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Dr. Su Xuan’s endometrial cancer teaching guidelines

(Schematic picture. Image source: shutterstock)

"Doctor, I saw a tumor during the ultrasound. Could I have endometrial cancer?"

This kind of problem often occurs in the clinic. Endometrial cancer is an unfamiliar term to the public. In the past, health education rarely paid much attention to this cancer. Everyone knows how to pay attention to breast cancer and how to prevent cervical cancer, but what about endometrial cancer?

"Doctor, I do smears every year, why do I still get endometrial cancer?" The patient helplessly raised this doubt, which further revealed the blind spots of the public health system, endometrial cancer and endometrial cancer. Like breast cancer, it has gradually become a common cancer in women, and its incidence has surpassed that of cervical cancer. But how many people know how to pay attention to this cancer?

There are no symptoms in the early stages of cervical cancer, so we need to rely on annual smears for screening.

Breast cancer has no symptoms in the early stages, so breast cancer screening is required every 2 years.

However, endometrial cancer is symptomatic in the early stages, and it almost always manifests itself as abnormal bleeding, so in theory it will alert the public more than cervical cancer and breast cancer.

The most common symptom of endometrial cancer is non-menstrual bleeding. Therefore, as long as you have regular non-menstrual bleeding, you need to be alert and think about the possibility of endometrial cancer. If people have repeatedly treated abnormal bleeding for 3 months to half a year and there is still no improvement, they need to check whether there is a problem.

Endometrial cancer, as the name suggests, is a cancer that grows from the lining of the uterus. Since the name "membrane" means that it is membrane-shaped and not a tumor, it is difficult to use ultrasound to show whether there is a tumor or an endometrial cancer of several centimeters in size. It behaves like weeds in a park, growing and spreading across the landscape. Unless it is very serious, it will not invade the deep muscle layer, which means that early stage endometrial cancer will not penetrate deep into the muscle layer like the roots of a big tree.

Therefore, as long as we can diagnose it early, we can easily solve endometrial cancer. What are the general recommendations for checking?

In the past, ultrasound was used for examination. As mentioned earlier, because it is membrane-shaped and cannot be measured, the thickness can only be used to judge and evaluate it. In the past 20 years, most doctors have The thickness is used to assess the risk of cancer.

However, when menstruation is about to come, the thickness of the endometrium itself will often exceed 1 cm, or even close to 2 cm. Therefore, doctors will be very troubled by using thickness to evaluate, and it is often a mistake. The sound was loud and the raindrops were small, it was a false alarm.

In the past, when doctors suspected that the endometrium was very thick, they would advise people to undergo endometrial scraping or endometrial biopsy. However, the normal endometrium was often found when the sections were sliced, because it would be related to menstruation. The endometrium that comes quickly may be confused, or errors may occur due to angle. How to judge accurately?

In fact, it is just like the weeds in the park. You can easily tell who the weeds are by seeing them with your own eyes. Hysteroscopy is the use of technology. It uses a small camera to extend into the uterine cavity. It can very accurately determine whether there are endometrial lesions. Only if there is a high degree of suspicion of lesions, a section needs to be performed. This can greatly reduce unnecessary endometrial scratching. Curettage and sectioning to reduce damage.

Moreover, when arranging a biopsy, if the biopsy can be done under a hysteroscope, the specimen can be obtained more accurately. Unlike the past, where the specimen was taken by blind scraping, the whole process can be less harmful. , diagnosis is more accurate.

(Video source: Q8 online health consultation) What should I do if endometrial cancer is diagnosed by biopsy?

As a rule of thumb, the vast majority of endometrial cancers are in the first stage. That is to say, 9 out of 10 patients only need to undergo "endometrial cancer staging surgery" It can be cured without chemotherapy or radiation therapy. Endometrial cancer is a cancer with a high curability rate. It is much simpler to treat than cervical cancer and breast cancer, so people don’t need to worry.

Generally, an imaging examination will be done before the operation to scan the abdomen for any metastasis. After the scan, you can prepare to arrange the operation. The surgical method is very simple. Laparoscopic minimally invasive surgery has become the first choice for this surgical treatment. If it is performed by a doctor with rich experience in laparoscopy, the patient can usually be discharged from the hospital 2 to 3 days after the operation, and there is little need for postoperative placement. Drainage tubes, nasogastric tubes, etc. can be used to eat and get out of bed the next day. The promotion of minimally invasive surgery has made the anti-cancer journey of endometrial cancer patients very high-quality, and most of them can easily defeat the cancer. Summary

Early detection of endometrial cancer requires public vigilance. If there is long-term abnormal bleeding, a hysteroscopy is required to find out whether there is a problem.

Laparoscopic endometrial cancer staging surgery is the first choice treatment. The wound is much smaller than traditional open enterotomy and the recovery is faster.

The vast majority of endometrial cancers are in the early stages and require only surgery, without the need for adjuvant treatments such as chemotherapy. If you face it bravely, you can still have a happy life.