Endometrial Cancer Treatment — Expert Gynecologic Oncologists
Written & medically reviewed by Dr. Shaivalini Kamarapu
MBBS · MS (Obstetrics & Gynaecology) · Fellowship in Reproductive Medicine · 20+ years of clinical experience
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What is endometrial cancer?
Endometrial cancer starts in the layer of cells that form the lining of the womb, called the endometrium — it is a cancer of the womb, or uterus. Most uterine cancers start as endometrial cancer. Another type, uterine sarcoma, starts in the muscles and tissues of the uterus, and usually has a different treatment approach.
Early symptoms include unusual bleeding, such as after menopause or between periods. Endometrial cancer can also cause pain in the pelvic area, less commonly during sexual intercourse, or pain when urinating or difficulty emptying the bladder.
Symptoms of endometrial cancer
Unusual bleeding, including after menopause or between periods
Pain in the pelvic area
Pain during sexual intercourse
Pain when urinating or difficulty emptying the bladder
A feeling of a mass or heaviness in the pelvic area
Unintended weight loss
Fatigue
Nausea
Pain in the legs, back, or pelvic area
These symptoms can also stem from other, noncancerous health problems, such as fibroids, endometriosis, endometrial hyperplasia, and polyps in the uterine lining. It's important to rule out endometrial cancer if another condition is causing similar symptoms.
Risk factors
Exposure to high levels of estrogen
Never having been pregnant
Starting menstruation before 12 years of age
Experiencing menopause after 55 years of age, or being over 50 and post-menopausal
Using estrogen-only hormone therapy after menopause, without progesterone
Taking tamoxifen, used to prevent or treat breast cancer
Having had previous radiation therapy to the pelvis
A family history of uterine, bowel, breast or ovarian cancer, or Lynch syndrome (HNPCC)
Having polycystic ovary syndrome (PCOS)
Diabetes, obesity, hypertension, or other aspects of metabolic syndrome
Endometrial hyperplasia — the endometrium growing too thick
A tumour in one of the ovaries
Endometrial cancer is rising in incidence, most likely due to the rising incidence of obesity.
Diagnosis
Medical history
The doctor will ask questions about your health history and your family's health history.
Physical examination
A general physical examination to assess overall health and any relevant signs.
Blood test
Blood work to help evaluate your general health and rule out other conditions.
Speculum examination
An examination of the vagina and cervix using a speculum, similar to a cervical screening test.
Transvaginal ultrasound
A small wand (transducer) is placed in the vagina to take images of the cervix, uterus, endometrium and ovaries.
Endometrial biopsy
A sample of the endometrium is tested, often taken without anaesthetic in a day clinic using a thin tube (pipelle) that gently collects a small sample of cells through the vagina.
Treatment
The kind of treatment recommended will depend on:
- The size of the cancer and where it is in the body (the stage of cancer)
- How quickly it is growing (the grade of cancer)
- Where in the endometrium it started (the type of cancer)
- Age, health and medical history
Treatment options
Surgery
Radiotherapy
Chemotherapy
Hormonal therapy
After treatment
Eating well and being active after treatment for endometrial cancer is important for recovery. It improves overall health and wellbeing, and reduces the risk of developing conditions such as heart disease and diabetes. Keeping a healthy weight, eating well and leading an active lifestyle may even lower the risk of other cancers developing in the future.