Endometrial cancer occurs in the endometrium, which is the inner lining of the uterus; it is caused by the abnormal growth of cells in this region. It usually occurs in women after their menopause, with most cases recorded in women in their seventies. It is a gynaecological malignancy that occurs among women in the United States and is the fourth most common cancer after breast, lung and colorectal cancer. In endometrial cancer, 90 per cent of cases are sporadic, and 10 per cent of cases are hereditary. This cancer is also known as uterine cancer and endometrial carcinoma. This paper will discuss endometrial cancer in detail.
Depending on the appearance of the cancerous cells, endometrial cancer can be divided into these types:
- Adenocarcinoma (endometroid cancer)
- Uterine carcinoma
- Squamous cell carcinoma
- Small cell carcinoma
- Transitional carcinoma
- Serous carcinoma
In the case of hereditary endometrial cancer, the presence of Lynch and Cowden syndrome increases the risk of this cancer. In sporadic cancer, most cases can be histologically classified into endometrial, clear cell and serous carcinoma, each having its clinical behaviour and genetic aetiology (O’Hara & Bell, 2012). The PTEN gene is the frequent genetic alteration associated with this cancer. It is located in the chromosome and encodes the protein and lipid phosphatase, which makes it act as a tumour suppressor (Okuda et al., 2010). The oncogenes responsible for endometrial cancer include K-ras, HER2/neu, EGFR, PI3KCA and FGFR2, which are usually inactive; however, when these activate, it results in abnormal cell growth at an alarming rate. Genetic stability is very important in maintaining bodily functions, and for this reason, it is important for DNA and mismatched repair systems to function correctly. The gene mutation can be in DNA, and mismatch repair leads to gene replication of cancer growth in hereditary cancer. 20 to 30 per cent of genetic mutations are caused by epigenetic inactivation. Instability in chromosomes leads to malignant tumour alterations. The presence of CA19-9 and neuron-specific enolase (NSE) is typically used as the identifiers of endometrial cancer. After the cancer is identified, the cells are tested further to confirm the type of endometrial cancer (Banno et al., 2012).
Telling a patient that she is suffering from cancer is a very delicate task, so there are many methods that doctors use to ease the suffering of their patients. If the patient is religious, then showing them compassionate care can help them rebuild hope for their future. In such times, the patient may blame themselves and think that their sins have caught up to them, which is the reason that God is punishing them with such a disease. It is imperative for doctors, regardless of their faith, to help the patients by telling them that God loves all his creations. He does not put more burden than one can bear. Assuring the patients can help them regain their faith and can help the doctors in their treatment as the patients will trust their doctors in return. Dealing with religious people can be a very tricky task as their belief in miracles by God can be greater than their faith in scientific facts. The reason behind this is that religions are filled with stories of miraculous healings of numerous people. This can give people false hope, which can be difficult to deal with. They will believe that things will turn out well if they pray hard enough, even if the test results are stating otherwise. This does not mean that their faith should be dismissed, as this will make them withdraw from the treatment, which is never ideal. Trust between the doctor and the patient is imperative, especially when the patient is suffering from a disease like cancer (Puchalski, 2001).
References
Banno, K., Kisu, I., Yanokura, M., Tsuji, K., Masuda, K., Ueki, A., Kobayashi, Y., Yamagami, W., Nomura, H., Tominaga, E., Susumu, N., & Aoki, D. (2012). Biomarkers in endometrial cancer: Possible clinical applications (Review). Oncology Letters, 3(6), 1175–1180. https://doi.org/10.3892/ol.2012.654
O’Hara, A. J., & Bell, D. W. (2012). The genomics and genetics of endometrial cancer. Advances in Genomics and Genetics, 2012(2), 33–47. https://doi.org/10.2147/AGG.S28953
Okuda, T., Sekizawa, A., Purwosunu, Y., Nagatsuka, M., Morioka, M., Hayashi, M., & Okai, T. (2010). Genetics of Endometrial Cancers. Obstetrics and Gynecology International, 2010, 984013. https://doi.org/10.1155/2010/984013
Puchalski, C. M. (2001). The role of spirituality in health care. Proceedings (Baylor University. Medical Center), 14(4), 352–357.
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