ENDOMETRIAL CANCER
Endometrial cancer is the most common malignancy of the female reproductive tract, and the majority of it occurs in women postmenopausal. It occurs in the lining of the uterus (which is endometrium) and spreads to other parts of the body if not addressed. Of all the considerations in treating endometrial cancer, perhaps most important is to understand its stage, where doctors can select the best kind of treatment.
IN THIS ARTICLE WE WILL OUTLINE
How endometrial cancer is staged and also about the FIGO staging system, the formal staging system utilized in a way to ascertain the disease severity.
What is Cancer Staging?
Cancer staging refers to the assessment of how advanced cancer has grown in the body.
Staging enables doctors to know how advanced cancer has developed, and staging also helps with the decision of the treatment method and the patient’s outcome of that treatment.
Staging endometrial cancer is assessing several things, such as:
Tumor size: The size of how big the cancer has developed in the uterus.
Extension to other tissues: Whether the cancer has spread to adjacent organs, i.e., ovaries, fallopian tubes, or lymph nodes.
Distant dissemination: If cancer has extended to distant sites within the body, i.e., lungs or liver.
What is the FIGO classification?
FIGO (INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS) STAGING SYSTEM
It is the system of classifying endometrial cancer that is accepted worldwide. It classifies the disease into four stages, and each stage has sub-stages to further divide the extent of the spread of cancer. Stages range from Stage 1, where the cancer is confined within the uterus alone, to Stage 4, where the cancer has spread to very distant parts of the body.We will now be having a deeper perspective of the FIGO classification:
Stage 1: Confined to the Uterus
Stage 1A: Here, the cancer is limited to the lining of the uterus (endometrium). It has not invaded the muscle layer of the uterus (myometrium). The Stage 1A cancers are small and are detected early while performing a routine checkup, which leads to better prognosis.
Stage 1B: Here, the cancer involves the muscle layer of the uterus but not beyond the organ. The cancer can be larger than in Stage 1A but not beyond the uterus. How deep the tumor invades the wall of the uterus can allow physicians to make an educated guess about how probable cancer will extend to other places.
Stage 2: Extension to the Cervix
Stage 2: Stage 2 cancer has spread outside the uterus and into the cervix (the lower portion of the uterus). Although the cancer has invaded an organ next to it, the cancer has not invaded beyond the cervix. Stage 2 cancer may be treated more aggressively, e.g., with a hysterectomy (removal of the uterus) and even radiation therapy to kill or remove all the cancer cells.
Stage 3: Spread to Structures in the Vicinity
Stage 3A: The cancer has spread to the outermost tissues of the uterus, the tubes, or the ovaries. The spread is still generally localized in the pelvic area but is no longer confined to the uterus itself.
Stage 3B: The cancer is now extending to the vagina or covering tissues over the uterus. That is, cancer develops faster and other treatment options like chemotherapy, radiation, or both may be needed in an attempt to stop growth.
Stage 3C: Cancer has extended to the pelvic lymph nodes or near the aorta (a major artery near the abdomen). Lymph node invasion is a consideration of great importance in the forecasting of the prognosis and the treatment modality. Lymph node invasion typically suggests that the cancer is more likely to extend to the rest of the body.
Stage 4: Distant Spread
Stage 4A: Cancer at this stage has reached organs near the uterus but outside the pelvic area now, i.e., bladder or rectum. They are near the uterus but outside the pelvic area now. Treatment of Stage 4A is surgery alone, chemotherapy, and radiotherapy, and prognosis cannot be made on patient condition and recovery.
Stage 4B: Worst is the stage when cancer has reached distant organs like the lungs, liver, or distant lymph nodes. Stage 4B is metastatic endometrial cancer, where the cancer is distant from the uterus and harder to treat. But even then, chemotherapy, targeted therapy, and, in some instances, immunotherapy can work to keep the cancer under control and have a good quality of life.
HOW STAGING INFLUENCES TREATMENT
Staging is a very important aspect in the planning of treatment for endometrial cancer. The sooner the diagnosis, the more and the better. Cancer may be treated by surgery alone if the cancer is found early. The more advanced the cancer has moved to the advanced stages, however, other treatment modalities, including chemotherapy, radiation, or hormone therapy, will be required as well to include in the eradication of any remaining cancer cells.
Physicians also employ staging to predict the likelihood of recurrence, or recurrence of the cancer once it has been treated.
Patients who are Stage 1 might be less likely to recur than patients who are Stage 3 or Stage 4, and that is an issue that impacts the rate of follow-up treatment and follow-up.
