Endometrial cancer is the most common gynaecological malignancy. The endometrium is the lining of the uterus (womb). In 2010, 2256 new cases were diagnosed in Australia. Uterine cancer remains the second most common cause of death due to a gynaecological cancer 1.
The good news in Australia is that survival rates have increased from 74.7% in the 1980s to 82% in 2010. . Better outcomes are the result of increase awareness, and early diagnosis (majority of patients are diagnosed at early stages I or II).
The most common symptom at presentation is abnormal vaginal discharge or bleeding, especially after menopause. Surgery remains the best curative option for early stages. Some patients also receive chemotherapy and/or radiotherapy with the intention of eradicating microscopic residual cancer cells.
At the Gold Coast in Queensland, Australia, there are about 35 to 50 new cases of endometrial cancer per year, most of them are presented and discussed in a multidisciplinary environment with the presence of gynaecological surgeons, medical oncologists, radiation oncologists, pathologist, and radiologist to advice in the best plan of management.
A recent audit at the Gold Coast University Hospital showed that about 2/3 of patients have endometrial cancer type I (endometrioid type). Type I endometrial cancer confer a better prognosis as they are usually diagnosed at early stages and have less chances of recurrence and metastasis. On the other hand the same report showed that Type II endometrial carcinomas (includes more aggressive subtypes such as serous, clear cell, and carcinosarcomas) recur up to 30% of the times.
Unfortunately many patients that survive endometrial cancer also suffer from obesity and many die due to obesity–related complications. Survivors also have to live with the emotional implications of being diagnosed with a cancer. Regular follow-up, counselling and life style modifications are important for a good long term outcome.