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 gynecological malignancy that occurs among women of the United States being the fourth most common cancer after breast, lungs and colorectal cancer. In endometrial cancer, 90 percent of cases are sporadic and 10 percent 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 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 behavior and genetic etiology (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 tumor 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 the DNA and mismatch repair systems to function correctly. The gene mutation can be in DNA and mismatch repair lead to genes replication of cancer growth in hereditary cancer. 20 to 30 percent of genetic mutations are caused by epigenetic inactivation. Instability in chromosomes leads to malignant tumor 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 to regain their faith that 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 the 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).
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.