What is endometrial cancer?

Endometrial cancer is a growth of abnormal cells that form tumors in the lining of the uterus. It is the most common type of cancer in the uterus. The uterus (womb) is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus.

The sooner cancer is found and treated, the better your chances for recovery. However, even advanced cancer can usually be treated. Treatment may slow or stop the growth of the cancer and ease symptoms for a time. Ask your healthcare provider what you can expect with the type of cancer that you have.

What is the cause?

Uterine cancer is one of the most common cancers among women. The cause of cancer of the uterus is not known. However, you are at greater risk of having this type of cancer if there is extra estrogen in your body. Your risk is also greater if your body is exposed to estrogen for too long a time.

You may be exposed to more estrogen if you:

• Have never been pregnant
• Started having periods at a very young age or you stopped having periods later than most women
• Are overweight
• Have a hormone imbalance that can lead to problems with the ovaries
• Have a certain type of ovarian tumor
• Have a history of polycystic ovary syndrome
• Use estrogen for hormone replacement therapy without progesterone

Some of the other things that may increase the risk of endometrial cancer are:

• Age over 50
• Tamoxifen treatment for breast cancer (very slight risk)
• A history of breast, ovarian, or colon cancer
• A history of diabetes, hypertension, gallbladder disease, or thyroid disease

What are the symptoms?

Symptoms may include:

• Abnormal vaginal bleeding
• Difficult or painful urination
• Pain during sex
• Pain in the pelvic area

In most cases of endometrial cancer, abnormal bleeding is the first symptom. Many women ignore this bleeding or blame it on menopause. If you have unusual bleeding or any of the other symptoms listed above, contact your healthcare provider.

How is it diagnosed?

Endometrial cancer begins inside the uterus rather than in the opening of the uterus (the cervix). For this reason, it is not usually found with a Pap test, which checks for cancer in the cervix. One of the following procedures may be used to get a sample of tissue:

• Endometrial biopsy: Your healthcare provider removes a small sample of the endometrium with a tiny straw-like tube put through your vagina and into the uterus through the cervix.
• D&C (dilation and curettage): The cervix is widened and a sharp tool is used to scrape the walls of the uterus. The tissue scrapings are checked for cancer cells.

If you have cancer, you may have other tests to see if the cancer has spread to other parts of your body. Tests you may have include:

• Blood tests
• Urine test
• CT scan, which uses X-rays and a computer to show detailed pictures of the uterus
• X-rays

How is it treated?

The treatment depends on the type of cancer cells and if the cancer has spread. If the cancer is diagnosed early, the uterus is usually removed. The ovaries, fallopian tubes (tubes from the ovaries to the uterus), part of the vagina, and some lymph nodes may also be removed. You and your healthcare provider will discuss possible treatments. You may also talk with a surgeon and a cancer specialist. Some things to think about when making treatment decisions are:

• Your age
• Your overall health
• The stage of the cancer (how advanced the cancer is)
• Whether the cancer has spread to other parts of your body

Other treatments are:

• Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells
• Radiation therapy, which uses high-energy X-rays to kill cancer cells
• Hormone therapy, which uses medicine to stop hormones in your body from helping tumors grow

Your treatment will also include:

• Preventing infections
• Controlling pain or other symptoms you may have
• Controlling the side effects from treatments
• Helping you manage your life with cancer
• If your uterus is removed, you will no longer be able to get pregnant. If the cancer is at a very early stage and you still want to get pregnant, it may be possible to treat the cancer with the hormone progesterone instead of with removal of the uterus.

Often, more than 1 type of treatment is used. With early treatment, there is a good chance of cure. After treatment, you will need to have regular follow-up visits with your healthcare provider. Talk to your provider about what hormones you should take.

Ask your healthcare provider about clinical trials that might be available to you. Clinical trials are research studies to find effective cancer treatments. It’s always your choice whether you take part in one or not.

How can I take care of myself?

If you have been diagnosed with cancer of the uterus:

• Talk about your cancer and treatment options with your healthcare provider. Make sure you understand your choices.
• Follow the full course of treatment prescribed by your healthcare provider.
• Report abnormal vaginal bleeding right away to your healthcare provider.
• Have an annual pelvic exam.
• If you have diabetes, keep it under control.
• Ask your healthcare provider:
  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

Other things that may help include:

• Eat a healthy diet and get regular exercise as recommended by your healthcare provider. Keep a healthy weight.
• Get plenty of rest.
• Try to reduce stress and take time for activities that you enjoy. It may help to talk with a counselor about your illness.
• Talk with your family and your healthcare providers about your concerns. Ask your healthcare provider any questions you have about the disease, treatments, side effects of the treatments, sexuality, support groups, and anything else that concerns you.
• If you smoke, try to quit.
• Ask your provider if you need to avoid drinking alcohol. It may interfere with medicines you are taking. Alcohol can also make it harder for white blood cells to fight infections.
• Tell your provider if your treatment causes discomfort. Usually there are ways to help you be more comfortable.

How can I help prevent the cancer from spreading or coming back?

• Complete the full course of surgery, radiation, or chemotherapy treatments ordered by your healthcare provider.
• See your healthcare provider right away if you notice a return of any previous symptoms, or you develop new symptoms.

For more information, contact:

• American Cancer Society, Inc.
  800-227-2345
  http://www.cancer.org
• National Cancer Institute
  800-422-6237 (TTY: 800-332-8615)
  http://www.cancer.gov