Endometrial cancer has a reputation for being caught early, when it is more easily treated.
But Gwen Ifill’s death shows that greater awareness and research are still needed to stem the continuing rise in mortality from this disease.
Ifill, a veteran journalist, was diagnosed with endometrial cancer less than a year ago. She died on Monday at the age of 61.
Cancer of the endometrium generally occurs in older women — the average age of diagnosis is 60. It is uncommon in women under the age of 45.
The endometrium is the lining of the uterus. It thickens early in a woman’s menstrual cycle to nourish an embryo and is shed if no pregnancy occurs.
The number of new endometrial cancer cases each year is similar for all racial and ethnic groups. But black women are almost twice as likely to die from this cancer as white women.
They are also more likely to be diagnosed with an aggressive form of this cancer and have lower five-year survival rates.
Dr. David Mutch, surgeon and gynecologic oncologist at Siteman Cancer Center, estimates that 250 women are treated annually at the center — what he calls a “very high volume.”
“It’s the most common gynecologic cancer,” said Mutch, “more common than ovarian cancer, which gets a lot of press.”
According to the National Cancer Institute, more than 60,000 cases will be diagnosed in 2016. More than 10,000 women will die from the disease. Between 2004 and 2013, the death rates for this cancer rose.
In comparison, there were an estimated 246,660 new cases of breast cancer and 22,280 cases of ovarian cancer in 2016.
Early detection is key
When detected early and treated, endometrial cancer offers a good prognosis — on average, 81 percent of women are alive five years after diagnosis. Many live much longer.
But if the cancer returns and spreads after treatment, it can be more deadly.
There is no screening test for endometrial cancer, which means women should stay alert for the symptoms.
“Any vaginal bleeding in a postmenopausal woman should prompt a visit to the gynecologist and an evaluation of the lining of the endometrium, which would include an endometrial biopsy and possibly an ultrasound,” said Mutch.
Irregular bleeding between periods in premenopausal women can also be a symptom of endometrial cancer. Other symptoms in pre- and postmenopausal women include spotting, abnormal vaginal discharge, or pelvic pain.
“[Early evaluation] will increase the likelihood that we’ll diagnose the disease at an earlier stage,” said Mutch. “If everyone did that, the mortality from that disease would be decreased significantly.”
Other noncancerous conditions can cause abnormal bleeding, but women should have a doctor look into any abnormal bleeding right away.
The cause of endometrial cancer is not entirely understood, but risk factors include age, diabetes, and things that affect hormone levels — like obesity, birth control pills, and estrogen therapy after menopause.
Certain genetic conditions — such as Lynch syndrome — are also linked to endometrial cancer.
“We screen everybody who has an endometrial cancer for Lynch syndrome to make sure that they don’t have it,” said Mutch, “and so they can notify their family members.”
Women with this genetic condition sometimes opt to have a hysterectomy before they develop endometrial cancer.
Lynch syndrome also increases the risk of colon cancer, which may warrant increased colon screening in both men and women.
More research funding needed
The main treatment for endometrial cancer is a hysterectomy — the surgical removal of the uterus. The fallopian tubes, ovaries, and some lymph nodes may also be taken out at the same time.
“We can usually do a hysterectomy through the minimally invasive route,” said Mutch. “We can take the uterus out either robotically or laparoscopically.”
Further treatment may be needed such as radiation, hormonal, or chemotherapy.
In addition to raising awareness about the symptoms of endometrial cancer, Mutch said there is a need for more funding of research and clinical trials. This includes better treatment for women whose endometrial cancer has returned.
“[Endometrial cancer’s] mortality is increasing and the NIH funding of it is very low, relative to its incidence,” said Mutch. “So a lot of patient advocates have been calling for more clinical trials for endometrial cancer.”
“There needs to be a grassroots effort by patients,” said Mutch, “and a call for more research on this cancer and more clinical trials to combat this disease.”