Endometriosis (cont.)
Endometriosis and cancer risk
Women with endometriosis have a mildly increased risk for development of
certain types of cancer of the ovary, known as
epithelial ovarian cancer (EOC). This risk seems to be highest in women with
endometriosis and primary
infertility (those who have never borne a child), but the use of
oral
contraceptive pills (OCPs), which are sometimes used in the treatment of
endometriosis, appears to significantly reduce this risk.
The reasons for the association between endometriosis and
ovarian epithelial cancer are not clearly understood. One theory is that the
endometriosis implants themselves undergo transformation to cancer. Another
possibility is that the presence of endometriosis may be related to other
genetic or environmental
factors that also increase a women's risk of developing ovarian cancer.
How is endometriosis diagnosed?
Endometriosis can be suspected based on symptoms of
pelvic pain and findings during physical examinations in the doctor's office.
Occasionally, during a rectovaginal exam (one finger in the vagina and one
finger in the rectum), the
doctor can feel nodules (endometrial implants) behind the uterus and along the
ligaments that attach to the pelvic wall. At other times, no nodules are felt,
but the examination itself causes unusual pain or discomfort.
Unfortunately, neither the symptoms nor the physical
examinations can be relied upon to conclusively establish the diagnosis of
endometriosis. Imaging studies, such as ultrasound, can be helpful in ruling out
other pelvic diseases and may suggest the presence of endometriosis in the
vaginal and bladder areas, but still cannot definitively diagnose endometriosis.
For an accurate diagnosis, a direct visual inspection inside of the pelvis and
abdomen, as well as tissue biopsy of the implants are necessary.
As a result, the only accurate way of diagnosing
endometriosis is at the time of surgery, either by opening the belly with
large-incision laparotomy or small-incision laparoscopy.
Laparoscopy is the
most common surgical procedure for the diagnosis of endometriosis. Laparoscopy
is a minor surgical procedure done under general anesthesia, or in some cases
under local anesthesia. It is usually performed as an out-patient procedure (the
patient going home the same day). Laparoscopy is performed by first inflating
the abdomen with carbon dioxide through a small incision in the navel. A long, thin viewing instrument
(laparoscope) is then
inserted into the inflated abdominal cavity to inspect the abdomen and pelvis.
Endometrial implants can then be directly seen.
During laparoscopy, biopsies
(removal of tiny tissue samples for examination under a microscope) can also be performed for a diagnosis. Sometimes biopsies obtained
during laparoscopy show endometriosis even though no endometrial implants are
seen during laparoscopy.
Pelvic ultrasound and laparoscopy are also important in excluding
malignancies (such as ovarian cancer) that can cause symptoms that mimic
endometriosis symptoms.
Next: How is endometriosis treated? »
- ibuprofen, Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc. - Explains the medication ibuprofen (Advil, Motrin, Nuprin, Medipren) a drug used for the management of mild to moderate pain, fever, and inflammation. Article includes descriptions, uses, drug interactions, and side effects.
- Hysterectomy - Learn about hysterectomy procedures and options available for women. There are many types of hysterectomy surgeries including a total, radical, laparoscopy assisted vaginal hysterectomy, supracervical, and oophorectomy. The type of hysterectomy procedure will depend upon the reason for the procedure.
- Abdominal Pain - Learn about abdominal pain (pain in the stomach / abdomen) including causes, symptoms, how abdominal pain is diagnosed, and how abdominal pain is treated.
Latest Medical News
Womens Health RSS