Conditions A-Z - Endometrial Cancer

Illustration of the anatomy of the female pelvic area
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What is endometrial cancer?

The lining of the uterus is called the endometrium. Cancer of the endometrium, the most common cancer of the female reproductive organs, is a disease in which malignant (cancerous) cells are found in the endometrium. Endometrioid cancer is a specific type of endometrial cancer.

Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcoma of the uterus. Nearly all endometrial cancers are adenocarcinomas (80 percent).

What are risk factors for endometrial cancer?

The following have been suggested as risk factors for endometrial cancer:

  • starting monthly periods early - before the age of 12
  • late menopause
  • infertility
  • never having children
  • obesity - 30 or more pounds overweight
  • being treated with tamoxifen for breast cancer
  • estrogen replacement therapy (ERT) for treatment of effects of menopause
  • diet high in animal fat
  • diabetes
  • age 55 or over
  • Caucasian women
  • high-socioeconomic status
  • family history
  • history of breast cancer
  • history of ovarian cancer
  • prior radiation therapy for pelvic cancer
  • personal history of polycystic ovary syndrome (PCOS) or atypical endometrial hyperplasia

What are the symptoms of endometrial cancer?

Consult a physician if you experience any/all of the following symptoms:

  • bleeding or discharge not related to your periods (menstruation)
  • post-menopausal bleeding
  • difficult or painful urination
  • pain during intercourse
  • pain and/or mass in the pelvic area
  • weight loss

How can endometrial cancer be prevented?

The exact cause of endometrial cancer is not known, and there is no medical cure for it at this time. However, physicians believe that avoiding the known risk factors, when possible, using oral contraceptives, controlling obesity, and controlling diabetes are the best ways to lower the risk of developing endometrial cancer.

How is endometrial cancer diagnosed?

Diagnosis includes a medical history and physical exam, including a pelvic exam to feel the vagina, rectum, and lower abdomen for masses or growths. A Pap test may be requested as part of the pelvic exam. Several additional tests may be used to diagnose endometrial cancer, including:

  • internal pelvic examination to feel for any lumps or changes in the shape of the uterus
  • Pap test (however, because cancer of the endometrium begins inside the uterus, problems may not show up on a Pap test.)
  • dilation and curettage (D and C), and/or endometrial biopsy, or similar test, to remove pieces of the lining of the uterus
  • transvaginal ultrasound (also called ultrasonography) - an ultrasound test using a small instrument, called a transducer, that is placed in the vagina

Treatment for endometrial cancer:

Specific treatment for endometrial cancer will be determined by your physician(s) based on:

  • your overall health and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The choice of treatment depends on the stage of cancer - whether it is just in the endometrium, or has spread to other parts of the uterus or other parts of the body. Generally, treatment for patients with cancer of the endometrium includes one or more of the following:

  • surgery, including:
    • hysterectomy - surgical removal of the uterus
    • salpingo-oophorectomy - surgery to remove the fallopian tubes and ovaries
    • pelvic lymph node dissection - removal of some lymph nodes from the pelvis
    • laparoscopic lymph node sampling - lymph nodes are removed through a viewing tube called a laparoscope, which is inserted through a small incision in the abdomen
  • radiation therapy
  • chemotherapy
  • hormone therapy

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