What is Endometrial Cancer? Symptoms, Causes, & Treatment

Endometrial cancer is a type of cancer that begins in the lining of the uterus, called the endometrium. This tissue normally thickens and sheds each month during your menstrual cycle, but sometimes cells in this lining can grow abnormally and become cancerous.

The good news is that endometrial cancer is often caught early because it tends to cause noticeable symptoms like unusual bleeding. When detected early, treatment is typically very effective, and many people go on to live full, healthy lives after treatment.

What is endometrial cancer?

Endometrial cancer develops when cells in the endometrium start growing out of control. Think of your endometrium as the inner wallpaper of your uterus that builds up each month in preparation for a possible pregnancy.

This cancer is the most common type of uterine cancer, affecting about 1 in 36 women during their lifetime. Most cases occur in women after menopause, typically between ages 50 and 70, though it can happen at any age.

There are two main types of endometrial cancer. Type 1 cancers are more common and usually grow slowly, while Type 2 cancers are less common but tend to be more aggressive and may spread faster.

What are the symptoms of endometrial cancer?

The most common early sign is unusual vaginal bleeding, especially after menopause. Your body is giving you an important signal that something needs attention, and catching it early makes a significant difference in treatment success.

Here are the key symptoms to watch for:

• Vaginal bleeding after menopause
• Bleeding between periods or periods that are heavier or longer than usual
• Unusual vaginal discharge that may be watery, pink, or have a strong odor
• Pelvic pain or pressure
• Pain during urination
• Difficulty emptying your bladder completely
• Unexplained weight loss
• Fatigue that doesn't improve with rest

Less common symptoms might include bloating, feeling full quickly when eating, or changes in bowel habits. These symptoms can also be signs of other conditions, so having them doesn't necessarily mean you have cancer.

Remember that many conditions can cause similar symptoms, and your doctor can help determine what's causing yours. The important thing is not to ignore persistent changes in your body, especially unusual bleeding.

What are the types of endometrial cancer?

Endometrial cancer is divided into two main types based on how the cancer cells look under a microscope and how they behave. Understanding your type helps your medical team create the most effective treatment plan for you.

Type 1 endometrial cancers make up about 80% of all cases. These cancers usually grow slowly and are often linked to excess estrogen in the body. They typically respond well to treatment, especially when caught early.

Type 2 endometrial cancers are less common but tend to be more aggressive. These cancers aren't usually related to estrogen levels and may spread more quickly to other parts of the body.

Within these two main categories, there are several specific subtypes. The most common subtype is endometrioid adenocarcinoma, which falls under Type 1. Other subtypes include serous carcinoma, clear cell carcinoma, and carcinosarcoma, which are generally considered Type 2 cancers.

What causes endometrial cancer?

Endometrial cancer develops when something causes the DNA in endometrial cells to change, leading them to grow and multiply uncontrollably. While we don't always know exactly why this happens, researchers have identified several factors that can increase the risk.

The primary factor is prolonged exposure to estrogen without enough progesterone to balance it out. Estrogen stimulates the endometrium to grow, and when there's not enough progesterone to keep this growth in check, cells may begin to grow abnormally over time.

Several conditions and situations can lead to this hormonal imbalance:

• Never having been pregnant (pregnancy increases progesterone levels)
• Starting menstruation early (before age 12) or menopause late (after age 52)
• Polycystic ovary syndrome (PCOS), which can cause irregular ovulation
• Obesity, as fat tissue produces estrogen
• Taking estrogen replacement therapy without progesterone
• Certain medications like tamoxifen used for breast cancer treatment

Some genetic factors can also play a role. Lynch syndrome, a hereditary condition that affects DNA repair, significantly increases the risk of endometrial cancer. Additionally, having a family history of endometrial, colorectal, or ovarian cancer may increase your risk.

It's important to remember that having risk factors doesn't mean you'll definitely develop cancer. Many people with multiple risk factors never develop endometrial cancer, while others with few risk factors do.

When to see a doctor for endometrial cancer?

You should contact your doctor promptly if you experience any unusual vaginal bleeding, especially if you're past menopause. Even light spotting after menopause warrants a conversation with your healthcare provider.

If you're still having periods, see your doctor if you notice bleeding between periods, periods that are much heavier than usual, or periods that last longer than normal. Changes in your typical pattern deserve attention.

Don't wait if you're experiencing pelvic pain that doesn't go away, especially if it's accompanied by other symptoms like unusual discharge or bleeding. While these symptoms often have benign explanations, it's always better to have them checked.

You should also discuss your risk factors with your doctor during routine visits. If you have a family history of endometrial, ovarian, or colorectal cancer, or if you have Lynch syndrome, your doctor may recommend more frequent screening.

What are the risk factors for endometrial cancer?

Understanding your risk factors can help you and your doctor make informed decisions about screening and prevention. Some factors you can't control, while others relate to lifestyle choices you can influence.

The most significant risk factors you cannot change include:

• Age (most cases occur after menopause)
• Never having been pregnant
• Starting periods before age 12 or reaching menopause after age 52
• Family history of endometrial, ovarian, or colorectal cancer
• Lynch syndrome or other genetic conditions
• Previous radiation therapy to the pelvis

Lifestyle and health-related factors that may increase risk include:

• Obesity, particularly carrying extra weight around your midsection
• Diabetes, especially Type 2 diabetes
• High blood pressure
• Taking estrogen without progesterone for hormone replacement
• Taking tamoxifen for breast cancer treatment
• Having polycystic ovary syndrome (PCOS)

Some factors actually lower your risk, such as having been pregnant, using birth control pills, or using an intrauterine device (IUD) that releases progestin. Physical activity and maintaining a healthy weight can also help reduce your risk.

What are the possible complications of endometrial cancer?

While endometrial cancer is often caught early and treated successfully, it's natural to wonder about potential complications. Understanding these possibilities can help you work with your medical team to prevent or manage them effectively.

The most serious complication is the spread of cancer to other parts of your body. Early-stage endometrial cancer is usually confined to the uterus, but if left untreated, it can spread to nearby organs like the ovaries, fallopian tubes, or lymph nodes.

Advanced cancer may spread to more distant areas, including:

• The abdomen and pelvis
• The lungs
• The liver
• The bones
• The brain (though this is rare)

Treatment-related complications can also occur, though your medical team works hard to minimize these. Surgery may lead to complications like infection, bleeding, or damage to nearby organs. Radiation therapy might cause fatigue, skin changes, or bowel and bladder problems.

Chemotherapy can cause side effects like nausea, fatigue, hair loss, and increased risk of infection. However, many of these side effects are temporary and can be managed with supportive care and medications.

The good news is that when endometrial cancer is caught early, the vast majority of people are cured and don't experience serious complications. Regular follow-up care helps catch any problems early.

How can endometrial cancer be prevented?

While you can't prevent endometrial cancer entirely, there are several steps you can take to lower your risk. Many of these strategies also benefit your overall health and well-being.

Maintaining a healthy weight is one of the most important things you can do. Excess weight increases estrogen production, which can raise your risk. Even losing a modest amount of weight can make a difference if you're currently above your ideal weight range.

Regular physical activity helps in multiple ways. Exercise helps maintain a healthy weight, may help regulate hormones, and has been shown to reduce the risk of several types of cancer, including endometrial cancer.

If you're considering hormone replacement therapy for menopause symptoms, discuss the options with your doctor. Taking estrogen alone increases endometrial cancer risk, but taking it with progesterone can help protect against this risk.

Birth control pills may actually lower your risk of endometrial cancer, with protection lasting for years after you stop taking them. However, they do carry other risks, so discuss whether this option makes sense for your situation.

If you have diabetes, keeping your blood sugar well-controlled may help reduce your risk. Work with your healthcare team to manage your diabetes effectively through diet, exercise, and medication as needed.

How is endometrial cancer diagnosed?

Diagnosing endometrial cancer typically starts with a conversation about your symptoms and a physical examination. Your doctor will want to understand your symptoms, family history, and any risk factors you might have.

The first step is usually a pelvic exam, where your doctor checks your uterus, ovaries, and other pelvic organs for any abnormalities. They may also perform a Pap test, though this doesn't directly detect endometrial cancer.

If your doctor suspects endometrial cancer, they'll likely recommend additional tests:

• Transvaginal ultrasound to measure the thickness of your endometrial lining
• Endometrial biopsy, where a small sample of tissue is removed for examination
• Hysteroscopy, where a thin, lighted tube is inserted through your vagina to look inside your uterus
• Dilation and curettage (D&C) if the biopsy doesn't provide enough tissue

If cancer is found, additional tests help determine the stage and extent of the disease. These might include CT scans, MRI, chest X-rays, or blood tests to check tumor markers.

The biopsy results will tell your doctor what type of endometrial cancer you have and how aggressive it appears. This information, combined with imaging tests, helps determine the best treatment approach for your specific situation.

What is the treatment for endometrial cancer?

Treatment for endometrial cancer depends on several factors, including the type and stage of cancer, your overall health, and your personal preferences. The good news is that most endometrial cancers are caught early when treatment is most effective.

Surgery is the primary treatment for most endometrial cancers. The most common procedure is a hysterectomy, which removes the uterus and cervix. Your surgeon may also remove the ovaries and fallopian tubes, especially if you're past menopause.

During surgery, your surgeon will also check nearby lymph nodes to see if cancer has spread. This information helps determine if you need additional treatment after surgery.

Additional treatments may include:

• Radiation therapy to kill any remaining cancer cells
• Chemotherapy for more advanced or aggressive cancers
• Hormone therapy for certain types of endometrial cancer
• Targeted therapy drugs that attack specific cancer cell features
• Immunotherapy to help your immune system fight the cancer

Your oncologist will create a treatment plan tailored specifically to your situation. They'll consider factors like your age, overall health, the type and stage of your cancer, and your personal goals and preferences.

Many people with early-stage endometrial cancer need only surgery and are considered cured. Others may need additional treatments, but even advanced endometrial cancer can often be successfully treated or managed as a chronic condition.

How to manage endometrial cancer at home?

Taking care of yourself at home during endometrial cancer treatment is an important part of your overall care plan. Simple strategies can help you feel better and support your body's healing process.

Focus on eating nutritious foods to support your energy and immune system. Choose a variety of fruits, vegetables, whole grains, and lean proteins. If treatment affects your appetite or causes nausea, try eating smaller, more frequent meals.

Stay as active as possible within your comfort level. Light exercise like walking can help maintain your strength, improve your mood, and reduce fatigue. Always check with your medical team before starting any new exercise routine.

Managing side effects is crucial for your comfort and well-being:

• Rest when you need to, but try to maintain some daily activities
• Stay hydrated by drinking plenty of water throughout the day
• Use relaxation techniques like deep breathing or meditation to manage stress
• Keep track of your symptoms and side effects to share with your medical team
• Take medications exactly as prescribed
• Attend all follow-up appointments

Don't hesitate to reach out to your healthcare team if you have concerns or if symptoms worsen. They're there to support you through every step of your treatment and recovery.

Consider joining a support group or connecting with other cancer survivors. Sharing experiences and tips with people who understand what you're going through can be incredibly helpful.

How should you prepare for your doctor appointment?

Preparing for your doctor appointment can help you make the most of your time together and ensure you get the information and care you need. A little preparation can reduce anxiety and help you feel more in control.

Write down all your symptoms, including when they started, how often they occur, and what makes them better or worse. Be specific about bleeding patterns, pain levels, and any other changes you've noticed.

Gather important information to share with your doctor:

• Your complete medical history, including previous surgeries or treatments
• All medications you're currently taking, including supplements
• Family history of cancer, especially endometrial, ovarian, or colorectal cancer
• Your menstrual history, including age at first period and menopause
• Pregnancy history and use of hormones

Prepare a list of questions you want to ask. Don't worry about asking too many questions – your doctor wants to help you understand your situation. Consider bringing a trusted friend or family member to help you remember important information.

If you're seeing a specialist, bring copies of any previous test results, imaging studies, or pathology reports. This helps your new doctor understand your complete medical picture without repeating unnecessary tests.

Write down what you hope to accomplish during the visit, whether it's getting a diagnosis, understanding treatment options, or discussing your concerns about symptoms.

What's the key takeaway about endometrial cancer?

The most important thing to remember about endometrial cancer is that early detection makes a tremendous difference in treatment success. Most endometrial cancers are caught early because they cause noticeable symptoms, particularly unusual bleeding.

Don't ignore persistent symptoms, especially vaginal bleeding after menopause or significant changes in your menstrual pattern. While these symptoms often have benign explanations, they always deserve medical attention.

Endometrial cancer is highly treatable, especially when caught early. The five-year survival rate for early-stage endometrial cancer is excellent, and many people go on to live full, healthy lives after treatment.

Remember that having risk factors doesn't mean you'll develop cancer, and you can take steps to reduce your risk through maintaining a healthy weight, staying active, and working with your doctor to manage other health conditions.

Trust your body and don't hesitate to seek medical care when something doesn't feel right. Your healthcare team is there to support you, answer your questions, and provide the best possible care for your individual situation.