The likelihood of a woman having endometrial cancer is 1-2% by the age of 75 and is the sixth gynecological malignancy worldwide. It rarely occurs before the age of 40.
What causes endometrial cancer ?
Cancer is not a single entity; therefore different types of endometrial cancer (EC) might form from different pathways. The most often kind of EC occurs after unopposed estrogen stimulation of the lining of the womb. This stimulation can be a result of specific medication or habitus, as described below.
- Early menarche (Start of the period at an early age)
- Long periods, unstable cycle
- Late Menopause Hormone replacement treatments
- Tamoxifen (a medicine used in patients with a history of breast cancer)
- Genetic factors
Spontaneous uterine bleeding after menopause. Endometrial cancer usually occurs with bleeding independent of the period or after the menopause.
Transvaginal ultrasound helps to identify the thickness of the lining of the womb and assess if it is greater than expected (endometrial hyperplasia). The Pap smear test may show some atypical cells from the endometrium but is not a diagnostic examination. We need to obtain a biopsy of the endometrium for analysis. There are multiple ways to sample endometrial tissue. Either by dilation and curettage (D&C) or pipelle biopsy, which are “blind” procedures with a random distribution of the biopsies or by a camera guided process. The latter one is called hysteroscopy involves the use of a very thin optical system that enters the uterine cavity using a camera, and takes biopsies directed from suspicious areas, eliminating the possibility of an undetectable lesion.
Robotic-assisted surgical treatment of endometrial cancer
The treatment of uterine cancer is surgical in the majority of cases. We adapt the procedure we perform on each patient according to the special features of the tumor (which may vary from patient to patient), preoperative imaging (MRI), and patient’s personal history. Treatment of choice depending on the extent (stage) of the disease is total hysterectomy (removal of the uterus, removal of the ovaries and fallopian tubes) with or without lymph node dissection. The treatment plan and procedure consultation before surgery are of utmost importance. Patients diagnosed with uterine cancer have a better prognosis when treated by surgeons with specialized training in gynecological oncology.
TALOS intuitive care combines gynecologists trained in complex gynecological cancer cases with the use of up to date surgical robots. Increased lymph node harvest, minimal blood loss, quick recovery and return to normal activities are now offered even in obese patients through the robotic-assisted minimally invasive surgery way.