What to do with multiple metastases of endometrial cancer

What should we do if endometrial cancer metastasizes? Endometrial cancer has no obvious symptoms in the early stages and is only discovered accidentally during gynecological examinations. Most endometrial cancers grow slowly and are confined to the endometrium or uterine cavity for a long time; some special pathological types of endometrial cancer, such as serous papillary adenocarcinoma, squamous cell carcinoma, clear cell carcinoma and poorly differentiated carcinoma, can develop very quickly and metastasize in a short period of time. The characteristic of cancer cells is that they can metastasize and spread, so what should we do if endometrial cancer metastasizes?

Common metastatic pathways of endometrial cancer include lymphatic metastasis: lymphatic metastasis is the main metastatic pathway of endometrial cancer. When the tumor infiltrates into the deep muscle layer or spreads to the cervical canal, or when the cancer tissue is poorly differentiated, lymphatic metastasis is likely to occur. The lymphatic metastasis pathways of cancer lesions in the lower uterine segment and cervical canal are the same as those of cervical cancer, which can spread to the parauterine internal iliac, external iliac, and common iliac lymph nodes; cancer lesions on the posterior wall of the uterus can spread along the uterosacral ligament to the rectal lymph nodes; and cancer lesions on the anterior wall can spread to the bladder lymph nodes.

Endometrial cancer can also drain retrogradely to the anterior vaginal wall via lymphatic vessels. Common metastatic pathways of endometrial cancer include direct spread: in clinical practice, the most common cause is the spread and growth of the inflammatory endometrium, which can extend upward through the uterine cornu to the fallopian tubes; downward to the cervical canal, and continue to spread to the vagina. It can even extend to the fallopian tubes and ovaries, and can flow to the pelvic peritoneum, uterine rectal pouch, and greater omentum. What should I do if endometrial cancer metastasizes?

The common metastatic pathway of endometrial cancer is hematogenous metastasis: in the late stage, it can metastasize to various organs of the body through the blood, and common sites are lungs, liver, bones, etc. Compared with the characteristics of hematogenous transmission, the main symptom of endometrial cancer is abnormal uterine bleeding. About 90% of patients will experience this symptom. Therefore, in the infection stage of endometrial cancer, this period is also the easiest stage for detection.

The occurrence of endometrial cancer is closely related to estrogen. The treatment is mainly surgical resection, combined with preoperative or postoperative radiotherapy, supplemented by conservative treatment with traditional Chinese medicine.

The surgery mainly includes hysterectomy and bilateral salpingo-oophorectomy. If the tumor is large or the cells are poorly differentiated, preoperative radiotherapy and postoperative lymph node dissection should be performed. For patients with positive estrogen receptors and progesterone receptors, progesterone or tamoxifen is usually used in combination. If both are negative, combined chemotherapy is performed.

Surgery is only for palliative resection or symptomatic treatment. After surgery, the body's vitality is damaged, and ginsenoside RH2 is generally used to assist in improving the success rate of surgery and reducing the recurrence and metastasis of tumors. Chinese and Western medicine have their own strengths in treating tumors, so the treatment of endometrial cancer must give full play to the respective advantages of traditional Chinese medicine, insist on long-term treatment, relax the patient's psychological state, do a good job of psychological treatment, increase dietary nutrition, and improve the body's immune function. In this way, better therapeutic effects can be achieved. Examinations of endometrial cancer have found that many are already in the late stage, generally accompanied by extrauterine metastasis. The current radiotherapy and chemotherapy regimens are relatively mature, and most are effective. Current studies have shown that combining ginsenoside RH2 during radiotherapy and chemotherapy can greatly enhance efficacy and reduce toxicity, shorten the recovery period, and prevent recurrence and metastasis.

What should we do if endometrial cancer metastasizes? Clinically, most patients can be diagnosed in the early stages before the cancer cells spread out. At this time, clinical treatment can also achieve better results. Moreover, for patients, early treatment has relatively little impact on the body.