Endomentrial Stromal Sarcoma
You may read or hear that ESS or Endometrial Stromal Sarcoma is one of the rarest forms of cancer, and while that is true, it is a manageable condition. It is important to really understand what is going on when you have this condition, so let’s take a look at how this form of uterine cancer differs from other types.
Firstly, when you discover that you have ESS, you should know that it is not what many commonly think of when they hear the phrase uterine cancer. Rather than being something caused by glands, this form of cancer develops within the soft tissue of the endometrium.
Endometrial Stromal Sarcoma Diagnosis
It is very helpful to take apart the phrase to discover what ESS means. Firstly, the organ or tissue being affected by the cancer is the endometrium, which is the innermost mucous membrane of the uterus. This is why ESS is also referred to as uterine cancer. However, it is “stromal sarcoma”, which distinguishes it from the more common “carcinomas” which come from glands. Sarcomas are fleshy growths in soft tissue, but they are also malignant, meaning that they alter the cells and their DNA, causing them to behave in a way they are not meant to.
Stromal cells are those that form the connective tissues inside any organ of the body, including the endometrium. So, when you have ESS, it is a form of cancer, a “sarcoma” of the cells in the endometrium.
Who is at Risk?
This form of uterine cancer is also unusual because it tends to appear in females below the standard age for this form of cancer. Rather than appearing in post-menopausal age groups, ESS more commonly manifests in women aged 40-50 (and who are premenopausal).
It is also believed that those who have taken medications that affect estrogen production are at greater risk; those who have had any sort of radiation treatment to the pelvic area within five to twenty-five years earlier; women of African American heritage; and some studies have shown that ESS is more common among women with thyroid disease.
Warning signs are easy to overlook or misdiagnose as well, and include pelvic pain or swelling, abnormally heavy or lengthy menstrual periods, and bleeding in between cycles. Unfortunately, the covert nature of ESS means that it has often progressed quite extensively before it is diagnosed.
That is why it is important for women to be their own advocates and ask for edometrial sampling that will identify any variety of uterine cancer.
Is ESS More Difficult to Treat?
Upon hearing that you have ESS, you may worry that the rarity of the condition is going to make it very challenging to treat. Fortunately, it is often seen as a less aggressive form of cancer and one that can be managed surgically and/or with hormone therapy.
The treatment varies on your particular diagnosis. There are two grades of ESS:
- Low grade ESS – This is one in which your condition is recognized as a slow growing form of the condition
- High grade ESS – This is also called “undifferentiated” and is believed to be a more aggressive form, likely to spread or metastasize. It is called undifferentiated simply because the cells no longer resemble those of standard endometrial cells, and this is evidence that the cancer has actually altered the cells and will prevent them from functioning normally. Such a patient is at risk for metastatic issues.
The most common treatment is hysterectomy, and if the cancer has progressed it can also mean removal of ovaries, fallopian tubes, and the cervix. Additionally, progesterone hormone therapy is common and useful in preventing any reoccurrence of the ESS. The survival rate is high, with the five year rate at 90%.
Vann, Madeline. What Is Endometrial Stromal Sarcoma? Everydayhealth.com. 2015. http://www.everydayhealth.com/uterine-cancer/endometrial-stromal-sarcoma.aspx