Endometrial cancer is the most common gynecologic cancer in the United States. A statistic like this can be daunting and a bit frightening, but the good news is according to gynecologic oncologist Emily Ko, MD, MSCR, assistant professor of obstetrics and gynecology at Penn Medicine, women diagnosed at an early stage generally have good outcomes.
“Knowing the symptoms of endometrial cancer is extremely important,” says Dr. Ko. “Irregular bleeding is typically the first symptom. At that point, a woman should see a physician for an exam, and all of the appropriate tests needed to make a diagnosis.” Endometrial cancer is a cancer that develops in the lining of the uterus called the endometrium. There are two types of endometrial cancer. Type 1 endometrial cancer tends to be associated with diabetes, obesity and metabolic syndrome, a cluster of conditions that includes high blood pressure, high blood sugar levels and high cholesterol.
“Together with cancer treatment, it’s important for women with this type of endometrial cancer to work on other areas of their health such as weight management, exercise and diet in order to have better control of the associated issues like diabetes and high blood pressure that can affect their overall health,” says Dr. Ko. She adds that there are even some clinical trials examining the use of metformin, widely used in the treatment of diabetes, to treat pre-cancerous cells in the uterus.
Type 2 endometrial cancer tends to be biologically different and is less related to metabolic syndrome, says Dr. Ko. “This type of endometrial cancer has a different way of developing in the uterus,” she adds. “We tend to see this type of cancer more frequently in African-American women.”
Who is at Risk for Endometrial Cancer?
While there are currently no screening recommendations for endometrial cancer, it’s important women speak with their physicians about their personal risk. Endometrial cancer is typically diagnosed in women over the age of 45. Other risk factors for endometrial cancer may include:
- Family history of endometrial cancer
- Early onset of menstruation
- Polycystic ovary syndrome (PCOS)
- Hormones – excessive estrogen through hormone replacement therapy or obesity
- Tamoxifen after menopause
Gynecologic Oncologists at Penn – Part of Your Entire Team
Key to successful outcomes is early detection and coordination of your care. “As surgeons, we perform complex surgery, but we also provide chemotherapy and collaborate closely with radiation oncologists at Penn,” says Dr. Ko.
“For women with endometrial cancer, we perform minimally invasive surgery via robotic-assisted surgery or laparoscopy,” she says. She also explains that in some cases, medical management with hormones or medications, or radiation alone may be used in place of surgery – especially for women who want to preserve their uterus.
For women who are still interested in having children, Penn gynecologic oncologists work closely with reproductive medicine and fertility specialists at Penn Fertility Care, so women undergoing treatment for cancer have options for child-bearing.
“Aside from comprehensive cancer care at the Abramson Cancer Center, we offer women exercise interventions, nutritional counseling and we have access to related services like diabetes and cardiovascular care,” says Dr. Ko. “Because we all work together, it’s easy to follow patients, and share information so we know the whole picture of health.”
And, Dr. Ko adds, advances in endometrial cancer research continue. “Technology and research have allowed us to get more sophisticated in the way we view cancer so we can treat it with more personalized approaches,” she says. “Tumor biology, targeted therapy, genetics and prevention are all adding more information so we can continue to enhance the standard of care.”