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Endometrial Cancer Staging and Surgery

Endometrial Cancer Staging and Surgery

Question

Dear OncoLink "Ask The Experts,"
My sister has just been diagnosed with stage I endometrial cancer. She is wondering that if she put off surgery for a month, would her cancer worsen dramatically? Is there a way to generally estimate the time between stage I to the next stage? Does endometrial cancer advance quickly? Thanks for any information you can give. 

Answer

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

First of all, you should know that endometrial cancer must be staged through surgery. In other words, there is no way to know for sure that the cancer is truly stage I until a complete hysterectomy and staging surgery has been completed. We may refer to a patient a having a "clinical stage I" tumor when we believe that through physical examination and imaging tests that the cancer appears to be limited to the uterus. However, there is no way to know that for sure without surgery. Surgery is the only way to check for microscopic spread of cancer cells to the lymph nodes or to the ovaries and other parts of the abdomen and pelvic. Microscopic spread to these areas would increase the stage of the tumor. Second, there is no reliable way to tell how quickly endometrial cancer spreads for an individual patient. While the surgery is not an emergency, I would not recommend putting it off for several weeks either.