Endometrial Cancer: Overview
What is endometrial cancer?
Cancer starts when cells change (mutate) and grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. They can spread to other parts of the body, too. This is called metastasis.
Endometrial cancer starts in the cells that form the inner lining of the uterus. This lining is called the endometrium. Endometrial cancer is by far the most common kind of uterine cancer. The other kind is uterine sarcoma. This rare cancer starts in the muscle walls of the uterus.
The uterus is part of the female reproductive system. You may know it as the womb. It’s pear-shaped and about the size of a fist. It sits in the lower belly (pelvic area), between the bladder and the rectum. The uterus is connected to the fallopian tubes. These tubes carry eggs from the ovaries into the uterus. The opening that connects the uterus to the vagina is the cervix.
Who is at risk for endometrial cancer?
A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.
The risk factors for endometrial cancer include:
- Older age
- High estrogen exposure because of things such as:
- Having never been pregnant
- Taking estrogen-only hormone replacement at menopause
- Starting periods at a young age
- Starting menopause at a later age
- Having metabolic syndrome
- Having PCOS (polycystic ovary syndrome)
- Taking tamoxifen to treat or help prevent breast cancer
- Type 2 diabetes
- Diet high in animal fats
- Not being physically active
- Family history of endometrial cancer
- Personal history of breast, ovarian, or colon cancer
- Past radiation therapy to the pelvis
- Personal history of atypical endometrial hyperplasia
- Certain genetic syndromes, such as Lynch syndrome
- Personal history of a type of ovarian tumor that produces estrogen, such as granulosa cell tumor
Talk with your healthcare provider about your risk factors for endometrial cancer and what you can do about them.
Can endometrial cancer be prevented?
There’s no sure way to prevent endometrial cancer. But there may be risk factors you can control to help lower your risk, such as weight, diet, and exercise.
To help reduce your endometrial cancer risk:
- Eat a healthy diet and stay at a healthy weight.
- Get regular physical activity.
- If you have diabetes, work with your healthcare team to manage your condition.
- Monitor and treat endometrial hyperplasia.
- Talk with your doctor about the pros and cons of menopause hormone therapy.
Are there screening tests for endometrial cancer?
There are currently no regular screening tests for endometrial cancer in women at average risk. Screening tests are done to check for disease in people who don’t have symptoms.
All women should see a doctor if they have abnormal vaginal bleeding. This can be one of the first signs of endometrial cancer.
Women at high risk, such as those with a family cancer syndrome like Lynch syndrome, should talk with their doctors about what can be done to check for this cancer. Yearly endometrial biopsies may be advised.
What are the symptoms of endometrial cancer?
The main symptom is abnormal vaginal bleeding. This happens in almost all women with endometrial cancer. The bleeding may include:
- Changes in the kind of bleeding during periods, such as an extra-long period or heavy bleeding
- Bleeding between periods
- Any vaginal bleeding after menopause
- Bleeding with or after sex
Other symptoms may include:
- Non-bloody vaginal discharge
- Pain when urinating
- Pain during sex
- Pain, pressure, or a lump in the pelvic area or lower belly (lower abdomen)
Many of these may be caused by other health problems. Still, it’s important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.
How is endometrial cancer diagnosed?
The most common way to find endometrial cancer is when a woman sees a doctor because of abnormal vaginal bleeding. Your healthcare provider will ask you about your health history, symptoms, risk factors, and family history of disease. A physical exam and a pelvic exam will be done.
You may also have 1 or more of these tests:
- Transvaginal ultrasound (ultrasonography)
- Hysteroscopy, which is a procedure where a long, thin, tube-like camera is put into the uterus so the lining can be checked for cancer or other changes
- Dilation and curettage (D&C)
- Endometrial biopsy
A biopsy is the only way to know for sure if you have cancer. Small pieces of tissue are taken from the tumor and tested for cancer cells.
After a diagnosis of endometrial cancer, you'll need more tests. These help your healthcare providers learn more about your overall health and the cancer. They're used to find out the stage of the cancer. The stage is how much cancer there is and how far it has spread (metastasized) in your body. It's one of the most important things to know when deciding how to treat the cancer.
Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your provider to explain the stage of your cancer to you in a way you can understand.
How is endometrial cancer treated?
Your treatment choices depend on the test results and the stage of the cancer. You also may need to decide if you want to be able to have kids. The goal of treatment may be to cure you, control the cancer, or to help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.
Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy (chemo), targeted therapy, and hormone therapy are systemic treatments.
Treatment can often cure endometrial cancer. Surgery is often done to remove the uterus and the cancer in it. You may have just 1 treatment or a combination of treatments.
Treatment options include:
- Radiation therapy
- Hormone therapy
- Targeted therapy
Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare provider before making a decision.
What are treatment side effects?
Cancer treatment such as chemo and radiation can damage normal cells. This can cause side effects like hair loss, mouth sores, and vomiting.
Talk with your healthcare provider about side effects linked to your treatment. There are often ways to manage them. There may be things you can do and medicines you can take to help prevent or control many treatment side effects.
Coping with endometrial cancer
Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.
Here are tips:
- Talk with your family or friends.
- Ask your healthcare team or social worker for help.
- Speak with a counselor.
- Talk with a spiritual advisor, such as a minister, rabbi, or imam.
- Ask your healthcare team about medicines for depression or anxiety.
- Keep socially active.
- Join a cancer support group.
Cancer treatment is also hard on the body. To help yourself stay healthier, try to:
- Eat a healthy diet, with a focus on high-protein foods.
- Drink plenty of water, fruit juices, and other liquids.
- Keep physically active.
- Rest as much as needed.
- Talk with your healthcare team about ways to manage treatment side effects.
- Take your medicines as directed by your team.
When should I call my healthcare provider?
Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:
- New symptoms or symptoms that get worse
- Signs of an infection, such as a fever
- Side effects of treatment that affect your daily function or don’t get better with treatment
Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.
Key points about endometrial cancer
- Endometrial cancer starts in the cells that form the inner lining of the uterus. It is the most common kind of uterine cancer.
- The main symptom is abnormal vaginal bleeding. Other symptoms can include pain during sex or when urinating.
- Risk factors include being older, having high estrogen exposure, having type 2 diabetes, being overweight, and not being physically active.
- If you are at high risk, talk with your healthcare provider about what can be done to check for this cancer.
- Treatment options include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, and immunotherapy.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of any new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.