Endometrial Cancer Survival Rate

What Is Endometrial Cancer?

Every year, around 50,000 women all across the United States are diagnosed with uterine cancer [¹]. One of the most prevalent kinds of uterine cancer is endometrial cancer, which is a malignant neoplasm found in the lining of the uterus, also called the endometrium.

The ICD-10 code for endometrial cancer is C54.1, which can help patients seeking treatment. When found early, this malignant neoplasm is highly treatable. The neoplasm starts at the lining of the uterus, but it is not to be confused with uterine sarcoma.

While uterine sarcoma involves the tissue or muscle of the uterus, endometrial cancer is a neoplasm that affects cells responsible for developing glands in the endometrium [²].

The following sections discuss some of the common types, details regarding the signs and symptoms, the diagnosis, survival rate, and treatment options for endometrial cancer.

Types of Endometrial Cancer

Endometrial cancer is found in the cells in the uterus's inner lining, also called the endometrium. This common sub-type of uterine cancer also includes multiple variations.

Variations in neoplasms found in different organs commonly link to the way cells present themselves under a microscope. For endometrial cancer, the types include [³];

• p53 mutation
• POLE mutation
• Copy number high
• Copy number low

There are also other kinds of endometrial cancers that aren't as common, with a greater chance of rapidly progressing to endometrial carcinomatosis (the spread of cancer to other regions of the body).

What Are the Signs and Symptoms of Endometrial Cancer?

Some common signs and symptoms of endometrial cancer usually present themselves before the disease progresses into carcinomatosis. Neoplasms in endometrial linings usually produce the following symptoms [⁴];

• Abnormal vaginal bleeding: This is one of the most common signs. In some, it may present itself as post-menopausal bleeding. For women that have not yet entered menopause, heavier or abnormal bleeding during or between periods is a common symptom.
• Abnormal discharge: This is also a common sign of a neoplasm in the endometrial lining. This discharge can be pink, watery, or even thicker and darker, often accompanied by a foul smell.
• Urinary tract concerns: Some issues, such as painful urination, might also present in the later stages.
• Other symptoms include pain during sexual intercourse, an enlarged uterus (noticeable during a pelvic exam), or sudden weight loss [⁵].

Note that abnormal bleeding is quite common. In fact, post-menopausal bleeding is only diagnosed as endometrial cancer in about 15% of cases [⁶]. The symptoms listed above aren't a sure sign of endometrial cancer. It is best to discuss any medical concerns with a professional before reaching a conclusion.

Endometrial Cancer Diagnosis and Staging

Diagnosis and staging of malignant neoplastic disease are essential in the recovery and treatment process. In fact, an earlier diagnosis can lead to better treatment and timely management of neoplasms, thus preventing carcinomatosis.

How is Endometrial Cancer Diagnosed?

Endometrial cancer can be diagnosed by understanding your medical history and further examination by a physician. This can include [⁷];

• A pelvic exam: A doctor may ask you to come in for a pelvic exam and feel for lumps or changes in the uterus.
• Ultrasounds: Your doctor can simply ask for an ultrasound in earlier stages, be it regular or transvaginal, to observe the endometrium externally.
• Pap smear: A common way to check for endometrial cancer is through a pap smear which tests cells in the cervix for changes that could either be cancerous or potentially turn cancerous in the future. This can also clarify other conditions that might be causing the symptoms.
• Biopsy: In some cases, your gynecologist might recommend an endometrial biopsy. This involves inserting a small tube in the uterus and collecting a tissue sample. The sample is later examined using a microscope for a malignant neoplasm.

Your doctor may also recommend dilation and curettage (D&C), which involves dilating the cervix and scraping the uterine lining with a curette. Tissues are later examined in a lab.

Endometrial Cancer Staging

Staging usually follows diagnosis and is the process where a neoplasm is evaluated for progression. This simply means doctors will attempt to analyze how far the disease has progressed. For a malignant neoplasm, different stages are defined to identify progression.

Some of the stages of endometrial cancer include [⁸];

• Stage 1: The cancer is restricted to the area of the uterus and cervix glands but has not yet reached nearby lymph nodes.
• Stage 2: Cancer has spread to the connective tissue of the cervix but is still confined to the uterus. Nearly lymph nodes have also not been exposed.
• Stage 3: Cancer has spread outside the confines of the uterus but hasn't reached other organs, such as the rectum or bladder. It has also not touched the nearby lymph nodes.
• Stage 4: Cancer has spread to other organs or lymph nodes.

Is Endometrial Cancer Hereditary?

Endometrial cancer doesn't have a direct hereditary link, so it may not be passed from mother to daughter. However, some gene defects may establish hereditary links in certain families.

For example, the Lynch syndrome caused by defects in MLH1 or MLH2 genes and others can lead to a higher chance of endometrial cancer [⁹]. However, this may not have a notable impact on treatment options.

Endometrial Cancer Survival Rate

The prognosis for endometrial cancer usually considers two separate metrics: survival rate and quality of life (QOL). Doctors and researchers typically define survival rate in terms of the five-year survival rate, which indicates the percentage of patients who are alive five years after their diagnosis.

The survival rate for endometrial cancer is highly dependent on the stage of the disease, including tumor size and extent of metastasis, as well as on the underlying health status of the patient. In general, endometrial cancer cancers caught at earlier stages (stage 0/in situ, stage 1) have a better outlook.

If the cancer has metastasized, treatment is more difficult, but in any case, it is important to maintain hope. It is important to understand that survival statistics represent averages - they should not be taken as prescriptive determinations of your future outcome.

What Is the Survival Rate for Endometrial Cancer?

Survival rates can allow you to understand what percentage of people are alive for a specific period of time after diagnosis. Long-term survival is usually measured at more than five years. However, a mean survival rate or survival probability isn't an accurate depiction of your personal survival rate, as responses to treatments may differ.

The mean survival rate calculation of endometrial cancer is also dependent on estimates determined through research of larger groups of people with a similar diagnosis and treatment. However, it is impossible to determine how an individual may respond to treatment.

Survival for endometrial cancer has different definitions. While some people may look for research on the 5-year survival rate, others might want to understand the chances of disease-free survival.

Survival According to Staging

The survival probabilities are calculated according to staging. However, since the four stages have multiple sub-sages and understanding can become complicated, the SEER database has divided them into three stages: localized, regional, and distant [¹⁰].

Based on research conducted on women diagnosed with endometrial cancer from 2012 to 2018, SEER presented the following findings;

• People with localized endometrial cancer had a 96% 5-year survival rate.
• People with regional endometrial cancer had a 72% 5-year survival rate.
• People with distant endometrial cancer had a 20% 5-year survival rate.

The findings conclude that stages are important in the survival rate and prognosis. Mean survival rates and chances of disease-free survival are better for people with localized endometrial cancer. However, the spread of cancer to distant areas can lower the chances of long-term survival.

Some other factors are also listed below [¹¹];

Myometrial Invasion

This is one of the most important factors that can affect long-term survival and relevant prognosis. Myometrial invasion refers to the growth of a tumor that can invade the uterus wall.

Myometrial invasion isn't just used to determine survival but also to calculate the chances of recurrence. The further the tumor pressed into the myometrium, the fewer the chances of long-term survival.

Type

Classification of endometrial cancer into different subtypes is essential for research. This can also shed light on the prognosis for different individuals. Some types of endometrial sarcomas progress much more rapidly than others. These include the following [¹²];

• Clear-cell carcinoma
• Serous adenocarcinoma
• Dedifferentiated carcinoma
• Undifferentiated carcinoma
• Mucinous adenocarcinoma

Age

Women who receive a diagnosis at a younger age have a much better chance of receiving ideal long-term survival rates. However, younger women are less likely to be diagnosed with uterine cancer at a quicker rate when compared to older women, which can lead to a different prognosis.

The reason for a better prognosis is the fact that tumors might not have grown into the myometrium at a younger age. As the disease progresses, it becomes harder to treat.

Other Factors

Different factors, such as obesity, may lead to other health concerns that can hinder treatment. Moreover, the presence of certain hormone receptors on cancer cells can mean the cancer is less aggressive and easily treatable.

Endometrial Cancer Treatment Options

Despite differing research on prognosis, treatment options are available. Different treatments apply to different kinds of individuals depending on their individual characteristics. These include your medical history, how far the disease has progressed, allergies to medication, and personal preference.

Treatment Types for Endometrial Cancer

Treatment types include;

1. Surgery

• Hysterectomy: The removal of the uterus.
• Salpingo-oophorectomy: The removal of the fallopian tubes and ovaries.
• Different surgeries that involve the removal of lymph nodes.

2. Radiation therapy

This involves removing cancer cells through different rays. Throughout the years, brachytherapy has emerged as an ideal option for many patients.

3. Chemotherapy

This involves using drugs that work at eliminating cancer cells.

4. Others

Recent developments have introduced immunotherapy and hormone therapy to the mix. However, clinical trials for most of these developments are still underway.

Clinical Trials for Endometrial Cancer

Clinical trials can be accessed for endometrial cancer, but every case is unique. Different drugs that have been approved by the FDA are often offered to patients on a trial basis. Entering these trials can expose you to different combinations of treatments, radiation, drugs, therapy, and surgeries.

However, the cost of joining a trial or applying for relevant insurance may vary from region to region. Your doctor can provide you with more information on the same.

Conclusion

Takeaway

Endometrial cancer diagnosis, prognosis, and treatment vary from individual to individual. The information provided in the sections above is simply a starting point. Discuss any concerns with your doctor before you proceed.

Despite the aggressive nature of endometrial cancer, a treatment option is always waiting on the horizon. Moreover, clinical trials continue to provide individuals with advanced treatment options to increase their chances of survival.