Endometrial cancer is cancer that 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 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
- 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
- Gallbladder disease
- High blood pressure
Endometrial Cancer 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
Endometrial Cancer Diagnosis
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.
Endometrial Cancer Treatment
If your cancer is an early stage endometrial cancer, our team of gynecologic oncologists will 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, this 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 treatments 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.