Around 24,000 people in the Unites States annually have an endometrial neoplasm and around 6,000 people are diagnosed with an [endometrial cancer](https://www.withpower.com/clinical-trials/endometrial-cancer). However, the prevalence and mortality from these cancers remain unknown because of the rarity of endometrial neoplasms and cancers, especially endometrial cancer.
Because most endometrial neoplasms occur in post-menopausal women, it is not always possible to identify the hormone or estrogen receptor status of the lesion to definitively indicate what hormones may be of relevance. While no clear estrogenic cause of epithelial lesions has been established, both estrogen-dependent and estrogen-independent mechanisms may be active. Estrogen-dependent mechanisms arise from direct cellular growth stimulation caused by estrogen. Estrogen-independent mechanisms include, on one hand, the interaction of various cell constituents with estrogen, and on the other, the production of androgen-independent secreted factors.
The most frequent endometrial neoplasms, in a worldwide sense, are a very old group of cancerous lesions. Nevertheless, endometrial sarcomas still constitute only 1% of these lesions. These neoplasms do not deserve much attention from a morphologic point of view, because the mainstay of diagnosis is not based on their appearance. On the other hand, benign proliferative lesions, which comprise about 90% of endometrial neoplasms, have a high potential of malignancy. Thus, more attention must be given to the diagnosis of these lesions.
Most primary endometrial cancers are treated with curettage only. Given that recurrence is extremely rare, patients should be assessed on an individual basis, and they should not be denied treatment if this is thought by the patient has cure potentially an important component of the decision making process for the patient and the clinician.
Treatment of endometrial neoplasm is dependent on type and grade of the tumor and location of the tumor within the uterus. For low-grade tumors and endometrioid types, surgery may be the best option for first-line treatment. Higher-grade tumors may progress or spread to other areas of the uterus, where more aggressive treatment may be indicated. Chemotherapy with either platinum-based or Taxane may also be of some benefit in the case of high-grade tumors with pelvic, distant, or liver spread. Radiation therapy may be an option for treatment if chemotherapy is not an option.
Signs of endometrial neoplasms can be vague and nondescript. There may be an abnormal uterine bleeding suggestive of malignancy or a normal menstrual cycle. A biopsy or other surgical procedure should be taken to rule out malignancy.
Endometrial cancers are often associated with a prior history of endometrial hyperplasia. In addition, some patients develop cancers outside the uterus. There is ongoing controversy whether some cases of cancer may develop from an epithelial precursor or whether they may develop elsewhere later in life and be interpreted as a endometrial cancer. The endometrial lining is constantly replaced by progesterone to produce a state of monthly amenorrhea. This is due to the action of inhibin produced by the corpus luteum and by the blastocyst. It is the loss of this monthly amenorrhea as a result of any factor that prevents progesterone production that prevents the endometrial cells from remaining immortal.
Survival rates for early stage endometrial cancer that progressed within 2 years of surgery were less than 10%, while rates for advanced lesions that recurred after surgery more than 2 years had increased. The latter patients with recurrent endometrial cancer underwent surgery that may have contributed to the development of an metastatic lesion in the lung or other sites.
[Prognosis is important not only to women with these diseases but also to their husbands(http://www.brit-jesp.org/journal/article/view/10/10-2095/10-2095.) who may be encouraged by their wives to seek medical help after their wife is diagnosed with these disease. A complete menstrual cycle is important to assess whether a woman has endometriosis or cancer of the uterus. In women with endometriosis, the first indication that endometriosis is a problem is the appearance of dark, bloody spots in a woman's ovaries or in the fallopian tubes. In most women, these spotting are not abnormal.
Data from a recent study, our results showed that the rate of metastasis did not differ between the endometrioid and carcinoid subtypes. Considering that these tumors are usually endometriotic in origin and have an excellent survivability, in patients without clinical symptoms, surgical staging and treatment is usually an outpatient procedure.
Although the lifetime risk of developing endometrial cancers is 1.6 percent, when endometrial cancer is present at the time of diagnosis, a diagnosis of endometrial cancer has a higher risk for development of a second endometrial cancer. To reduce the risk of developing another endometrial cancer, patients diagnosed with an endometrial cancer at an early stage of diagnosis are likely to need to be carefully followed up and to be treated with the most effective modality for endometrial cancer: surgery. At present, patients diagnosed with EC, endomyoma, and adenomyosis at an early stage are more likely to be successfully treated with a hysterectomy and more likely to go on to have children.
These side effects are not uncommon. However, the patient profile of those who experienced more severe side effects was distinct within the sample and may not necessarily represent the population of users.