Endometrial cancer is the most common gynaecological malignancy and the sixth commonest cancer in women worldwide. The incidence of the disease has jumped 132% over the past three decades and is set to get worse as a result of an ageing population and the frightening global increase in obesity and diabetes.

However, advances in the diagnosis and treatment of endometrial cancers are also occurring at a rapid pace, with a fresh focus on genomic profiling and targeted therapies. While surgical removal of the tumour remains the mainstay of treatment, adjuvant therapies are also a shifting paradigm.

Diagnostic tools for endometrial cancer include:

# Pelvis examination: In this examination, the reproductive organs are checked. It is often part of a routine checkup, but might be required if one has symptoms of endometrial cancer.

# Imaging : Transvaginal Ultrasound is the primary imaging which assess the contour of the inner lining of uterus to determine irregularity. MRI and CT scans are also used for better visualization and assessment.

# Hysteroscopy: In this procedure, the inside of the uterus and endometrium is examined by a thin, flexible tube called the hysteroscope.

# Endometrial Biopsy: Here sample tissue is removed from the lining of the uterus and sent to the lab to test for cancer. Its usually done along with hyseteroscopy

Advances in endometrial cancer treatment

Surgery remains the Gold standard treatment option for early-stage endometrial cancer. Additional treatment based on the stage of the cancer and other factors might include radiation with or without chemotherapy, hormone therapy, immunotherapy and targeted therapies.

New treatments for advanced disease include:

# Molecular subtypes: Huge changes have come about in determining the molecular subtypes of cancers and deciding treatment as per type. Doctors now recommend molecular analysis of endometrial cancers for all freshly diagnosed patients which can be used to guide treatment decisions in selected subtypes and also it determines the prognostic implication.

# Immunotherapy: These therapies use specific drugs to enable the immune system fight cancer better. A type of immunotherapy called immune checkpoint inhibitors, has shown promise in treating certain forms of endometrial cancer. These immunotherapy drugs are

particularly useful in tumours with defects in a specific DNA repair process, referred to as mismatch repair.

# Targeted therapy: These therapies use drugs or other substances that interfere with particular molecules or targets, to block the growth and proliferation of cancer, causing less harm to healthy cells.

New light

Recent research shows, Novel non invasive tests using protein and DNA biomarkers and cytology carry the potential to alter diagnostic pathways and to allow for the scrutiny of high-risk populations. It has been revealed that the molecular classification of endometrial cancers not only has a prognostic impact, but also therapeutic worth and is more and more being used to prompt ancillary treatment calls.

By raising the use of debulking surgery and targeted treatments, especially immunotherapy, the management of advanced and recurrent disease has also been revolutionised.