Grey-haired man in a white coat with blue latex gloves, sitting in front of a microtome (device for making very small incisions), photo from behind over his left shoulder.

Endome­tri­al car­ci­no­ma: New Devel­op­ments and Dig­i­tal Offers

With around 11,000 new cas­es each year, endome­tri­al can­cer (endome­tri­al car­ci­no­ma or uter­ine body can­cer) is one of the most com­mon can­cers in women in Ger­many. The inci­dence increas­es with increas­ing risk fac­tors (above all obe­si­ty). Due to the ini­tial symp­toms of the bleed­ing dis­or­der in the pre­menopause or post­menopausal bleed­ing, endome­tri­al car­ci­no­ma is main­ly diag­nosed in the ear­ly stages by hys­teroscopy with frac­tion­at­ed abrasion.

About the Illness

Due to the rel­a­tive­ly ear­ly diag­no­sis com­pared to oth­er tumors, the prog­no­sis and sur­vival are usu­al­ly good. It is there­fore all the more impor­tant that the can­cer is treat­ed com­pre­hen­sive­ly and thor­ough­ly. Due to our close inter­dis­ci­pli­nary exchange and our high sci­en­tif­ic com­pe­tence, we can offer you the most mod­ern and mul­ti­modal treat­ment con­cepts for endome­tri­al can­cer at the Charité.

Emer­gence and Causes

The devel­op­ment of endome­tri­al can­cer is only par­tial­ly under­stood to date. In prin­ci­ple, can­cer devel­ops as a result of changes in the genet­ic mate­r­i­al in the cells of the lin­ing of the uterus. If cells divide often, mis­takes in the genet­ic infor­ma­tion occur more and more by chance. The lin­ing of the womb (endometri­um), like any lin­ing in the body, is a type that divides fre­quent­ly. If such errors accu­mu­late in the genet­ic infor­ma­tion of the cells, the cells lose their nor­mal func­tion and uncon­trolled cell growth occurs — can­cer. For exam­ple, malig­nant growths (tumors) can grow from benign pre­cur­sors or polyps. A genet­ic pre­dis­po­si­tion can also favor this process.

Ear­ly Detection

Pre­ven­tion is actu­al­ly the best after­care. Unfor­tu­nate­ly, there are still no estab­lished pre­ven­tive exam­i­na­tions to detect endome­tri­al can­cer even ear­li­er. Screen­ing meth­ods such as mam­mog­ra­phy for breast can­cer or the Pap smear (Papan­i­co­laou test) for cer­vi­cal can­cer have not been sci­en­tif­i­cal­ly proven for endome­tri­al can­cer. There­fore, a pre­cau­tion­ary ultra­sound of the inter­nal gen­i­tal organs is not rec­om­mend­ed in prin­ci­ple. Like­wise, there are no tumor mark­ers in the blood that can pre­dict can­cer or mon­i­tor its progress. There­fore, abnor­mal vagi­nal bleed­ing, for exam­ple, either between men­stru­al peri­ods or after menopause, must always be clar­i­fied in a stan­dard­ized manner.

The gold stan­dard for diag­nos­ing endome­tri­al can­cer is sur­gi­cal hys­teroscopy and scrap­ing of the uterus (frac­tion­al abra­sion). This is used to obtain tumor cells, which can be viewed under the micro­scope and clas­si­fied in more detail. The results of this exam­i­na­tion are part­ly deci­sive for ther­a­py and there­fore require the exper­tise of expe­ri­enced pathologists.

Ther­a­py

The ther­a­py of endome­tri­al can­cer (endome­tri­al car­ci­no­ma) must be decid­ed indi­vid­u­al­ly depend­ing on the stage of spread, involve­ment of lymph nodes and his­tol­ogy. In prin­ci­ple, it is made up of three dif­fer­ent pil­lars: surgery, chemother­a­py and radi­a­tion ther­a­py. The opti­mal ther­a­py is mul­ti­fac­to­r­i­al and is derived from all exam­i­na­tion results (includ­ing his­to­log­i­cal exam­i­na­tion of the scrap­ing and imag­ing), the dis­ease sta­tus of the woman con­cerned and the wish­es of the patient.

Offers at the Char­ité women’s clinic

At the Clin­ic for Gyne­col­o­gy, we are com­mit­ted to under­stand­ing the woman and her ill­ness as a whole. Due to our close coop­er­a­tion with col­leagues in phys­io­ther­a­py, social ser­vices, nutri­tion­al advice, pal­lia­tive med­i­cine and psy­cho-oncol­o­gy, we can pro­vide you with com­pre­hen­sive advice and sup­port on liv­ing with a can­cer diag­no­sis. From years of coop­er­a­tion, we have been able to gath­er a wealth of expe­ri­ence and have been able to opti­mize our process­es in deal­ing with can­cer patients. We look for­ward to wel­com­ing you to our clin­ic soon. In line with the mot­to of the Char­ité: Togeth­er we make a whole.

Note on the endometrial cancer app with a description and a link to the application.

There is also a dig­i­tal offer for all affect­ed patients in Ger­man-speak­ing coun­tries. At https://endometriumkarzinom-app.de/

Sources

S3-Leitlin­ie Diag­nos­tik, Ther­a­pie und Nach­sorge der Pati­entin­nen mit Endometri­umkarzi­nom
Link: https://www.leitlinienprogramm-onkologie.de/leitlinien/endometriumkarzinom/

Inter­na­tion­al guide­lines:
ESGO/ESTRO/ESP guide­lines for the man­age­ment of patients with endome­tri­al car­ci­no­ma.
Link: https://ijgc.bmj.com/content/ijgc/31/1/12.full.pdf

Endome­tri­al car­ci­no­ma app of the Char­ité women’s clin­ic.
Link: https://endometriumkarzinom-app.de/

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