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Endometrial Cancer

The endometrium is the lining of the uterus or womb. Endometrial cancer is the most common gynaecological cancer with around one in 35 women being diagnosed with an endometrial cancer in their lifetime.

Risk factors

  • Being overweight or obese

  • Age >50

  • A thickened lining of the womb (endometrium – endometrial hyperplasia) 

  • A genetic predisposition

  • Having no children

  • Taking oestrogen without progesterone as hormone replacement therapy

Symptoms

  • Bleeding after menopause

  • Heavy periods, that is new for your

  • Abnormal vaginal discharge

  • Changes to your bladder or bowel function

  • It is important to see your doctor promptly if you develop any of these symptoms

Image by National Cancer Institute

Diagnosis

In the first instance your GP should arrange a pelvic ultrasound and refer you to a gynaecologist for urgent assessment. A biopsy of the endometrium is required and can be done either under local anaesthetic in the rooms or under a general anaesthetic during a hysteroscopy procedure. Dr Goulding can offer both of these options and will tailor her recommendations based upon your particular circumstances. She prides herself on the fast assessment, diagnosis and treatment that she offers to patients with endometrial cancer.

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sentinel lymph node mapping 

Symptoms

The kind of treatment you have will depend upon the size of the cancer, whether it has spread beyond the uterus, your age, health and medical history.

Endometrial cancers that have not spread beyond the uterus are often cured with surgery alone, however if the cancer has risk factors for recurring or has spread beyond the uterus other treatments may be recommended after your surgery to reduce the risk of the cancer coming back.

 

This includes radiation treatment (either to the top of the vagina, brachytherapy or to the entire pelvis, external beam therapy; or both), chemotherapy and other targeted treatments. Sometimes if you have an early cancer of the endometrium that is low risk you may be treated with hormones (an intrauterine contraceptive device) and monitoring, this is offered on a case-by-case basis and is an option to some women who are still desiring their fertility.

Surgery in endometrial cancer

Surgery is the gold standard of treatment for most endometrial cancers. This includes a laparoscopic (key hole) hysterectomy with removal of tubes and ovaries and sampling of the lymph nodes (glands) within the pelvis. This is typically done via a sentinel lymph node biopsy, a procedure that minimises the side effects of having a lymph node assessment. Dr Goulding is able to perform this surgery with skill and precision.

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