KUALA LUMPUR, July 2 – In Malaysia, endometrial cancer, also known as corpus uteri cancer, has become the fifth most common cancer among women, with a prevalence rate of 5.6 per cent.
A worrying shift is emerging as the disease, once considered common in older, postmenopausal women, is increasingly being diagnosed in women under 50.
This unexpected rise is not just a statistical anomaly; it’s a wake-up call. The implications for younger women are profound as they grapple with the dual challenges of preserving their fertility and battling a disease they never expected to face so early in life.
Dr Andi Anggeriana, consultant obstetrician, gynaecologist, and gynae-oncologist at Sunway Medical Centre, delves into the factors driving this trend, the importance of early detection and the role of robotic surgery in modern treatment.
The Alarming Trend Among Younger Women
Endometrial cancer, like many other cancers, can be silent in its early stages. However, there are some key symptoms that women should be aware of, regardless of age.
“Abnormal uterine bleeding, either postmenopausal bleeding or abnormal bleeding, is the most common symptom of endometrial cancer,” Dr Andi noted.
Other symptoms include pelvic pain, unexplained weight loss, and difficulty or pain during urination or intercourse or unusual vaginal discharge.
Dr. Andi shares that she has witnessed a growing number of younger patients diagnosed with endometrial cancer.
“We are seeing more cases in women under 50, and even some in their early 30s,” she revealed.
This shift is alarming because it impacts not only the patient’s health but also their fertility, which is often a significant concern for this age group.
The reasons behind this trend are complex. Obesity, a sedentary lifestyle, and hormonal imbalances, particularly those associated with polycystic ovary syndrome (PCOS), are thought to be significant risk factors due to their contribution to the rise of estrogen levels in the body that can thicken the uterine lining, which could be causing this trend.
“These younger women even often come for fertility consultations or hormonal imbalances, only to discover they have endometrial cancer. This revelation can be devastating, as it often comes when they are planning or have just started their families,” Dr Andi explained.
Impact On Fertility And Quality Of Life
Endometrial cancer, particularly in its early stages, can sometimes be treated with fertility-sparing options. However, the treatment plan depends on the stage and grade of the tumour.
“For women who are diagnosed early, there is a possibility to preserve the uterus and manage the cancer with hormonal therapy,” Dr. Andi stated.
Yet, this approach requires careful monitoring and carries risks, including the potential for cancer recurrence.
For those who are unable to preserve their fertility, the emotional and psychological toll can be significant.
“Many of these women have not yet started or completed their families, and the diagnosis can be devastating,” Dr. Andi noted.
The loss of fertility often adds to the emotional burden of the cancer diagnosis, making comprehensive support systems crucial for these patients.
Treatment Options And Recent Advancements
The treatment of endometrial cancer is personalised based on the individual’s condition, including the cancer’s stage and grade, the patient’s age, and their desire to preserve fertility.
The primary treatment is surgery, which involves a total hysterectomy and the potential removal of lymph nodes, followed by chemotherapy and radiation based on the cancer stage.
Additionally, there are targeted therapies with drugs. For early-stage cancer, hormonal therapy might be an option for young women who want to maintain their fertility. However, it requires careful monitoring as it can sometimes control the cancer long enough for women to have children, as cautioned by Dr. Andi.
As treatment options for endometrial cancer advance, robotic-assisted surgery in gynecologic oncology enables precise removal of cancerous tissue while preserving healthy surrounding tissue.
Dr Andi highlights its benefits, particularly for those prioritising recovery and quality of life. “Robotic-assisted surgery offers greater precision, smaller incisions, and faster recovery times compared to traditional surgery, resulting in less scarring, reduced pain, and a quicker return to normal activities for women of all ages.”
Early Detection And Awareness
Given the rise in cases among younger women, early detection and awareness are more critical than ever. Dr Andi stresses the importance of regular gynaecological check-ups, especially for women with risk factors such as obesity, PCOS, or a family history of cancer.
“We often see patients who come in for fertility assessments and are surprised to learn they have endometrial cancer,” she says. This underscores the importance of not ignoring symptoms such as abnormal bleeding, even in younger women who may not consider themselves at risk.
Endometrial cancer is no longer a disease confined to older women. The rising incidence among younger women is a call to action for the medical community and the public.
With advancements like robotic surgery, there is hope for effective treatment with fewer side effects. However, early detection remains the key to preserving fertility and ensuring the best possible outcomes.
For younger women, being vigilant about their reproductive health and seeking medical advice at the first sign of abnormal symptoms could make all the difference.
Dr. Andi aptly stated, “Awareness and timely intervention are our best tools in the fight against endometrial cancer. The earlier, the better, so you can live a longer and fuller life.”
