Endometrial cancer, also known as uterine cancer, develops in the lining the uterus (endometrium), where unregulated growth of those cells causes cancerous tumors. Postmenopausal women, usually around age 60, are more likely to develop the condition, which is uncommon in women under age 45.
While other types of cancer may form in the uterus, endometrial cancer is the most common. According to the National Cancer Institute, it accounts for around 6 percent of all cancers in women in the United States.
A uterine biopsy is required to verify the diagnosis of this cancer. Because it can cause abnormal vaginal bleeding, the cancer is often identified at an early stage before it has spread outside the uterus.
Endometrial cancer has a high survival rate if detected quickly. The American Society of Clinical Oncology reports that the five- and 10-year survival rates for women with uterine cancer are 82 and 79 percent respectively.
As with most cancers, the cause of this and other uterine cancers is unknown. However, several factors may contribute to a woman’s risk for developing the disease, including the following.
Symptoms often involve unusual vaginal bleeding, spotting and discharge. This includes bleeding between periods, bleeding after menopause and discharge without any blood. While abnormal bleeding may be the sign of other noncancerous conditions, it should be reported to a doctor immediately.
Symptoms that are more common in the later stages of the disease include pelvic pain, unexplained weight loss, painful sex and the feeling of a mass (tumor) in the pelvic area.
If endometrial cancer is suspected, a doctor will perform a transvaginal ultrasound (an ultrasound performed internally through the vagina) or hysteroscopy (a thin, lighted tube with camera inserted through the vagina) to view the pelvic region. A biopsy will then be performed on tissue from the endometrium to confirm whether cancer cells are present.
Treatments for endometrial cancer will differ for each woman depending on the stage of the cancer, the patient’s general health, whether future fertility is being considered and other variables. Treatment options include the following.
The most common way to treat endometrial cancer is to perform a total hysterectomy by removing a woman’s uterus and cervix. This may be paired with a bilateral salpingo-oophorectomy, which removes the ovaries and fallopian tubes. A total hysterectomy will make it impossible for a woman to have children in the future, so if fertility is a concern the patient should consult with a fertility preservation doctor before undergoing this procedure.
Some patients may still need to be given radiation therapy or hormone treatment after surgery to kill any further cancer cells.
In hormone therapy, medications are used to alter hormone levels in a woman’s body. This is a more common treatment for advanced endometrial cancer.
The primary hormone therapy drug for endometrial cancer is progesterone (or comparable drugs called progestins), which slows the growth of endometrial cancer cells. Other drugs, including tamoxifen, LHRH agonists and aromatase inhibitors, suppress the production of estrogen in a woman’s body to prevent the estrogen from stimulating cancer cell growth.
Chemotherapy involves the use of chemicals by pill (orally) or through the veins (intravenously) to kill cancer cells. The stage of the cancer determines the regimen for this treatment and patients may receive more than one drug at a time.
Radiation therapy uses X-rays and other radiation to halt cancer cell growth. External radiation is performed using a machine outside the body. Internal radiation involves the placement of radiation-filled devices, such as wires or cylinders, inside the vagina for a short time.
Patients should discuss treatment side effects with their oncologist. Some risks may include: