ovaries can be a site of cancer spread, and their presence can in some cases stimulate the growth of cancer cells. In women who have not reached the menopause, this operation will cause an immediate menopause that will require specific support.
Pelvic lymph node dissection: This step consists of removing the lymph nodes of the pelvis for analysis. It is an important procedure that checks whether the cancer has spread to the lymph nodes and determines the precise stage of the disease, so that complementary treatments can be adapted if necessary. The less invasive sentinel lymph node technique can sometimes be offered in certain cases.
Radiotherapy uses radiation to destroy cancer cells that may persist after surgery. It can be given in two ways: either externally, where the radiation passes through the skin to reach the pelvis, or by brachytherapy, where a radioactive source is placed directly in the vagina for a more targeted treatment.
Chemotherapy is a treatment that circulates throughout the body via the bloodstream to destroy cancer cells. It is offered in certain specific situations: when the cancer is at an advanced stage, when it is growing rapidly, or if there are significant risk factors for recurrence.
Hormone therapy can be offered in certain cases of endometrial cancer that are sensitive to hormones (positive hormone receptors). It works by blocking the action of the hormones that could stimulate the growth of cancer cells. This treatment is particularly used in the event of recurrence, for advanced cancers, or in some young women wishing to preserve their fertility when the situation allows it.
It is a quick examination that allows the inside of the uterus to be examined using a small camera. It is performed in the consulting room or under light anaesthesia.
Radiotherapy is not painful during the sessions, but it can cause side effects that will be monitored and managed.
This is an important question, particularly for young women. In the majority of cases, the standard treatment for endometrial cancer includes removal of the uterus and ovaries, making a future pregnancy impossible. However, for some young patients with a very early cancer, it is sometimes possible to discuss a treatment that preserves fertility. This decision is taken after an in-depth discussion with the medical team, taking into account your personal situation and the characteristics of your cancer. Do not hesitate to raise your wishes for a pregnancy with your doctor from the very start of your care.
They vary according to the treatments: fatigue, digestive problems, hot flushes… The medical team supports you in managing them as well as possible.
A personalised surveillance schedule is drawn up. Follow-up after treatment includes:
- Regular clinical examinations
- Pelvic ultrasounds
- Blood tests
- Other imaging examinations depending on the case
The effects vary according to the treatments: fatigue, nausea, digestive problems, risk of infection… The medical team supports you in managing them as well as possible.
Resuming physical activity is gradual and encouraged. Your medical team will guide you on the appropriate pace.
Changes to intimate life are possible. Do not hesitate to discuss them with your medical team, who can advise and guide you.
Some treatments require hospitalisation, others can be carried out as outpatient care. The programme is adapted to each situation.
Many associations offer valuable support and guidance throughout your journey. Click here to discover a selection of patient associations that can accompany you.
