Posted in endometrial cancer, prognosis, outlook; Comments 1 ; Posted 22 months ago by Andreas Obermair
Numbers of patients diagnosed with endometrial cancer are increasing, with Cancer Australia estimating over 3,000 cases and 400 deaths per year in Australia. Upon an endometrial cancer diagnosis I am commonly asked: “What is the likelihood that I will survive this cancer?”
Relative survival rates provide an estimate of what percentage of people with the same cancer are alive—for benchmarking we normally report data at five years—after the initial diagnosis of cancer, compared to healthy people of the same age and sex in the general population.
Survival rates will not tell you how long you may live (this would be virtually impossible to predict), but can be used as an indicator of the successfulness of treatments.
Five-year Survival Rate
In 2012–2016, females diagnosed with all types and stages of endometrial cancer combined had an overall 85% chance of surviving for five years compared to the general Australian population.
Endometrial cancer has a higher likelihood of survival in comparison with the five-year survival rates for ovarian cancer (46%) and cervical cancer (74%).
Endometrial cancer prognosis also depends on a range of factors, including
- The characteristics of the patient (age, lifestyle and other illnesses),
- The type of endometrial cancer, and
- At what stage the cancer is diagnosed.
Those diagnosed with endometrial cancer at an older age typically have a poorer prognosis compared to those diagnosed at a younger age.
Staging and Survival Rate
The International Federation of Gynecology and Obstetrics (FIGO) reports those diagnosed with stage I endometrial cancer before the cancer spreads outside the uterus, have a relative five-year survival rate of 85% to 95%.
Survival for stage 3 or 4 endometrial cancer depends on how successful surgery has been and how much tumour had to be left behind after surgery.
FIGO reports the five-year survival rate of distant (late-stage) endometrial cancer is 17%. Presenting to a doctor with symptoms for early detection is important.
Endometrial Cancer Type and Survival Rate
Typically, the majority of patients with endometrioid type of endometrial cancer will do well. The prognosis of these patients is often limited by their general medical health—higher body weight, sedentary lifestyle, and diabetes mellitus are all associated with poorer prognosis.
Patients with low-grade endometrioid cancers can expect an excellent prognosis.
Endometrial cancer patients diagnosed with other cell types (clear cell, serous) or with uterine sarcomas can expect a worse prognosis, which is the reason why a surgeon will almost always recommend postoperative chemotherapy with or without radiation treatment to reduce the risk of a cancer recurrence for these patients.
Quality of Treatment
Research also has shown that patients treated by experienced teams who manage endometrial cancer patients frequently, do better than patients managed by surgeons who only see a few endometrial cancer patients in their lifetime.
Endometrial Cancer Treatment
Survival rates for endometrial cancer have improved over time due to more accurate investigation, diagnosis and staging of disease, improvements in the speed of referral, availability of evidence-based guidelines, and advances in surgery.
The key to successful endometrial cancer treatment is the removal of the uterus (hysterectomy).
Surgery for endometrial cancer will typically remove the uterus, fallopian tubes and both the ovaries. Commonly some lymph nodes will need to be removed also to determine the extent of the disease. Patients with lymph nodes that contain cancer will need further postoperative treatment, such as radiotherapy, chemotherapy, or combinations of both.
Will My Cancer Come Back?
Cancer of all types and stages may recur. Recurrence may be local or in the pelvis or at distant sites, such as the abdomen or lungs.
After surgery for endometrial cancer and after discussion with your gynaecological oncologist, it is important to make a plan for follow up, which sometimes can be for up to five years. After five years, the risk of a recurrence becomes negligibly low. More importantly, patients need to be aware of the signs of recurrence.
If any bleeding, pain or unexplained fatigue develops, patients should see their gynaecological oncologist without delay.
Survival rates are a guide only and you may have worries or questions. A gynaecological oncologist can discuss how these estimates apply to you. If this is something you wish to discuss, please arrange an appointment.