Having Endometrial Cancer can be a scary experience, but the good news is there are many treatment options available. Some are available in the form of surgery, but others are medication-based.
Symptoms
Symptoms of endometrial cancer are generally related to abnormal vaginal bleeding. Some women with this cancer may also have other symptoms. If you think you might have endometrial cancer, see a healthcare provider right away. The sooner you receive a diagnosis, the more treatment options you may have.
A healthcare provider will ask you about your health history and your symptoms. They will also ask if you have any risk factors for this cancer. Some of the risk factors include having a family history of cancer, having a family history of endometriosis, and having an abnormal vaginal discharge.
You will be asked to undergo a pelvic exam, which checks your reproductive organs. Your doctor may also perform a transvaginal ultrasound to check your uterus.
If your doctor finds a tumor during your pelvic exam, he or she will likely perform an endometrial biopsy. A biopsy involves taking a small sample of tissue from the uterine lining. The sample is then sent to a lab to be tested for cancer cells.
In addition to these tests, your healthcare provider may refer you to a mental health specialist to discuss the emotional side of cancer. You may also be referred to a support group to connect with others going through similar experiences.
Chemotherapy may also be used to treat endometrial cancer. Chemotherapy is a drug therapy that uses medication to kill cancer cells. Chemotherapy may be given intravenously (IV) or in pill form. Chemotherapy can be used to help slow the progression of late-stage cancer, and it can also prolong your life.
Treatment for endometrial cancer varies depending on the stage and type of cancer. Some treatments involve the use of chemotherapy drugs, while others involve surgery or radiation therapy.
Diagnosis
Usually, endometrial cancer is diagnosed when it causes abnormal vaginal bleeding. In some cases, cancer may have developed before symptoms occur. In these cases, early detection can be very important. It can help patients and doctors to make the best treatment decisions.
Treatment options for endometrial cancer include surgery, radiation, and chemotherapy. It can also be treated with targeted drug therapies. These therapies target cancer cells and cause them to die. These treatments may be used together with chemotherapy to treat advanced diseases.
Surgical treatments for endometrial cancer include bilateral salpingo-oophorectomy and total abdominal hysterectomy. This treatment option is considered to be curative in most cases. For low-resource situations, bilateral salpingo-oophorectomy is often considered a reasonable treatment option.
Surgery for endometrial cancer can include a systematic lymphadenectomy and washings. Surgery may also include the removal of extrauterine disease. For women who have advanced cancer, immunotherapy may be considered. This treatment interferes with the cancer cells’ protein blinding process.
Other tests for diagnosing endometrial cancer include PET/CT, CT, and ultrasound. These tests are used to determine the extent of the disease before surgery. MRI can be used to detect extrauterine soft tissue involvement. In addition, a PET scan can detect small metastatic deposits in the omentum.
Pelvic exams may be helpful in some cases of advanced uterine cancer. However, these exams are not very useful for early endometrial cancer.
CT is often ordered as a baseline investigation prior to the histologic diagnosis of endometrial cancer. This is especially useful for detecting lymph nodes. In cases where high-grade histology is present, CT may be a useful test for determining whether cancer has spread. It can also be useful for detecting local diseases.
Treatment
Getting an early diagnosis of endometrial cancer is a critical step in its treatment. If it is detected early, the survival rate can be as high as 95%. However, some women with endometrial cancer may require additional treatments, such as chemotherapy or hormone therapy.
The earliest stage of endometrial cancer is often treated with surgery. This can involve removing the uterus, fallopian tubes, and cervix. In some cases, the ovaries may also be removed.
After surgery, the cancer is usually treated with chemotherapy. Chemotherapy kills cancer cells and may also help to improve the woman’s quality of life. Chemotherapy is usually given for 18 weeks. Chemotherapy is usually given in combination with other therapies.
If cancer has spread to other parts of the body, radiation therapy may be used. This treatment uses high-energy X-rays or radioactive substances to kill cancer cells. External beam radiation is a type of radiation therapy, while machine-directed radiation is another.
If cancer has spread to the lymph nodes, lymphadenectomy may be performed. Lymph nodes are part of the lymphatic system, which is an important part of the immune system. Lymph nodes are located in the abdomen, pelvis, and armpits.
In addition to surgery, chemotherapy, and radiation therapy, hormone therapy may be used to treat endometrial cancer. These therapies target specific cancer cells, causing less harm to normal cells.
There are also a variety of support options available for patients and families affected by endometrial cancer. Individual counseling and Internet-based discussion groups are available to provide support and information. You can also talk to an expert fertility counselor about options for fertility preservation.
If you or a loved one is diagnosed with endometrial cancer, you may want to take part in a clinical trial to study the latest advances in treatment. You may also want to talk to a family member or friend about your options and how to make the best decisions for you and your family.
TP53 mutations
TP53 mutations in endometrial cancers are mainly confined to the CN-high and POLE subtypes. They are associated with poor outcomes. In our study, we defined the spectrum of TP53 mutations and analyzed their associations with a range of clinical and genetic characteristics.
The study consisted of a total of 144 ECs. Of these, 34 cases were POLE subtype, while 164 were p53wt. The majority of the tumors were in the advanced stage. The p53-abn tumors were more likely to be high-risk. In addition, a large proportion of p53-mutant tumors were serous carcinomas.
The majority of TP53 mutations were frameshift mutations. In addition, we identified single cases with novel TP53 in-frame deletion mutations. These cases were analyzed by next-generation DNA sequencing (NGS).
Overall, the spectrum of TP53 mutations was comparable in SECs and EECs of the CN-high genomic subtype. However, the frequency of mutations was significantly higher in CN-high ECs than in POLE ECs. This may be due to intratumoral heterogeneity in temporal clonal evolution. It is unclear whether this difference is due to differences in radiosensitivity or the induction of p53 target genes.
We evaluated the prognostic value of p53 overexpression and the role of tumor stage, BMI, and post-menopause in this patient group. Compared to patients with p53wt tumors, those with p53-overexpressing tumors exhibited poor overall survival (OS) and lower survival rates at stage IIIC. In addition, p53 overexpression was a significant independent prognostic factor. This study suggests that p53 overexpression may be a useful biomarker for predicting the response of endometrial cancers to chemotherapy and radiotherapy. It also provides novel implications for individualized genome-directed management of endometrial cancer.
This study provides a detailed analysis of TP53 mutations in endometrial carcinomas. It is the first study to evaluate the spectrum of TP53 mutations in ECs and their association with clinical and genetic features.
YWHAE-FAM22 translocation
YWHAE-FAM22 translocation is associated with endometrial stromal sarcoma (ESS). The YWHAE gene rearrangement is most commonly found in high-grade ESS (HGESS), which is a rare subtype of ESS. HGESS is characterized by a high-grade tumor that harbors a YWHAE-NUTM2A/B fusion. The tumor often shows brisk mitotic activity, a serpiginous growth pattern, and necrosis. HGESS has a poor prognosis compared with low-grade ESS. It often metastasizes to the pelvis and vertebrae.
YWHAE-rearranged ESS is more aggressive than HGESS. It has a serpiginous growth pattern through the myometrium and a low-grade spindle cell component. This type of tumor is associated with a lower mortality rate than UUS. It is also associated with a permeative growth pattern through the myometrium.
YWHAE-FAM22 translocation can be identified through a FISH assay. FISH is particularly useful in diagnosing difficult cases of ESS. YWHAE-rearranged ESSs are still categorized as ESS, and treatment is different than that of low-grade ESS.
In addition to YWHAE-FAM22 translocation, JAZF1 and PHF1 rearrangements were also identified in ESS. FISH can detect the presence of a JAZF1-JJAZ1 gene fusion. The tumors were positive for PHF1, JAZF1, and/or YWHAE. This study also reported an unusual ossifying sarcoma of the heart, which had a JAZF1 rearrangement. JAZF1 rearrangements are often associated with low-grade ESS. Nevertheless, they were found in all tumor types.
In addition to JAZF1 and PHF1, a fusion of YWHAE and BCORL1 was also identified. This fusion occurs because of a t(X;17)(p11;q21). In this case, YWHAE at 17p13 was fused in frame to either NUTM2A or NUTM2B. This fusion may have prognostic implications. Future research should investigate the role of these proteins in cell death in EC. It is also important to determine whether this type of translocation is also associated with nonpleomorphic uterine sarcomas.
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