Endometriosis Isn't the Same as Endometrial Cancer
- Actress Amy Schumer, 42, experienced painful periods because of endometriosis, a chronic disease that causes pelvic pain and menstrual changes. She underwent surgery to help manage the chronic condition.
- Endometriosis occurs when tissue similar to the tissue that normally lines the inside of the uterus, known as the endometrium, grows on the outside of the uterus. It often brings debilitating pain and can often be difficult to diagnose.
- Endometrial cancer begins when cancerous cells form in the tissues of the endometrium or lining of the uterus. Symptoms typically associated with this type of cancer include vaginal bleeding and pelvic pain – like endometriosis.
- Although endometriosis and endometrial cancer cause similar symptoms, they are not the same because, in the case of the cancer, the endometrial cells lining the uterus become cancerous, while endometriosis remains benign.
- Treatment advancements for advanced endometrial cancer patients and those at higher risk for recurrence include combination therapies where immunotherapy is added to standard-of-care chemotherapy.
Actress Amy Schumer, 42, revealed she lives with endometriosis, a chronic disease that causes pelvic pain, menstrual changes, and fertility issues earlier this year.
Although this condition may present symptoms similar to endometrial cancer, it is “not cancer,” says OB/GYN and oncologist at Cedars-Sinai Medical Center Dr. Bobbie Rimel.
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“I have endometriosis, an autoimmune disease that every woman should read about,” Schumer wrote in an Instagram post about her diagnosis.
Schumer, a mother of one, discussed her condition while addressing concerns about her appearance.
In 2021, Schumer underwent surgery removing 30 endometriosis lesions to help treat her diagnosis partly because she experienced “painful periods.”
“He removed my appendix because the endometriosis had attacked it. There was a lot of blood in my uterus, and I’m, you know, sore, and I have some, like, gas pains. But, other than that, I already feel that my energy is [returning],” Schumer explained.
“I’ve enjoyed feedback and deliberation about my appearance as all women do for almost 20 years. And you’re right, [my face] is puffier than normal right now,” she said while promoting body positivity.
“Like every other woman/person, some days I feel confident and good as well, and others I want to put a bag over my head. But I feel strong and beautiful and so proud,” Schumer added.
Expert Resources on Endometrial Cancer
- Endometrial Cancer — How to Spot the Signs And Symptoms Earlier
- Endometrial Cancer — Choosing The Right Doctor
- Chemotherapy Can Play A Vital Role In Treating Advanced and Aggressive Endometrial Cancers
- Combo Immunotherapy-Chemo Treatment May Help Slow Progression of Advanced Endometrial Cancer: Studies Show Promising Results
- What to Know About Approved Immunotherapy Combination for Endometrial Cancer
- Hope for Endometrial Cancer: FDA Approves Durvalumab/Chemotherapy Combination for Hard-to-Treat Advanced Disease
- How Doctors Recognize and Diagnose Different Types of Endometrial Cancer
Coping With an Endometrial Cancer Diagnosis
Endometrial cancer begins when cancerous cells form in the tissues of the endometrium or lining of the uterus. Symptoms typically associated with this type of cancer include vaginal bleeding and pelvic pain.
“Endometrial cancer is often treated with surgery,” Dr. Rimel said.
The type of surgery depends on if the cancer remains contained in the uterus or if it’s spread outside of the uterus already.
Patients whose cancer is confined to the uterus are considered low risk for recurrence and are likely to be treated with surgery alone. However, patients with advanced cancer that have metastasized beyond the uterus are considered at higher risk. These patients will likely need additional treatments beyond surgery, such as chemotherapy, immunotherapy, or radiation.
A minimally invasive surgery called laparoscopic surgery is an option for patients. It uses small incisions in the abdomen. The surgeon uses an affixed camera during the procedure to look inside the abdomen and remove the organs that need to be taken out. These organs may include the cervix, uterus, fallopian tubes, and ovaries.
“The procedure can also include removal of the necessary lymph nodes,” Dr. Rimel adds.
Patients are encouraged to ensure their surgeon is qualified to perform the surgery by asking if they are board-certified gynecologic oncologists.
WATCH: Choosing the right surgeon.
What Is the Recovery From Surgery Like?
Dr. Rimel explains that patients will likely experience some discomfort for the first few days after surgery. Most of the pain will be around the incisions.
“They may feel really tired after their surgery, but they’re generally able to get up, make a sandwich, check email, that kind of thing,” Dr. Rimel said.
Patients can return to normal activities within about a week or two; however, each patient’s recovery time may vary.
“In general, once people have had surgery, if no other treatment is required, it’s recommended that they follow up for examinations,” Dr. Rimel explains.
WATCH: Surgery is the foundation of endometrial cancer treatment.
During these recommended follow-ups, patients’ medical history is discussed. They are often asked if they’ve experienced any symptoms like vaginal bleeding, abdominal pain, or new symptoms post-surgery for endometrial cancer.
Advancements In Endometrial Cancer Treatment
Patients with advanced endometrial cancer or patients who’ve experienced recurrence have reason to be hopeful because treatment options are improving their quality of life.
“We have the option of treating patients with a combination of carboplatin and paclitaxel, which are two different chemotherapies, and now we have the ability to add immunotherapy to that,” Dr. Rimel explains.
Immunotherapy is an umbrella term for new treatments. Some are drugs, some are antibodies, and some are other molecules that activate the body’s immune system to overcome something the cancer has been suppressing.
Patients with late-stage endometrial cancer previously only had chemotherapy as a treatment, but now a three-drug combination exists.
WATCH: Treatment Options for Early Endometrial Cancer and Beyond
“We use chemotherapy for six cycles or treatments in a row once every three weeks with carboplatin and paclitaxel, and then in addition, we add the immunotherapy and use it as a maintenance therapy with the goal of keeping the cancer from coming back and extending remission,” Dr. Rimel explained.
The targeted drug trastuzumab deruxtecan, known as Enhertu, was recently approved for any tumor that expresses a high amount of the protein HER2 (human epidermal growth factor receptor 2), including endometrial cancers. It is one of several options doctors may consider to treat cancer if tests show it is advanced and strongly HER2 positive.
Enhertu is a targeted cancer therapy that combines an antibody with a chemotherapy drug. The treatment is designed to deliver the chemotherapy directly to cancer cells by binding to specific proteins on the cells’ surface, reducing the impact on healthy cells and increasing the drug’s effectiveness.
Enhertu specifically finds and neutralizes HER2 (Human Epidermal Growth Factor Receptor 2), a protein that can promote the growth of cancer cells.
“It’s actually a type of chemotherapy because the antibody is bringing the drug directly to the cancer cell, that drug can be dumped in directly to the cancer cell and hopefully avoid a lot of the systemic kinds of symptoms that people have as a result of chemotherapy,” Dr. Rimel explains. “It’s not only an efficient way of bringing the drug to a cancer cell, but it’s also a very effective way. And recently, it was approved for tumors that express this molecule, HER2, which is present in a proportion of endometrial cancers, not all of them.”
Dr. Rimel says your doctor should test you to see if your cancer has high levels of HER2. If it does, this drug is one option that may help you live longer with fewer side effects than chemo or radiation.
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