Endometrial Cancer

Endometrial cancer

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Endometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb).

Causes

Endometrial cancer is the most common type of uterine cancer. The exact cause of endometrial cancer is unknown. 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 cancer.

Most cases of endometrial cancer occur between the ages of 60 and 70. A few cases may occur before age 40.

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

Tamoxifen, a drug used for breast cancer treatment

Women with the following conditions also seem to be at a higher risk of endometrial cancer:

Colon or breast cancer

Diabetes

Gallbladder disease

High blood pressure

Symptoms

Symptoms of endometrial cancer include:

Abnormal bleeding from the vagina, including bleeding between periods or spotting/bleeding after menopause

Extremely long, heavy, or frequent episodes of vaginal bleeding after age 40

Lower abdominal pain or pelvic cramping

Thin white or clear vaginal discharge after menopause

Exams and Tests

During the early stages of disease, a pelvic exam is often normal. As the cancer becomes more advanced, there may be 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 endometrial cancer, but does not diagnose it)

If cancer is found, imaging tests may be done to see if the cancer has spread to other parts of the body. This is called staging.

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 true 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.

Treatment

Treatment options include surgery, radiation therapy, and chemotherapy.

Surgery to remove the uterus (hysterectomy) may be done in women with early stage 1 cancer. The doctor may also recommend removing the tubes and ovaries.

Surgery combined with radiation therapy is another treatment option. It is often used for women with

Stage 1 disease that has a high chance of returning, has spread to the lymph nodes, or is a grade 2 or 3.

Stage 2 disease.

Chemotherapy or hormonal therapy may be considered in some cases, most often for those with stage 3 and 4 disease.