Endometrial cancer (uterine cancer) - symptoms and treatment

Causes of the disease

Hormonal disorders

. The development of a tumor is caused by disturbances of endocrine metabolism, in particular, hyperestrogenism - an increase in the level of the female sex hormone estrogen. This condition can occur with diseases such as obesity (various degrees of obesity increase the risk of developing RTM from 3 to 6 times), diabetes mellitus, hypertension, and some types of ovarian tumors. Risk factors in this group are frequent abortions or miscarriages, absence of pregnancy and childbirth, late menopause, and the woman receiving estrogen hormone replacement therapy. Hormone-dependent tumors often develop against the background of uterine polyps and endometrial hyperplasia. Among all cases of RTM, neoplasms arising due to hormonal disorders account for 70%.

Endometrial atrophy

. Cancer of the uterine body occurs in the absence of endocrine metabolic disorders. This reason is also characterized by a general decrease in immunity. Against the background of atrophic processes and immunosuppression, RTM develops in 30% of patients.

Malignant neoplasms of the endometrium can be provoked by genetic disorders and family history

.
An additional risk factor is a history of breast cancer
, since taking a chemotherapy drug for its treatment increases the likelihood of developing RTM.

Patient Questions

If radiation therapy is prescribed after surgery, what complications can be expected from it?

Currently, the Center uses the latest equipment to conduct radiation therapy, which allows minimizing radiation reactions and complications.

As a rule, external beam radiation therapy is prescribed to the pelvis. Consequently, radiation reactions and complications from those organs that fall into the irradiation zone are possible:

• bladder;
• vagina;
• rectum.

If you experience discomfort or dysfunction of these organs, you must contact a specialist from our department.

Is it possible not to remove the ovaries during surgery?

It is forbidden. The ovaries must be removed along with the uterus. This is a hormonal organ that is involved in pathological metabolism leading to endometrial cancer. In addition, the ovaries are one of the main target organs to which endometrial cancer metastasizes first.

Sometimes patients worry that after removal of their ovaries they will “no longer be women.” This is wrong. Secondary sexual characteristics will not disappear after removal of the ovaries. Female sex hormones will still be synthesized in the body, but not in such quantities. This function is taken over by other internal secretion organs, for example, the adrenal glands.

After removal of the ovaries, women develop climacteric (castration) syndrome to varying degrees before menopause. As practice shows, in most cases it is tolerated quite easily and goes away after a certain time (1-2 months).

It manifests itself in the form of vegetative reactions:

• increased heart rate;
• sweating;
• the appearance of a feeling of heat or chills, sometimes fear;
• increased blood pressure.

These reactions do not pose any serious threat to the body, but if they “don’t give you peace” and lead to various neurotic states and decreased ability to work, then it is possible to prescribe non-hormonal drugs, which are usually used when a physiological menopause occurs. In such cases, you need to consult and get recommendations from a gynecological oncologist.

Is it possible to be sexually active with this diagnosis?

Can. In most cases, this question worries a woman after surgery. If radiation therapy is not prescribed in the postoperative period, then you can be sexually active no earlier than 1.5-2 months after the operation. Before doing this, it is advisable to consult a gynecologist.

If radiation therapy is prescribed in the postoperative period, then sexual activity should begin no earlier than the radiation reactions have subsided. It is impossible to give exact dates due to the fact that each woman’s body has its own threshold for tolerating radiation therapy.

Before starting sexual activity, you should also consult a gynecologist.

Symptoms of RTM

Main symptom

cancer of the uterine body - bleeding from the genital tract, which most often becomes the reason for visiting a doctor. If in the fertile age acyclic, that is, bleeding that does not occur during menstruation, can be signs of other diseases (erosion, endometriosis, benign neoplasms), then in the postmenopausal period such bleeding is characteristic primarily of endometrial cancer.

Sometimes bleeding is accompanied by other discharge: copious watery (leukorrhea), in the later stages - purulent, the color of meat slop, with a putrid odor.

Pain during RTM occurs rarely and indicates the spread of the process. Painful sensations are often localized in the lower abdomen, lower back, sacrum, and appear (or intensify) during sexual intercourse, urination, and straining. May be constant or cramping.

In later stages

illness and general condition worsens. When the process moves to the cervix, stenosis of the cervical canal may develop. Compression of the ureter and penetration of the tumor into the bladder threatens the appearance of hydronephrosis, uremia, hematuria; with invasion of the sigmoid or rectum, constipation, mucus, and blood appear in the stool. Often, with metastasis to the organs of the pelvic region, ascites occurs - an accumulation of fluid in the abdominal cavity.

Launched RTM can cause the appearance of secondary formations in the liver and lungs.

What complications can occur during and after surgery?

One of the most dangerous complications of the postoperative period is pulmonary embolism.

The presence of oncological pathology in the patient, surgery on the pelvic organs, and concomitant cardiovascular pathology are factors that aggravate this risk. Therefore, on the eve of the operation, the patient begins to prevent thromboembolic complications (drug thromboprophylaxis). It consists of subcutaneous administration of direct-acting anticoagulants (heparin, low molecular weight heparins). Thromboprophylaxis continues until the patient is activated, but not less than 7 days after surgery.

Prevention of blood clots - use of anti-embolic stockings

An important element of thromboprophylaxis is the use of anti-embolic stockings or bandaging the lower extremities with elastic bandages immediately before surgery, especially in patients with varicose veins of the lower extremities. One of the elements of thromboprophylaxis is early activation of the patient. We allow patients to get up the very next day or 1 day after surgery.

Lymphocysts

Lymphocysts may occur after removal of pelvic or retroperitoneal lymph nodes. As a rule, they either go away on their own or require conservative anti-inflammatory therapy. If conservative therapy is ineffective, then puncture, emptying and drainage of the lymphocyst is performed under ultrasound control.

Bloody issues

After surgery, there may be bloody discharge from the vaginal stump. This is usually associated with the formation of a hematoma (collection of blood) in the area of ​​the vaginal stump and its emptying. The wound surface bleeds slightly during and after surgery for some time. A hematoma forms.

Its formation may be accompanied by an increase in body temperature to 38-39 degrees Celsius. After adequate drainage of the hematoma, the temperature drops to normal levels.

An increase in body temperature in the first 5 days after surgery is associated with the patient’s body’s reaction to surgery and is not a sign of an inflammatory process.

Urinary disorders

Urinary disorders (urinary incontinence, incomplete emptying of the bladder - atonic bladder) in the postoperative period are associated with the fact that during surgery, especially with extended interventions, when it is necessary to remove adjacent tissues (parameters) along with the uterus, it is necessary to isolate the ureters and separate from the cervix to the bladder.

In this case, the innervation of the bladder and ureters is disrupted, and some of the nerve fibers are intersected. These disorders are reversible and disappear after restoration of innervation. Prolonged placement of a catheter in the bladder after surgery also contributes to the development of bladder atony. And in this case, early activation of the patient is the prevention of urination disorders.

Types of uterine cancer

Neoplasms of the uterine body are classified according to several criteria.

Due to the occurrence:

• Type I - appear due to long-lasting hyperestrogenism and endometrial hyperplasia. They have a slower flow. Such tumors are often highly differentiated and are often characterized by a favorable prognosis.
• Type II – develops during atrophic processes of the endometrium. Mostly poorly differentiated, the prognosis is less favorable.

By type of growth:

• endophytic - grows into the thickness of the uterus;
• exophytic – grows into the lumen;
• mixed (endoexophytic).

By degree of differentiation:

• high (G1);
• moderate (G2);
• low (G3).

Histological classification:

• squamous cell carcinoma;
• glandular squamous;
• serous;
• mucinous;
• adenocarcinoma;
• clear cell adenocarcinoma;
• neoplasms with low cell differentiation.

Follow-up and control

Treatment for people diagnosed with cancer does not end when active therapy is completed. Your doctors will continue to check to see if the cancer has returned, monitor any side effects, and monitor your overall health. This is called follow-up.

Experts recommend pelvic examinations every 2-4 months for the first 4 years after treatment, and then every 6 months for the next 3 years. For all three types of cancer, follow-up may include x-rays, CT scans, MRIs, ultrasounds, and blood tests (CA-125 determination).

Women who have had ovarian/fallopian tube cancer have an increased risk of developing breast cancer, colon cancer, or Lynch syndrome (some types of ovarian/fallopian tube cancer).

Relapse control

One of the goals of follow-up is to monitor relapse. The cancer process resumes due to the fact that small areas of undetected cancer cells may remain in the body. Over time, the number of these cells may increase until they appear on test results or cause abnormal signs.

Monitoring long-term and delayed side effects

Long-term side effects may persist after the treatment period. Other side effects, called delayed ones, may take months or even years to develop.

Discuss with your doctor the risk of these side effects depending on the type of cancer, your individual treatment plan, and your overall health. If your treatment is known to cause some late effects, you may need to have certain physical examinations, scans or blood tests to detect and treat them.

Maintaining your own medical records

You and your doctor will work together to develop a personalized follow-up plan. Be sure to discuss any concerns about your future physical or emotional health.

Stages of uterine cancer

Staging of RTM is carried out according to the international classifications TNM and FIGO.

How does endometrial cancer develop?

Cancer begins with the appearance in the body of just one mutated - altered cell that differs from normal ones. It occurs due to exposure to various substances, including certain medications, diseases, hereditary characteristics and other factors. Most of these cells are identified and destroyed by the immune system, but some still manage to hide from the attention of our natural defenses or resist it. Over time, those that managed to survive create many copies of themselves and form a tumor that can grow into surrounding tissues. In addition, they have another dangerous property - unlike regular cells, which are born, work and die in a strictly defined place, cancer cells can move throughout the body. They enter the circulatory or lymphatic system. The lymphatic system complements the cardiovascular system. The lymph circulating in it - intercellular fluid - washes all the cells of the body and delivers necessary substances to them and takes away waste. In the lymph nodes, which act as “filters,” dangerous substances are neutralized and removed from the body. systems, with their help they spread to various organs, become established in them and create metastases - additional neoplasms.

How does cancer develop in the uterus?

The uterus is an organ similar in size and shape to an average pear in which the fetus grows and develops during pregnancy. It consists of 2 areas:

• the upper part is called the body;
• and the lower one, connecting to the vagina, is the cervix.

The body of the uterus has 3 main layers:

• Internal - endometrium
  . During pregnancy, it thickens and nourishes the embryo, and in its absence, the mucous membrane separates and leaves the body approximately once a month. Such cycles are repeated until the onset of menopause - the cessation of menstruation at approximately the age of 49-52 years.
• Middle - myometrium
  , consisting of the muscles necessary to push the baby out during childbirth.
• External - serous membrane
  covering the organ from the outside.

Most life-threatening tumors of the uterine body develop in the endometrium. The most common type is adenocarcinoma

, which arise in glandular cells that secrete various substances.

Sarcomas are much less common

starting in the myometrium - the muscle layer, or connective tissue that supports the organ.

Diagnosis of uterine cancer

At the initial appointment, the doctor collects an anamnesis of the patient’s life and illness and conducts an examination. During a general examination, the patient’s general condition, body weight, presence/absence of jaundice of the sclera and mucous membranes, and the condition of the lymph nodes are assessed. In most cases, women with symptoms of RTM turn to a gynecologist, so the appointment will include an examination in a gynecological chair and taking smears for histological examination. Already during the examination, the doctor can assess the size of the uterus, appendages, and the condition of the cervix.

An ultrasound examination of the pelvic organs is mandatory.

(uterus, ovaries), abdominal cavity. It helps to identify the presence of a neoplasm, its location, size, presence or absence of metastatic lesions, and evaluate nearby lymph nodes.

Colposcopy and hysteroscopy are performed

– examination of the vagina, cervical canal, cervix, uterine cavity by inserting a probe with a video camera. During these procedures, a scraping is taken from the cavity or cervix for cytological examination. Collection of biomaterial for cytology analysis can also be performed using aspiration biopsy of the endometrium, diagnostic curettage of the uterine cavity.

The diagnostic standard includes general tests

urine and blood,
biochemistry
and blood clotting time, analysis for
tumor markers
.

These diagnostic procedures are performed on all gynecologist patients. They help to identify pathological processes in the early stages.

Additionally, if there is still suspicion of cancer, the following are prescribed:

• computed tomography or magnetic resonance imaging
  with the introduction of contrast to visualize the depth of penetration of the process, assess the involvement of distant organs and lymph nodes in it;
• PET-CT
  – to detect tumors and metastases of very small sizes, in the initial stages before the appearance of complaints and symptoms;
• X-ray of the chest
  - to exclude or confirm metastasis to the lymph nodes and organs of this area.

Degree of tumor differentiation

If a tumor is found, the doctor examines the tissue sample under a microscope to determine the type and grade of the tumor. This grade tells how different the type of cancer cells is from normal endometrial cells. The degree of tumor differentiation can determine how quickly it will grow. Highly differentiated tumors often grow faster and spread more often. The degree of differentiation also helps determine the further treatment protocol.

When diagnosing endometrial cancer, it is very important to determine the stage of the disease. This is the most important information for determining treatment tactics. The stages of the disease are determined based on whether the tumor has grown into neighboring organs or spread to other parts of the body.

When a tumor spreads to other organs, it consists of exactly the same pathological cells as the primary tumor and is called exactly the same. For example, endometrial cancer can spread to the lungs; in this case, endometrial tumor cells will be present in the lung. This is called metastatic endometrial cancer, not lung cancer. This complication is treated according to protocols for the treatment of endometrial cancer, not lung cancer.

To determine whether the tumor has spread, your doctor may order one of the following types of tests:

• Lab tests. A Pap test can show whether the tumor has spread to the cervix, and blood tests can reveal abnormal liver and kidney function. Your doctor may also order a test for CA-125, which is often elevated in various types of cancer.
• Chest X-ray: A chest X-ray can help identify a tumor in the lung.
• Computed tomography: Computed tomography takes many sequential X-ray slices, covering a large number of organs, and allows you to get a highly accurate picture and find a tumor in distant parts of the body: lymph nodes, lungs, etc. Sometimes computed tomography is performed with the introduction of a contrast agent.
• An MRI works like a large magnet that is connected to a computer and helps produce very accurate images of the uterus, other internal organs and lymph nodes. Sometimes an MRI is also performed with the injection of a contrast agent.

Often, surgery is necessary to accurately determine the stage of the disease. The surgeon removes the uterus and takes tissue samples from the pelvis and abdomen. When the uterus is removed, the specimen is examined to assess how deeply the tumor has grown. The surgeon also checks whether nearby organs and lymph nodes are damaged.

Treatment methods for uterine cancer

Surgery is recognized as an effective method of getting rid of endometrial cancer.

. It is practiced separately, as well as in combination with radiation, chemotherapy, and hormone therapy.

With RTM, abdominal, laparoscopic, or vaginal laparoscopic-assisted surgery can be performed. Simultaneously with hysterectomy, dissection of the pelvic or other lymph nodes is carried out, if necessary. If possible, women at a young age with the initial stage of highly differentiated tumors are shown organ-preserving operations - the uterus and fallopian tubes are removed, the ovaries are preserved.

In case of contraindications to surgical treatment, a special radiotherapy

Some types of cancer are treated
with hormone therapy
.

After surgery, taking into account the type, stage of the tumor process, the presence or absence of metastasis and organ damage, radiation therapy (general or intracavitary) or chemotherapy is performed. Radiation and chemotherapy can be prescribed in combination.

For moderate and poorly differentiated cancer that metastasizes to distant lymph nodes and organs, large distant metastases, and clinical manifestations, chemotherapy

, sometimes in conjunction with palliative radiation therapy. As the disease progresses, palliative measures or inclusion of patients in clinical trials of new cytostatic or targeted agents are advisable.

Metastasis

The spread of metastases in uterine cancer occurs in the following ways:

• Lymphogenic (through lymphatic vessels);
• Hematogenous (with blood flow);
• Implantation (in the abdominal cavity).

First of all, lymphogenous spread of tumor cells occurs.
In this case, regional lymph nodes are affected. Metastases in the lymph nodes are characteristic of late stages of the tumor process. As the oncological focus develops, cancer cells are transferred to individual lymph nodes. When uterine carcinoma begins to increase in size and affects the blood vessels, hematogenous spread of metastases occurs. First of all, other pelvic organs are affected, and then the lungs and bones. Detection of uterine metastases in the liver and kidneys is extremely rare.

The implantation method of metastasis worsens the prognosis of the disease. The appearance of metastases in the abdominal cavity occurs due to the connection of the uterus with the peritoneum through the fallopian tubes. Detection of metastases is carried out using instrumental research. For this use:

• CT, MRI. Tomography makes it possible to establish the localization, size, degree of spread of the cancer process to surrounding tissues, as well as the presence and location of metastatic foci;
• PET-CT. The use of a radioisotope contrast agent makes it possible to most accurately determine the location of metastases. The injected contrast accumulates in pathological foci; a series of layer-by-layer images makes it possible to determine the location and number of metastatic tumors.

Forecast

The prognosis for survival from uterine cancer, as well as complete recovery and relapses, depends on many factors. First of all, this is the time of cancer detection; the earlier the tumor is diagnosed, the more favorable the prognosis. The type of malignancy, the patient’s age, the presence of concomitant diagnoses, the chosen treatment tactics and the body’s response to therapy also influence.

Average prognosis for five-year survival if cancer is detected at the appropriate stage:

• in situ – 90%;
• I – 75%;
• II – 69%;
• III (A, B, C) – 58%, 50%, 47%;
• IV (A, B) – 17%; 15%.

Recurrence of uterine cancer is possible, most often it occurs within 2 years after treatment. The relapse rate is on average about 10%, it depends on the type of tumor and the degree of differentiation.

Treatment

The scope of treatment for uterine cancer is related to the stage of tumor development, its structure and location. The main treatments for uterine carcinoma include:

• Surgery,
• Radiation therapy
• Chemotherapy,
• Hormone therapy,
• Diet food.

Surgery

Surgery is a mandatory method of treating uterine tumors. The extent of the operation depends on many factors. These include:

• Stage of uterine cancer;
• Presence of concomitant diseases;
• Woman's age;
• The degree of differentiation of tumor cells.

In the case of stage 4 malignant neoplasm of the uterus in combination with severe concomitant diseases, surgical intervention is not advisable.
In such cases, palliative therapy is prescribed. Organ-conserving operations for uterine cancer are performed extremely rarely. Indications for this are the patient’s young age and the early stage of development of the tumor process. In this case, the surgeon removes the uterus and fallopian tubes while preserving the ovaries. This measure allows you to avoid early menopause.

Surgery to remove uterine cancer can be of the following types:

• Amputation. This method involves removing the body of the uterus while preserving its cervix. The advantages of uterine amputation are better tolerability of the operation, reduced risk of complications, and prevention of sexual disorders. The indications for amputation of the uterus are the early stage of the tumor and the young age of the patient. The absence of factors for the development of cervical cancer is also taken into account;
• Extirpation. A total hysterectomy involves the complete removal of the uterus along with the cervix. If regional lymph nodes are affected, lymphadenectomy is performed and material is taken for biopsy. This method of surgical intervention is prescribed in case of spread of the tumor process and its detection in the later stages.

Radiation therapy

Radiation therapy is prescribed with the aim of getting rid of the tumor focus in case of its incomplete removal during surgery. There are several ways to carry out irradiation: external and internal. As a rule, a combination of both methods is performed to increase the therapeutic effect. Radiation therapy before surgery is recommended to reduce tumor size. In the case of inoperable uterine cancer, radiation refers to palliative therapy methods designed to alleviate the patient's condition.

Chemotherapy for uterine cancer

Chemotherapy for uterine cancer is carried out in the later stages of the disease. This method is part of the complex treatment of uterine malignancy. Chemotherapy is also prescribed in cases of inoperable tumor as palliative treatment. Chemotherapy drugs for the treatment of uterine cancer are prescribed in the following cases:

• Widespread malignancy;
• Autonomous nature of the tumor;
• Active metastasis;
• Relapses of the tumor process.

Platinum-containing cytostatic drugs are used for chemotherapy treatment of uterine cancer:

• Cisplatin;
• Carboplatin;
• Adriamycin;
• Doxorubicin;
• Taxol;
• Epirubicin, etc.

Hormone therapy

This method of treating uterine cancer is used in cases of detection of a hormone-dependent tumor.
Hormonal therapy is in most cases prescribed to young girls with highly differentiated cancer. For this purpose, antiestrogens or gestagens are used, which suppress the amount of female sex hormones (estrogens), an excessive amount of which is one of the causes of the development of uterine tumors. Hormone therapy can be carried out in combination with other treatment methods to achieve maximum results. A good therapeutic result is achieved thanks to hormonal therapy using progestogen drugs: Megaisa, Depostat, 17-OPK, Provera, Farlugal, Depo-Provera, etc. Such drugs can be prescribed as monotherapy or in combination with Tamoxifen. If the process of metastasis is active and treatment with progestogens is ineffective, the drug Zoladex is prescribed. In some cases, hormone therapy is combined with chemotherapy treatments.

When selecting the most appropriate therapeutic method for each specific situation, specialists at the Yusupov Hospital Oncology Clinic take into account the following decisive factors:

• Physiological condition of the patient;
• Endocrine disorders;
• Histological indicators;
• Size and prevalence of malignant neoplasm.

Diet food

Compliance with nutritional recommendations is part of the comprehensive treatment of uterine cancer. Nutritionists recommend that patients:

• Limit fat intake. Excessive amounts of fatty foods have a negative impact on health, leading to obesity. The combination of these factors increases the risk of developing a tumor process in the uterus due to emerging hormonal imbalances;
• Include enough fruits and vegetables in your diet. This recommendation is aimed at enriching the daily diet with natural vitamins, minerals and antioxidants that have a positive effect in the prevention of cancer;
• Eat foods rich in proteins. The daily menu includes products that provide the daily protein requirement. For this purpose, lean varieties of meat, poultry and fish, and dairy products are used.

It is necessary to exclude canned foods, as well as hot and spicy foods from the diet.

Prevention of RTM

An important role in the prevention of uterine cancer is played by maintaining normal weight, moderate physical activity, and timely detection and elimination of hormonal disorders. Reduces the risk of tumor development by taking modern combined oral contraceptives.

Postmenopausal women taking hormone replacement therapy or with a history of breast cancer should be wary of RTM and carefully monitor their health.

Absolutely all women are recommended to undergo a preventive examination by a gynecologist at least once a year. If you have bleeding from the genital tract (even minor), abdominal pain, or enlarged lymph nodes, you should consult a doctor as soon as possible.

You can undergo diagnostics and receive recommendations for treatment by making an appointment at the SM-Clinic. Recording is carried out around the clock.

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Causes of endometrial cancer development

Today, doctors do not know exactly why this type of oncology begins to develop in a woman’s body - they only know the factors that can trigger the onset of this event. These include:

• An imbalance of hormones
  - substances that are created by our glands, pass through the bloodstream to organs and tissues and tell them how to act - to work or rest, to secrete something or absorb something.
  The main female hormones are progesterone
  , which prepares the body for pregnancy, and
  estrogens
  , which regulate the menstrual cycle and the functioning of the reproductive system. Their content in the body constantly changes throughout the month, due to which the correct state of the endometrium is maintained, and menstruation begins on time. Shifting the balance of these compounds toward more estrogen increases the likelihood of cancer.
• Hormone replacement therapy
  . This treatment helps reduce hot flashes, a feeling of intense heat throughout the body, reduce vaginal dryness, and prevent osteoporosis, a decrease in bone density that often appears after menstruation ends. Using estrogen alone increases the risk of developing life-threatening endometrial tumors. To reduce it, progesterone is additionally prescribed, but this combination cannot be called harmless - taking it can lead to breast cancer or the formation of blood clots that clog blood vessels.
• Obesity
  . Excess adipose tissue is also considered a disease-provoking factor, since it is capable of producing estrogens. Excess weight at body mass indexBody mass index is equal to weight in kilograms divided by the square of height in meters. BMI = kg/m2. from 25 to 29.9 this probability doubles, and obesity more than triples. It is especially dangerous for postmenopausal women.
• Increase in the number of menstrual cycles
  . The earlier your period starts and the later it ends, the longer your body is exposed to estrogen, and the higher your chances of developing endometrial cancer.
• During pregnancy, the hormonal balance shifts - the amount of progesterone in the body that protects against this type of tumor increases. Thus, the presence of several pregnancies reduces the risks, and their absence increases them.
• Tamoxifen
  is a drug that is used to prevent and combat breast cancer. It acts as an estrogen in the uterus, which can cause the uterine lining to grow after menopause and increase the likelihood of developing dangerous tumors.
• Polycystic ovary syndrome
  is the appearance of many small or large cysts - fluid-filled blisters - on these important organs. In patients with this diagnosis, the hormonal balance is disturbed, and the amount of progesterone is reduced.
• Diabetes mellitus
  is the body’s inability to transfer glucose from the blood to tissue cells to obtain the energy they need. In women with this disease, endometrial cancer occurs approximately 2 times more often than in other representatives of the fair sex.
• Age
  : The older a woman is, the higher her risks.
• 
  high-fat diet Additionally, some scientists believe that eating these foods directly affects how the body uses estrogen.
• Lack of physical activity.
  Multiple studies have shown that exercise reduces risks, while being immobile and sedentary increases them.
• Hyperplasia
  - increased growth
  of the endometrium
  can also cause the development of life-threatening neoplasms.
• Some types of ovarian tumors
  that produce estrogen. As a result of the disease, the level of this hormone increases, which leads to serious consequences, including the growth of the inner layer of the uterus.
• Family history
  : The likelihood of developing this type of cancer increases the presence of close blood relatives with a similar diagnosis or other diseases. For example, Lynch syndrome, which disrupts the repair mechanism of DNA that stores data about hereditary information in cells.
• Risk factors also include radiation.
  Even the doses received during radiation therapy can damage DNA and lead to tumors.
• Breast
  and
  ovarian
  can also increase the chances of developing life-threatening endometrial tumors.

Oral contraceptives - birth control pills, as well as hormone-free intrauterine devices reduce the likelihood of this type of cancer.

How can you tell what caused the bleeding?

Data from various studies show that cancer of the uterine mucosa (endometrium) is diagnosed in only 10%. Bleeding or bloody discharge from the uterus in postmenopausal women is considered a reliable sign of endometrial cancer, while there are many other reasons for this bleeding. Hyposonography or sonohistography aids in diagnosis. This is a simple, painless transvaginal ultrasound method. In addition, when using a thin catheter, a sterile saline solution or a special gel is injected into the uterine cavity, which helps the gynecologist examine the cavity during an ultrasound examination and recognize other causes of bleeding.