Alo Yeditepe
Assoc. Prof. Dr. Nilüfer Çetinkaya KOCADAL, an Obstetrics and Gynecology Specialist and Gynecological Oncologist, stated that there are over 30,000 endometrial (uterine) cancer patients in Turkey, pointing out that women aged 55–65 are particularly at risk. Assoc. Prof. Dr. KOCADAL pointed out that obesity, late menopause, early menstruation, excessive exposure to estrogen, and metabolic diseases also increase the risk, warning that abnormal bleeding seen especially after menopause should be taken seriously and evaluated without fail.
Commonly known as “uterine cancer,” endometrial cancer originates from the cells lining the inner layer of the uterus and is one of the most common tumors among gynecological cancers. Assoc. Prof. Dr. Nilüfer Çetinkaya KOCADAL, a gynecological oncology specialist at Yeditepe University Hospitals, Department of Obstetrics and Gynecology, said that according to Turkish data, 14 out of every 100,000 women are diagnosed with this disease, and approximately 8,000 new cases are detected each year. Noting that the incidence has increased in recent years due to rising obesity rates and longer life expectancy, Assoc. Prof. KOCADAL said, “While endometrial cancer is more common in women aged 55–65, it can also affect younger women due to obesity and increasing metabolic diseases.” Assoc. Prof. KOCADAL stated that the importance of this disease lies in its ability to cause abnormal bleeding in women, bringing early diagnosis to the forefront, adding, “When people refer to ‘uterine cancer,’ they are actually referring to endometrial cancer. However, HPV-related cervical cancer is a different type of uterine cancer that originates in the cervix.”
Assoc. Prof. Dr. KOCADAL stated that starting menstruation at an early age, late menopause, excessive exposure to estrogen, metabolic diseases such as diabetes, hypertension, and hyperlipidemia, and uncontrolled and untreated polycystic ovary syndrome create a risk for endometrial cancer. She also pointed out the risk of obesity, which has become a significant problem for all societies in recent years. Emphasizing that obesity is also a very important factor in endometrial cancer, Assoc. Prof. KOCADAL said, "When we look at Turkey-based studies, we see that obesity rates among women over the age of 15 reach 20-23 percent. Polycystic ovary syndrome patients are seen in 10-14 percent of cases. When left untreated and unaddressed, these factors increase the incidence of endometrial cancer in later life."
Explaining that the first noticeable symptom of endometrial cancer is usually bleeding, Associate Professor KOCADAL said, "The first symptom that patients notice in endometrial cancer is irregular, excessive bleeding. Vaginal bleeding is seen in 30-36% of postmenopausal (post-menopause) patients. Although most are benign, they must be evaluated. However, if there is pressure, pain, excessive bleeding, spotting, bleeding during intercourse, or bloody discharge in the lower abdominal area, a doctor should be consulted," she said.
Reminding that approximately 5% of endometrial cancers arise from genetic factors, Assoc. Prof. KOCADAL continued: “The most important of these is Lynch syndrome. Endometrial cancer can be seen at an earlier age in these patients. Therefore, early diagnosis can be made with annual ultrasonographic checks starting at around the age of 30, with a biopsy taken from the uterus when necessary.”
Reminding that there is no routine screening program for early diagnosis of endometrial cancer, Assoc. Prof. Dr. KOCADAL said, “Therefore, it is very important for patients to see a doctor without delay when they experience abnormal bleeding. In addition, annual ultrasonographic evaluations can be indicative in some high-risk patients. If necessary, a sample can be taken from inside the uterus.”
Providing information about the treatment process, Associate Professor KOCADAL explained: "Approximately 70 percent of endometrial cancers are in the early stages and are confined to the uterus. Therefore, surgery is a viable treatment option. Surgery is a very important treatment method for patients diagnosed early and with low-stage disease. In some risk groups, radiation therapy or drug therapy may be required after surgery. Factors such as the patient's age, the histological type of the tumor, the extent of the disease, involvement of organs outside the uterus, and whether there is metastasis to the lymph nodes influence the success of treatment."
Explaining the protective approaches used for young patients, Assoc. Prof. KOCADAL said, "In young patients who have not entered menopause, have not given birth, and have good ovarian function, if the tumor is limited to the endometrium, uterus-preserving treatment can be applied in selected cases. Medical treatment with progesterone derivatives is administered, pregnancy is achieved after the disease is controlled, and the final treatment is planned after delivery."
Emphasizing the importance of early diagnosis in endometrial cancer, Assoc. Prof. KOCADAL concluded her remarks as follows: "Endometrial cancer is the most common type of gynecological tumor in women. The most important factor that brings the patient to the doctor is excessive, abnormal, and irregular bleeding. It is vital for patients to seek the necessary advice at a health center when they notice these changes." It should not be forgotten that early diagnosis can save a woman's life. This is particularly important because the prognosis for endometrial cancer is favorable, especially in the early stages.
About
Faculty and Year of Graduation:
Istanbul University Cerrahpaşa Medical Faculty, 2006
Alo Yeditepe
