Endometrial Cancer

Overview

Endometrial cancer begins in the cells that form the lining of the uterus, known as the endometrium. The uterus is the female reproductive organ where fetal development occurs and is also known as the “womb.” Another term for endometrial cancer is uterine cancer.

Endometrial cancer causes

Endometrial cancer occurs when the endometrium cells develop mutations (changes) to their DNA, and then the abnormal cells multiply out of control.

Endometrial cancer risk factors

Factors that can increase your risk for developing endometrial cancer include:

• Being obese
• Being older
• Changes in the balance of female hormones – estrogen and progesterone – in the body
• Going through menopause at a later age
• Having diabetes
• Having Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC)
• Having polycystic ovarian syndrome (PCOS)
• Having taken the hormone drug tamoxifen for breast cancer
• Never having been pregnant
• Starting your menstrual period before age 12

Endometrial cancer symptoms

Signs and symptoms of endometrial cancer can include:

• Bleeding between menstrual periods
• Pelvic pain
• Vaginal bleeding after menopause

Endometrial cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors. During this time, your doctor will also perform a pelvic exam to check for irregularities.
• Biopsy – in this test, your doctor removes a biopsy (small sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancer.
• Hysteroscopy – during this test, your doctor inserts a thin, flexible tube with a light on the end (hysteroscope) through your vagina and cervix and into your uterus. The hysteroscope has a lens that allows your doctor to see inside your uterus and examine for any irregularities.
• Ultrasound – this type of imaging test uses sound waves to create detailed images of the inside of your body. Your doctor then uses these images to look for any signs of cancer. Your ultrasound will most likely be transvaginal, meaning that the ultrasound technician will insert a special wand into your vagina and through your cervix to capture images of your uterus.

Endometrial cancer treatments

Depending on your personal health history, the extent of the cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery – you may need to undergo surgery to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible.
• Chemotherapy – you may need to also undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Hormone therapy – in this treatment, you take medications to lower certain hormone levels in the body that could be helping the cancer spread. This treatment may be used if your endometrial cancer is advanced and has spread beyond your uterus.
• Immunotherapy – this treatment works with your body’s immune system to fight the cancer.
• Radiation therapy – during this treatment, powerful energy beams – such as X-ray or protons – destroy cancer cells. Depending on what your doctor determines is best for you and your situation, the radiation therapy may be delivered outside or inside the body.
• Targeted therapy – this treatment involves taking medications that target specific weaknesses of the cancerous cells, working to destroy them.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. Your doctor may suggest seeing an oncologist for more specialized treatment.