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Mujeres posmenopáusicas y el cáncer endometrial
Shawana S. Moore, DNP, CRNP, WHNP-B, hizo la revisión médica de este documento
¿Qué es el cáncer endometrial?
Es un tipo de cáncer uterino que se desarrolla en la mucosa interna del útero y es el tipo de cancer que afecta mas frecuentemente el Sistema reproductivo femenino .
¿Quién tiene riesgo de cáncer endometrial?
Cualquier persona que tenga un útero puede tener cáncer endometrial, pero la mayoría de casos se diagnostican en mujeres posmenopáusicas.
¿Por qué las mujeres posmenopáusicas tienen un mayor riesgo?
Aunque los ovarios dejan de producir estrógeno y progesterona después de la menopausia, aún puede encontrarse estrógeno en el tejido adiposo. Esto causa un desequilibrio hormonal que implica un mayor riesgo de cáncer endometrial.
El recibir terapia hormónal después de la menopausia usando exclusivamente estrógenos sin progesterona también incrementa el riesgo de cáncer endometrial.
Algunos factores de riesgo frecuentes
- Tener un período temprano o una menopausia tardía
- Tener sobrepeso u obesidad
- Tener un síndrome metabólico que es un grupo de condiciones que elevan el riesgo de enfermedades cardíacas y de diabetes tipo 2
- Tener condicion es tales como síndrome de ovario poliquístico (SOP) o tomar medicamentos tales como los utilizadoes para terapias de estrógeno que afectan los niveles hormonales
- No haberse embarazado
- Tener el síndrome de Lynch
¿Sabías lo siguiente?
Tener tu primer período antes de los 12 años o experimentar la menopausia tarde incrementa el riesgo de cáncer endometrial debido a la mayor exposición a estrógenos.
Algunos signos y señales frecuentes
- Sangrado o manchado entre los períodos menstruales
- Sangrado vaginal después de la menopausia
- Dolor durante las relaciones sexuales
- Sensacion de presión o dolor pélvico
Estos no son todos los síntomas de cáncer endometrial y también podrían ser causados por otras condiciones. Estos síntomas podrían ignorarse fácilmente, así que es importante hablar con tu proveedor de servicios médicos sobre cualquier síntoma preocupante en cuanto aparezca. Si experimentas cualquiera de estos síntomas, comunícate con tu proveedor de servicios médicos.
Métodos de diagnóstico
- Examen pélvico: examen en el cual un Proveedor de servicios médicos (medico o enfermera) palpa el útero, la vagina y los ovarios para detectar cualquier anomalía
- Ultrasonido: Un examen que mide el grosor del endometrio y el tamaño del útero
- Muestras de tejidos:
- Biopsia: Un procedimiento que extrae un monto pequeño de tejido para su examinación con un microscopio
- Histeroscopia: La inserción de un tubo delgado flexible a través de la vagina para que el medico o enfermera pueda ver la mucosa del útero y tomar una muestra del tejido
- Dilatación y legrado (D&C, por sus siglas en inglés): Un procedimiento para extraer muestras de tejidos del útero para examinar y detectar células cancerosas
Opciones de tratamiento
- Cirugía para extraer el útero, los ovarios y las trompas de Falopio
- Quimioterapia
- Radiación
- Farmacoterapia dirigida
- Terapia hormonal
- Inmunoterapia
Desigualdad del índice de supervivencia
Aunque las mujeres tienen, en general, un 95% de probabilidades de sobrevivir el cáncer endometrial , un estudio determinó que las mujeres de raza negra tienen un 90% más de riesgo de mortalidad a los 5 años en comparación con las mujeres de raza blanca.
Anatomía del útero
Dato curioso
El útero tiene 3 pulgadas de largo (para la mayoría de mujeres que no están embarazadas).
Este recurso se preparó con la asistencia y apoyo de Eisai Inc.
References
https://www.britannica.com/science/human-reproductive-system/The-uterus
https://www.cancer.org/cancer/endometrial-cancer/causes-risks-prevention/risk-factors.html
https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/signs-and-symptoms.html
https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/how-diagnosed.html
https://www.cancer.org/cancer/endometrial-cancer/treating.html
https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461
https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916
Postmenopausal Women and Endometrial Cancer
Medically reviewed by Shawana S. Moore, DNP, CRNP, WHNP-B
Postmenopausal Women and Endometrial Cancer
Fluctuating hormones and higher levels of estrogen can increase the risk for endometrial cancer
What Is Endometrial Cancer?
Endometrial cancer is a type of uterine cancer that develops in the inner lining of the uterus and is the most common cancer that affects a woman’s reproductive system.
Who Is at Risk for Endometrial Cancer?
Anyone with a uterus can be diagnosed with endometrial cancer, but most cases are found in postmenopausal women.
Why Postmenopausal Women Are High-Risk
Although ovaries stop making estrogen and progesterone after menopause, estrogen is still made in fat tissue. This causes a hormone imbalance that leads to a higher risk for endometrial cancer.
Hormone therapy after menopause using estrogen alone without progesterone also increases the risk for endometrial cancer.
Some Common Risk Factors
- Getting your period early or late menopause
- Being overweight or having obesity
- Having metabolic syndrome, a cluster of conditions that put you at higher risk for heart disease and Type 2 diabetes
- Having conditions, such as polycystic ovary syndrome (PCOS), or taking medications, such as estrogen, that affect hormone levels
- Never having been pregnant
- Having Lynch syndrome
Did You Know?
Starting your period before age 12 or going through menopause later in life increases the risk of endometrial cancer because of the increased exposure to estrogen.
Some Common Signs & Symptoms
- Bleeding or spotting between periods
- Vaginal bleeding after menopause
- Pain during sex
- Pelvic pain or pressure
These are not all of the symptoms of endometrial cancer and they could be caused by other conditions. These symptoms could be easily overlooked, so it is important to talk to your healthcare provider about any symptoms of concern as soon as they arise. If you experience any of these symptoms, contact your healthcare provider.
Methods of Diagnosis
- Pelvic exam — An examination where a HCP carefully feels the uterus, vagina and ovaries to check for any abnormalities
- Ultrasound — An exam that measures the endometrium thickness and uterus size
- Tissue sampling —
- Biopsy — A procedure that removes a small amount of tissue for examination under a microscope
- Hysteroscopy — The insertion of a thin, flexible tube with a light on it through the vagina so the HCP can view the lining of the uterus and take a tissue sample
- Dilation & curettage (D&C) — A procedure to remove tissue samples from the uterus to examine for cancer cells
Treatment Options
- Surgery to remove the uterus, ovaries and fallopian tubes
- Chemotherapy
- Radiation
- Targeted drug therapy
- Hormone therapy
- Immunotherapy
Survival Rate Disparity
Although women overall have a 95% chance of surviving endometrial cancer , a study found that Black women have a 90% higher five-year mortality risk compared to white women.
Anatomy of the Uterus
Fun Fact
The uterus is 3” long (in most non-pregnant women).
This resource was created with funding and support from Eisai Inc.
References
https://www.britannica.com/science/human-reproductive-system/The-uterus
https://www.cancer.org/cancer/endometrial-cancer/causes-risks-prevention/risk-factors.html
https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/signs-and-symptoms.html
https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/how-diagnosed.html
https://www.cancer.org/cancer/endometrial-cancer/treating.html
https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461
https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916
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