What are the signs of recurrence of endometrial cancer?

Signs of endometrial cancer recurrence include irregular vaginal bleeding, pelvic pain, weight loss, abdominal mass, and distant metastasis. Recurrence may be related to factors such as tumor differentiation, insufficient surgical scope, lymph node metastasis, etc., and needs to be comprehensively evaluated using imaging and tumor markers.

1. Irregular vaginal bleeding

Non-menstrual or postmenopausal vaginal bleeding is a common sign of recurrence and may be related to local lesions eroding blood vessels. The amount of bleeding can range from dripping to massive gushes, often accompanied by bloody secretions. Endometrial thickness needs to be checked by vaginal ultrasound, and diagnostic dilation and curettage should be performed to clarify the pathology if necessary.

2. Pelvic pain

Falling pain in the lower abdomen or dull pain in the lumbosacral region indicates recurrence in the pelvis, which is often caused by tumor infiltration into surrounding tissues or compression of nerves. The pain may radiate to the inner thigh and worsen with changes in position. Pelvic MRI can show the relationship between the lesion and surrounding organs.

3. Weight loss and fatigue

Unexplained weight loss of more than 5% accompanied by persistent fatigue requires vigilance. It is common in widespread recurrence or distant metastasis. The tumor-wasting effect leads to metabolic disorders, which may be accompanied by loss of appetite and anemia. Dynamic monitoring of serum CA125 levels is helpful for early detection.

4. Abdominal mass

Palpation of a fixed hard mass in the lower abdomen indicates local recurrence, which is common in the vaginal stump or pelvic wall. When the mass grows rapidly, it can compress the ureter and cause hydronephrosis. CT examination can clarify the size of the mass and its relationship with adjacent structures.

5. Symptoms of distant metastasis

Lung metastasis can cause cough and hemoptysis, bone metastasis can cause pathological fractures, and liver metastasis can cause jaundice and ascites. PET-CT is sensitive for detecting systemic metastases, and metastasis biopsy can confirm whether the pathological type has changed.

Gynecological examination, tumor markers and imaging should be reviewed every 3 months after surgery, and a balanced diet and moderate exercise should be maintained. Avoid high-estrogen foods such as royal jelly, and keep your body mass index within a normal range. When abnormal symptoms occur, timely treatment is required. Treatment plans after recurrence need to be individually formulated based on the scope of the disease, and may include re-operation, radiotherapy or targeted therapy.