Guidelines for Comprehensive Management of Endometrial Cancer Patients

Endometrial cancer is one of the most common malignant tumors of the female reproductive system, posing a serious threat to women's health. Comprehensive management of endometrial cancer patients—from prevention to rehabilitation—is crucial. This article will provide a detailed discussion on the prevention, diagnosis, radiotherapy, and various aspects of radiotherapy nursing for endometrial cancer, offering comprehensive guidance for patients and their families.

I. Prevention

1. Understand cancer prevention knowledge: Learning about the causes, early symptoms, and risk factors of endometrial cancer can help detect abnormalities early and take preventive measures. For example, obesity, hypertension, diabetes, infertility, late menopause, and long-term use of tamoxifen are all associated with an increased risk of developing endometrial cancer.

2. Undergo regular gynecological screenings: Middle-aged women, menopausal women, those with menstrual disorders, and postmenopausal women experiencing irregular vaginal bleeding should undergo annual screenings. This helps detect precancerous signs early and ensures timely intervention, improving the cure rate of endometrial cancer.

3. Use estrogen correctly: Menopausal women using hormone replacement therapy (HRT) should do so under medical supervision and in combination with progestin. This approach counteracts estrogen's proliferative effects on the endometrium, thereby reducing the risk of endometrial cancer.

4. Adopt healthy lifestyle habits: Controlling conditions such as hypertension, diabetes, and obesity can help lower the incidence of endometrial cancer. Additionally, maintaining a healthy lifestyle—such as eating a balanced diet and engaging in regular physical activity—can further reduce the risk. It is recommended to consume low-fat, high-fiber foods like vegetables, fruits, whole grains, and legumes while limiting red and processed meats. Moderate exercise enhances immune function, helps maintain a healthy weight, and lowers disease risk.

II. Diagnosis

1. Early symptom identification: The early symptoms of endometrial cancer mainly include irregular vaginal bleeding after menopause, increased menstrual flow and prolonged menstrual periods in women who have not yet reached menopause, and menstrual disorders. When these symptoms occur, prompt medical consultation and gynecological examination are necessary.

2. Auxiliary examinations: Commonly used auxiliary examination methods include B-ultrasound examination, diagnostic curettage, hysteroscopy, and pathological examination. B-ultrasound can assess uterine size, endometrial cavity shape, presence of masses in the cavity, endometrial thickness, and whether there is myometrial invasion and its depth. Diagnostic curettage is the most commonly used and valuable method for confirming endometrial cancer. Hysteroscopy allows direct visualization of the uterine cavity and cervical canal to check for the presence, size, and location of cancerous lesions, and enables targeted biopsy under direct vision, making it particularly accurate for diagnosing focal endometrial cancer. Pathological examination is the gold standard for definitively diagnosing endometrial cancer.

III. Radiotherapy

Radiation therapy is a classic treatment modality for gynecologic malignancies. Malignant tumors of the cervix, endometrium, vagina, and vulva, from stage I to stage IV, can all be treated with radiotherapy for different therapeutic purposes.

IV. Radiotherapy Nursing Tips

1. Proper Diet: During radiotherapy, it is essential to consume a diet rich in calories and protein, such as eggs, dairy products, and fish, while increasing intake of fresh fruits and vegetables and maintaining a balance between refined and whole grains. Drink plenty of water, at least 2000ml per day, and eat more vegetables and fruits to ensure smooth bowel movements.

2. Vaginal Care: Daily vaginal douching is recommended during radiotherapy, and a vaginal dilator may be used if necessary. Avoid hot water scalding and refrain from using chemically formulated commercial douche products for disinfection or sterilization. Keep the perineal area clean and well-ventilated by wearing loose, comfortable underwear made of pure cotton or silk, changing daily, and frequently sun-drying clothes to prevent bacterial growth.

3. Regular Follow-up: Blood tests, including white blood cell and platelet counts (which are most affected), should be performed weekly during radiotherapy. If levels drop below normal, appropriate measures should be taken. Since radiotherapy weakens the immune system, avoid catching colds, maintain a regular lifestyle, stay mentally relaxed, and engage in moderate physical activity.

4. Maintain a Healthy Mindset: Stay calm and optimistic, engage in moderate exercise, ensure adequate nutrition, and enhance immune function.

V. Special Group Considerations

1. Women of Childbearing Age: Any menstrual irregularity in women of childbearing age, especially postmenopausal women experiencing abnormal vaginal bleeding, should raise suspicion of uterine pathology. Prompt medical evaluation is necessary to rule out endometrial cancer. For endometrial cancer patients who wish to preserve fertility, personalized treatment plans should be developed based on individual circumstances to maximize the chances of maintaining reproductive function.

2. Advanced-Stage Patients: For patients with advanced endometrial cancer, surgery may not be the first-line treatment option. In such cases, comprehensive treatment approaches—including chemotherapy, radiotherapy, and hormonal therapy—can help alleviate symptoms and prolong survival. Patients should actively cooperate with their prescribed treatment regimens while maintaining a positive mindset and good quality of life.

VI. Summary

The comprehensive management of endometrial cancer requires a holistic approach encompassing prevention, diagnosis, and rehabilitation. Scientific preventive measures can reduce incidence risk; early detection and diagnosis improve cure rates; optimized treatment protocols extend survival; and thorough rehabilitation enhances quality of life. Patients and their families should proactively educate themselves about endometrial cancer and maintain close collaboration with healthcare providers to combat the disease effectively. Meanwhile, the broader community should strengthen public awareness and education initiatives to improve disease recognition and vigilance.

Department Introduction

Department IV of Radiation Oncology specializes in photon and carbon ion therapy for gynecological and breast malignancies, with key disease types including cervical cancer, endometrial cancer, vaginal cancer, vulvar cancer, ovarian cancer, and breast cancer. The department offers comprehensive treatment modalities such as radical radiotherapy, neoadjuvant radiotherapy before surgery, adjuvant radiotherapy after surgery, chemotherapy, immunotherapy, targeted therapy, hormonal therapy, and combined approaches integrating these methods. The department comprises 13 medical staff members, including 2 associate senior title holders, 1 attending physician, and 3 resident physicians. Department personnel have received advanced training at Tianjin Cancer Hospital, Beijing Cancer Hospital, Beijing 301 Hospital, Peking University Third Hospital, Shanghai Proton and Heavy Ion Center, and Sichuan Cancer Hospital.

Department Director Dang Youquan, Associate Chief Physician, has 24 years of experience in tumor radiotherapy and has undergone advanced training at multiple renowned tertiary hospitals nationwide. She possesses extensive expertise in radiotherapy and comprehensive treatment for gynecological and breast tumors. Currently, she serves as a committee member of the Ion Radiotherapy Branch of the China Medical Equipment Association, executive director of the Western Cancer Specialist Alliance, standing committee member of the Gynecological Brachytherapy Committee of the Gansu Anti-Cancer Association, committee member of the Radiotherapy Committee for Elderly Oncology of the Gansu Geriatrics Medical Association, committee member of the Tumor Nutrition Branch of the Gansu Nutrition Society, and part-time instructor at Wuwei Vocational College. The department regularly invites Professor Jorg Hauffe from the Munich Proton Therapy Center in Germany, Professor Hirohiko Tsujii—renowned as "the world's leading expert in heavy ion tumor therapy" from Japan, and Professor Yee-Min Jen, former chairman of the Taiwan Radiation Oncology Committee, for ward rounds and clinical guidance. The department also receives ongoing clinical and research supervision from Professor Liu Zi, chairman of the Gynecological Oncology Committee at the First Affiliated Hospital of Xi'an Jiaotong University, and Professor Li Sha, chief physician of the Radiotherapy Department at the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. The department has completed 5 provincial and municipal research projects, published over 10 academic papers, and obtained 3 invention patents. Over the years, its evidence-based comprehensive cancer treatment approach has achieved remarkable therapeutic outcomes, earning widespread recognition from patients, peers, and the medical community.