What Symptoms of Endometrial Cancer are Associated with Menstruation?

Currently, although there are many methods for treating malignant tumors, it is still necessary to detect the condition promptly upon onset, which plays a crucial role in controlling and treating the disease. Endometrial cancer is a malignancy that women are prone to develop, and it can cause changes in menstrual patterns. Understanding these characteristics is beneficial for timely detection of the condition. So, what are the menstrual manifestations of endometrial cancer?

What are the menstrual manifestations of endometrial cancer?

1. The primary menstrual manifestation of endometrial cancer is abnormal menstruation. The most common symptom is irregular vaginal bleeding, which may be intermittent and vary in volume. Initially, the bleeding may be light, but as the condition progresses, the volume may increase, although massive bleeding is less common. Patients who have not yet undergone menopause may experience heavier menstrual flow and longer menstrual cycles with varying blood flow. Those who have already undergone menopause and experience vaginal bleeding should be wary of the possibility of endometrial cancer, which is medically referred to as postmenopausal irregular vaginal bleeding.

2. Abnormal vaginal discharge is another symptom. A minority of patients may experience increased vaginal discharge, which may resemble pale blood-tinged water in the early stages. In later stages, when combined with infection, it may become purulent and foul-smelling.

What tests are required for endometrial cancer?

1. B-ultrasound Examination: This can assess the size of the uterus, the thickness of the endometrium, the presence of heterogeneous echoes or intrauterine growths, and the extent of myometrial infiltration. Its diagnostic accuracy exceeds 80%. Since many patients with endometrial cancer are obese, transvaginal ultrasound offers advantages over transabdominal ultrasound. Due to its convenience and non-invasiveness, B-ultrasound has become the most routine examination for diagnosing endometrial cancer and is also a method for initial screening.

2. Fractional Curettage: This is the most commonly used and valuable method for confirming endometrial cancer. It can not only determine whether cancer is present but also ascertain whether it involves the cervical canal, differentiating endometrial cancer from cervical adenocarcinoma, thereby guiding clinical treatment. For patients with perimenopausal heavy vaginal bleeding or continuous bleeding, fractional curettage can also serve as a hemostatic measure. Samples from fractional curettage need to be separately labeled and sent for pathological examination to confirm or exclude endometrial cancer.

3. Hysteroscopy: This allows direct observation of the uterine cavity and cervical canal for the presence of cancerous lesions, their location, size, and extent of involvement, as well as whether the cervical canal is affected. Biopsy of suspicious lesions under direct vision can help detect smaller or earlier lesions, reducing the rate of missed diagnosis of endometrial cancer. The accuracy of biopsy under hysteroscopy is nearly 100%. Both hysteroscopy and fractional curettage carry risks of complications such as bleeding, infection, uterine perforation, cervical laceration, and post-abortion syndrome. Hysteroscopy also poses a risk of water intoxication. There is controversy over whether hysteroscopy can lead to the dissemination of endometrial cancer, but most current studies suggest that it does not affect the prognosis of endometrial cancer.

4. Cytological Examination: Endometrial specimens can be obtained through methods such as uterine brushing and uterine aspiration smears for the diagnosis of endometrial cancer. However, due to its low positive rate, it is not recommended for routine use.

5. Magnetic Resonance Imaging (MRI): MRI can clearly display the size and extent of endometrial cancer lesions, myometrial infiltration, and pelvic and paraaortic lymph node metastasis, thereby providing a more accurate estimation of tumor staging. CT has slightly lower resolution for soft tissues compared to MRI, so MRI is more commonly used for preoperative assessment in hospitals with the necessary facilities.

6. Tumor Marker CA125: In early-stage endometrial cancer patients, CA125 levels are generally not elevated. However, in cases with extrauterine metastasis, CA125 levels can increase significantly and serve as a tumor marker for monitoring disease progression and treatment response.