Learn about the symptoms and causes of this cancer of the uterus. Treatments include hysterectomy, radiation therapy, and chemotherapy and other medicines.
Endometrial cancer is a type of cancer that begins as a growth of cells in the uterus. The uterus is the hollow, pear-shaped pelvic organ where fetal development happens.
Endometrial cancer begins in the layer of cells that form the lining of the uterus, called the endometrium. Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer.
Endometrial cancer is often found at an early stage because it causes symptoms. Often the first symptom is irregular vaginal bleeding. If endometrial cancer is found early, surgically removing the uterus often cures it.
Symptoms of endometrial cancer may include:
Make an appointment with a health care professional if you experience any symptoms that worry you.
The cause of endometrial cancer isn't known. What's known is that something happens to cells in the lining of the uterus that changes them into cancer cells.
Endometrial cancer starts when cells in the lining of the uterus, called the endometrium, get changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. The changes tell the cells to multiply quickly. The changes also tell the cells to continue living when healthy cells would die as part of their natural life cycle. This causes a lot of extra cells. The cells might form a mass called a tumor. The cells can invade and destroy healthy body tissue. In time, the cells can break away and spread to other parts of the body.
Factors that increase the risk of endometrial cancer include:
Changes in the balance of hormones in the body. The two main hormones the ovaries make are estrogen and progesterone. Changes in the balance of these hormones cause changes in the endometrium.
A disease or condition that increases the amount of estrogen, but not the level of progesterone, in the body can increase the risk of endometrial cancer. Examples include obesity, diabetes and irregular ovulation patterns, which might happen in polycystic ovary syndrome. Taking hormone therapy medicine that contains estrogen but not progestin after menopause increases the risk of endometrial cancer.
A rare type of ovarian tumor that gives off estrogen also can increase the risk of endometrial cancer.
The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.
To reduce your risk of endometrial cancer, you may wish to:
Tests and procedures used to diagnose endometrial cancer include:
Examining the pelvis. A pelvic exam checks the reproductive organs. It's often done during a regular checkup, but it might be needed if you have symptoms of endometrial cancer.
During the exam, a health care professional carefully inspects the outer genitals. Two fingers of one hand are inserted into the vagina and the other hand presses on the abdomen to feel the uterus and ovaries. A device called a speculum is inserted into the vagina. The device opens the vaginal canal so the health professional can look for signs of cancer or other problems.
If endometrial cancer is found, you'll likely be referred to a doctor who specializes in treating cancers involving the reproductive system, called a gynecologic oncologist.
Once your cancer has been diagnosed, your health care team works to determine the extent of your cancer, called the stage. Tests used to determine your cancer's stage may include a chest X-ray, a CT scan, blood tests and positron emission tomography, also called a PET scan. Your cancer's stage may not be known until after you have surgery to treat your cancer.
Your health care team uses information from these tests and procedures to assign your cancer a stage. The stages of endometrial cancer are indicated using numbers ranging from 1 to 4. The lowest stage means that the cancer hasn't grown beyond the uterus. By stage 4, the cancer has grown to involve nearby organs, such as the bladder, or has spread to distant areas of the body.
During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs.
Endometrial cancer is usually first treated with surgery to remove the cancer. This may include removing the uterus, fallopian tubes and ovaries. Other treatment options may include radiation therapy or treatments using medicines to kill the cancer cells. Options for treating your endometrial cancer will depend on the characteristics of your cancer, such as the stage, your general health and your preferences.
Treatment for endometrial cancer usually involves an operation to remove the uterus, called a hysterectomy. Treatment also usually includes the removal of the fallopian tubes and ovaries, called a salpingo-oophorectomy. A hysterectomy makes it impossible for you to become pregnant in the future. Also, once your ovaries are removed, you'll experience menopause if you haven't already.
During surgery, your surgeon also will inspect the areas around your uterus to look for signs that cancer has spread. Your surgeon also may remove lymph nodes for testing. This helps determine your cancer's stage.
Radiation therapy uses powerful energy to kill cancer cells. The energy can come from X-rays, protons or other sources. In certain situations, radiation therapy may be recommended before surgery. Radiation therapy can shrink a tumor and make it easier to remove.
If you aren't healthy enough to undergo surgery, you may opt for radiation therapy only.
Radiation therapy can involve:
Chemotherapy uses strong medicines to kill cancer cells. Some people receive one chemotherapy medicine. Others receive two or more medicines together. Most chemotherapy medicines are given through a vein, but some are taken in pill form. These medicines enter the bloodstream and then travel through the body, killing cancer cells.
Chemotherapy is sometimes used after surgery to lower the risk that the cancer might return. Chemotherapy also can be used before surgery to shrink the cancer. This makes it more likely that the cancer is removed completely during surgery.
Chemotherapy may be recommended for treating advanced endometrial cancer that has spread beyond the uterus or to treat cancer that has come back.
Hormone therapy involves taking medicines to lower the hormone levels in the body. In response, cancer cells that rely on hormones to help them grow might die. Hormone therapy may be an option if you have advanced endometrial cancer that has spread beyond the uterus.
Targeted therapy uses medicines that attack specific chemicals in cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy for treating advanced endometrial cancer.
Immunotherapy uses medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. For endometrial cancer, immunotherapy might be considered if the cancer is advanced and other treatments haven't helped.
Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. Palliative care is done by a team of health care professionals. This can include doctors, nurses and other specially trained professionals. Their goal is to improve the quality of life for you and your family.
Palliative care specialists work with you, your family and your care team to help you feel better. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time as strong cancer treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
After you receive a diagnosis of endometrial cancer, you may have many questions, fears and concerns. Every person eventually finds a way to cope with an endometrial cancer diagnosis. In time, you'll find what works for you. Until then, you might try to:
Make an appointment with a member of your care team or a gynecologist if you have symptoms that worry you. If you're diagnosed with endometrial cancer, you're likely to be referred to a doctor who specializes in cancers of the reproductive system, called a gynecologic oncologist.
Because appointments can be brief and there's often a lot to discuss, it's a good idea to be prepared. Here's some information to help you get ready, and what you can expect from your health care team.
Your time with your health care professional is limited, so preparing a list of questions ahead of time can help you make the most of your time together. List your questions from most important to least important in case time runs out. For endometrial cancer, some basic questions to ask include:
In addition to the questions that you've prepared, don't hesitate to ask additional questions during your appointment.
Be prepared to answer some questions about your symptoms. Questions may include: