Endometrial cancer

　　The etiology of endometrial cancer is not fully understood. Most authors believe that there are two types of endometrial cancer, which may have two pathogenic mechanisms. One type is younger and, under the long-term action of estrogen without progesterone antagonism, the endometrium undergoes proliferative changes, ultimately leading to carcinogenesis, but the tumor differentiation is good; the other type of pathogenic mechanism is unclear and may be related to genetic variation, more common in post-menopausal elderly women, thin, and with low estrogen levels. The endometrium around the tumor can be atrophic, with high malignancy and poor differentiation, leading to poor prognosis.

　　Endometrial cancer is more common in the following high-risk factors:

　　Anovulation: In cases with functional uterine bleeding accompanied by anovulatory or luteal dysfunction, long-term menstrual irregularities cause the endometrium to be continuously stimulated by estrogen, without the opposing or insufficient progesterone, resulting in the endometrium lacking cyclical changes and remaining in a proliferative state for a long time.

　　Infertility, especially infertility caused by anovulatory ovarian dysfunction, significantly increases the risk of endometrial cancer. Among patients with endometrial cancer, about 15% to 20% have a history of infertility. These patients, due to anovulation or oligomenorrhea, suffer from a lack or insufficient progesterone, leading to persistent estrogen stimulation of the endometrium.

　　Obesity, especially post-menopausal obesity, significantly increases the risk of endometrial cancer. Some statistics show that with a standard weight, an excess of 9 to 23 kg increases the risk of endometrial cancer by a factor of 3, and if the excess is greater than 23 kg, the risk increases tenfold.

　　Complications of endometrial cancer include polycystic ovary syndrome, functional uterine bleeding, uterine fibroids, and ovarian tumors that secrete estrogen.

　　1. Polycystic ovary syndrome: Polycystic ovary syndrome (PCOS) is characterized by menstrual disorders, amenorrhea, anovulation, hirsutism, obesity, infertility, and bilateral ovarian enlargement呈囊性改变. Patients may have the above typical symptoms or only have part of the symptoms, but infertility caused by ovulatory disorders is the main clinical manifestation of polycystic ovary syndrome.

　　2. Functional uterine bleeding: Functional uterine bleeding, abbreviated as FUB, is a common gynecological disease, referring to abnormal uterine bleeding. After examination, no organic lesions in the whole body and reproductive organs are found, but it is caused by dysfunction of the nervous and endocrine system. It is manifested as irregular menstrual cycle, excessive menstrual flow, prolonged menstrual period, or irregular bleeding.

　　3. Uterine fibroids and ovarian tumors that secrete estrogen: Uterine fibroids, also known as uterine smooth muscle tumors, are the most common benign tumors in the female reproductive system. Most of them are asymptomatic, and a few are manifested as vaginal bleeding, palpable mass in the abdomen, and compressive symptoms, etc. Pain may occur when torsion of the pedicle or other conditions occur, which is common in multiple uterine fibroids. Treatment and prevention can be used with purple lingzhi tablets, which can enhance immunity and nourish the illness.

　　Patients with endometrial cancer have no obvious symptoms in the very early stage, and then appear vaginal bleeding, vaginal discharge, pain, and other symptoms.

　　Symptoms of endometrial cancer

　　1. Vaginal bleeding: mainly manifested as postmenopausal vaginal bleeding, with a small amount of bleeding. For women who have not yet menopausal, it can be manifested as increased menstrual flow, prolonged menstrual period, or menstrual disorder.

　　2. Vaginal discharge: mostly blood-stained fluid or serous secretion. In the case of infection, purulent and bloody discharge with a foul smell may occur. About 25% of patients with abnormal vaginal discharge seek medical attention.

　　3. Lower abdominal pain and other symptoms: If the cancer involves the cervical internal os, it can cause uterine cavity empyema, resulting in lower abdominal distension and spasm-like pain. In the late stage, infiltration of surrounding tissues or compression of nerves can cause lower abdominal and lumbar sacral pain. In the late stage, anemia, weight loss, and cachexia and other symptoms may appear.

　　Signs and symptoms of endometrial cancer

　　Early endometrial cancer gynecological examination may not show any abnormalities. In the late stage, the uterus may be significantly enlarged, and there may be obvious tenderness when there is uterine cavity empyema. Occasionally, cancer tissue may be extruded from the cervical canal, which is easy to bleed upon contact. When the cancer focuses infiltrate surrounding tissues, the uterus may be fixed or irregular nodular masses can be felt around the uterus.

　　Based on the above symptoms, further auxiliary examinations can determine whether it is endometrial cancer. Therefore, women should always pay attention to their menstrual changes, and pay attention to the characteristics of vaginal discharge; once symptoms appear, seek medical attention to the hospital in advance.

　　The prevention of endometrial cancer mainly targets the risk factors related to the onset of the disease:

　　1. Carry out cancer prevention and health examination, strengthen health and medical knowledge, and educate women with menopausal abnormal vaginal bleeding, vaginal discharge, combined with obesity, hypertension, or diabetes to be vigilant, seek medical attention in a timely manner, and achieve early diagnosis.

　　2. Treat precancerous medical history, especially for patients with endometrial hyperplasia, especially atypical hyperplasia, should be treated actively, and follow-up should be strict. For patients with poor efficacy, hysterectomy should be performed in a timely manner. If the patient already has children, or has no hope of childbearing or is older, conservative treatment may not be necessary. Hysterectomy can be performed directly.

　　3. It is best not to use radiotherapy when there are benign gynecological diseases, in order to avoid triggering tumors.

　　4. Strictly control the indications for estrogen use. For postmenopausal women using estrogen for replacement therapy, it should be used under the guidance of a doctor, and progesterone should be used to regularly transform the endometrium.

　　5. For people with high-risk factors, close follow-up or monitoring should be carried out: Endometrial cancer patients should be followed up closely and regularly after treatment to try to find out whether there is recurrence as early as possible. About 75% to 95% of recurrences occur within 2 to 3 years after surgery. Routine follow-up should include a detailed medical history (including any new symptoms), pelvic examination, vaginal cytology smear, X-ray chest film, serum CA125 detection, and blood routine and blood chemistry tests, etc. CT and MRI may be performed if necessary.

　　The examination of endometrial cancer includes hysteroscopy, cystoscopy, rectoscopy, lymphography, CT, and nuclear magnetic resonance imaging, and B-ultrasound, etc.

　　1. Hysteroscopy: Among postmenopausal women with vaginal bleeding, about 20% are endometrial cancer patients. The use of hysteroscopy can directly observe the cervical canal and uterine cavity, detect lesions, and accurately take biopsies, which can improve the diagnostic rate of biopsies, avoid missed diagnosis in routine curettage, and provide information on the extent of the lesion and whether the cervical canal is involved, assisting in the correct clinical staging before surgery.

　　2. Cystoscopy and rectoscopy: It is of great significance for determining whether there is tumor invasion, but biopsy should be performed to confirm it before it can be diagnosed as involvement of the bladder or rectum.

　　3. Lymphography, CT, and nuclear magnetic resonance imaging (MRI): Lymphatic metastasis is the main way of dissemination of endometrial cancer. CT, MRI, and other methods are mainly used to understand uterine and cervical lesions, the depth of muscular layer infiltration, and whether there is enlargement of lymph nodes (over 2cm), etc. Due to their high cost, they have not yet been used as routine examinations.

　　4. B-ultrasound: There has been some progress in the use of B-ultrasound in the auxiliary diagnosis of endometrial lesions. Transvaginal B-ultrasound can help understand the size of the uterus, the shape of the uterine cavity, the presence of any masses within the uterine cavity, the thickness of the endometrium, whether there is infiltration of the muscular layer, and the depth of infiltration, providing reference for clinical diagnosis and pathological sampling (uterine cavity biopsy, or curettage). For postmenopausal women with uterine bleeding, further diagnostic methods can be chosen based on the results of transvaginal B-ultrasound.

　　What kind of food is good for endometrial cancer patients:

　　1. Strongly acidic foods: egg yolks, cheese, cakes made with sugar, persimmons, mullet roe, and bonito, etc.

　　2. Moderately acidic foods: ham, bacon, chicken, tuna, pork, eel, beef, bread, wheat, butter, horse meat, and so on.

　　3. Weakly acidic foods: white rice, peanuts, beer, wine, fried tofu, seaweed, clam, octopus, and eel.

　　4. Weakly alkaline foods: Red beans, radish, apple, kale, onion, tofu, etc.

　　5. Moderately alkaline foods: Dried radish, soybeans, carrots, tomatoes, bananas, oranges, pumpkin, strawberries, protein, dried plums, lemon, spinach, etc.

　　6. Strongly alkaline foods: Camel's thorn, grapes, tea, kelp sprout, kelp, lemon, etc.

　　The following foods should be avoided for endometrial cancer:

　　1. Avoid eating stimulants such as mutton, shrimp, crab, eel, salted fish, and black fish.

　　2. Avoid spicy foods and drinks such as chili, Sichuan pepper, scallions, garlic, and white wine.

　　3. Avoid eating foods with hot properties, blood coagulation, and hormone components such as longan, jujube, maltose, and royal jelly.

　　Home Remedies for the Auxiliary Treatment of Endometrial Cancer:

　　1. Winter Melon Seed Drink: Grind 30 grams of winter melon seeds, add 30 grams of rock sugar, put in a bowl, pour in 300 milliliters of boiling water, and simmer over low heat. Take 1 dose/day, 7 days/course.

　　2. Panax notoginseng Lotus Root Pudding: Mix 5 grams of Panax notoginseng powder with 1 egg to make a paste. Cut 250 grams of fresh lotus root into pieces, squeeze juice (about 30 milliliters), add 30 milliliters of water, boil, then add the Panax notoginseng powder and egg paste, add salt to taste. Take 1 time/day. Mainly for endometrial cancer with blood stasis and heat.

　　3. White银杏 and Winter Melon Seed Soup: Boil 10 white ginkgo seeds, 30 grams of winter melon seeds, 15 grams of lotus seed meat, and 1.5 grams of pepper in a pot, add 2 liters of water, boil with high heat, then change to low heat to cook until the white ginkgo and lotus seeds are soft. Take 2-3 times/day, 1 dose/day. Function: Strengthen the spleen and promote diuresis, stop vaginal discharge. Mainly for endometrial cancer; symptoms include vaginal discharge.

　　4. Goats Rue and Jujube Soup: Boil 30 grams of goats rue and 10 jujubes in water. 1 dose/day. Function: Clear heat and detoxify. Mainly for endometrial cancer of the hot-toxin type. Tofu and Egg: Boil 60 grams of tofu skin and 1 egg in water, add some sugar to eat. Function: Clear heat and promote diuresis. Mainly for endometrial cancer; symptoms include vaginal discharge.

　　5. Maltose and Jujube Paste: Boil 20 grams of jujube seeds and 60 grams of glutinous rice in 500 milliliters of water to make porridge. After boiling, add 20 grams of maltose to dissolve it, and then boil for another 2-3 minutes. Take 1 time/day, 15 days/course. Can be taken for a long time. Mainly for anemia after surgery for endometrial cancer.