Endometrial cancer starts in the endometrium, the lining of the uterus (womb).
The exact cause of endometrial cancer is unknown, but research has shown that an increased level of estrogen may play a role. Estrogen helps stimulate the buildup of the lining of the uterus. This can lead to overgrowth of the endometrium and endometrial cancer.
Most cases of uterine cancer occur between the ages of 60 and 70. A few cases may occur before age 40.
Risk factors for uterine cancer
The following factors related to your hormones increase your risk of endometrial cancer:
- Estrogen replacement therapy without the use of progesterone
- History of endometrial polyps
- Infrequent periods
- Never being pregnant
- Obesity
- Polycystic ovary syndrome (PCOS)
- Starting menstruation at an early age (before age 12)
- Starting menopause after age 50
- Taking Tamoxifen, a drug used for breast cancer treatment
Women with the following conditions also seem to be at a higher risk of endometrial cancer:
Endometrial cancer symptoms
The first signs of uterine cancer may be similar to symptoms of other conditions that affect your reproductive system. For example, abnormal bleeding is a common symptom of different kinds of cancer or of uterine fibroids. Uterine cancer symptoms include:
- Abnormal bleeding from the vagina, including bleeding between periods or spotting or bleeding after menopause
- Extremely long, heavy, or frequent episodes of vaginal bleeding after age 40
- Thin white or clear vaginal discharge after menopause
What does uterine cancer feel like?
Uterine cancer symptoms may feel like pain or cramping low in your abdomen.
Endometrial cancer diagnosis
During the early stages of uterine cancer, your doctor may not find anything unusual during a pelvic exam. As the cancer becomes more advanced, pelvic exams will reveal changes in the size, shape or feel of the uterus or surrounding structures.
Tests that may be done include:
- Endometrial biopsy
- Dilation and curettage (D and C)
- Pap smear (may raise a suspicion for uterine cancer, but does not diagnose it)
Tests like endometrial biopsy are used to gather tissue that can be examined under a microscope to see if it looks like cancer.
If cancer is found, imaging tests may be done to see if the cancer has spread to other parts of the body. This is used for staging – determining how far the cancer has spread.
Stages of endometrial cancer are:
- Stage 1: The cancer is only in the uterus.
- Stage 2: The cancer is in the uterus and cervix.
- Stage 3: The cancer has spread outside of the uterus, but not beyond the pelvis area. Cancer may involve the lymph nodes in the pelvis or near the aorta (the major artery in the abdomen).
- Stage 4: The cancer has spread to the inner surface of the bowel, bladder, abdomen, or other organs.
Cancer is also described as grade 1, 2 or 3. Grade 1 is the least aggressive, and grade 3 is the most aggressive. Aggressive means that the cancer grows and spreads quickly.
Endometrial cancer treatment
If your cancer is an early-stage endometrial cancer, our team of gynecologic oncologists may recommend surgical treatment. Our surgeons are experts in both the traditional, open approach, as well as the robotic, minimally invasive approach using the da Vinci™ Surgical System.
Because of the location of the endometrium, uterine cancer can spread to other organs in the pelvis. If your disease is advanced and metastatic, meaning the cancer has spread, our doctors may recommend chemotherapy and radiation therapy to stop the growth of the cancer. Our doctors will inform you of the latest treatments and advances available, in both chemotherapy and radiation treatments.