Endometrial Cancer May Be Easier to Catch Than You Think

Do Not Ignore Endometrial Cancer Symptoms

The most common symptom of endometrial cancer is abnormal vaginal bleeding. Depending on your age and stage of life, this may look like:

• Bleeding after menopause
• Bleeding between periods
• Periods that are heavier or last longer than usual
• Spotting or unusual vaginal discharge after menopause

You might also notice:

• Pelvic pain or cramping
• Pain during sex
• Pain when urinating
• Unexplained weight loss

Are You at Risk for Endometrial Cancer?

Researchers do not know exactly what causes endometrial cancer. Some factors may increase your risk by affecting the balance between estrogen and progesterone hormones. Other factors relate to your medical history or genetics.

You may be at higher risk if you:

• Are over age 50, especially after menopause
• Have a family history of endometrial or colorectal cancer, including Lynch syndrome
• Have diabetes
• Have never been pregnant
• Have obesity
• Have polyendocrine metabolic ovarian syndrome (PMOS), previously known as PCOS
• Reached menopause later in life
• Started your period before age 12
• Take estrogen-only hormone replacement therapy after menopause
• Take tamoxifen for breast cancer

These risk factors can raise your odds, but they do not guarantee you will develop endometrial cancer. Some women diagnosed with endometrial cancer have none of these risk factors.

Diagnosing Endometrial Cancer

If you have abnormal bleeding, tell your primary care provider or gynecologist right away. They may review your medical history, order blood tests and perform a pelvic exam to learn more about what is causing your symptoms.

Additional tests may include:

• Transvaginal ultrasound — uses sound waves to create images of the uterus and measure the thickness of the endometrium
• Endometrial biopsy — removes a small sample of tissue from the uterine lining to look for cancer cells
• Hysteroscopy — allows your provider to look inside the uterus using a thin, lighted camera
• Dilation and curettage (D&C) — collects tissue from the uterus when you need additional evaluation

If testing reveals cancer, your provider may use imaging to see whether it has spread and plan treatment.

Endometrial Cancer Treatment Options

Every person’s cancer treatment plan is different. Your care team will look at your stage of cancer, overall health and personal goals to recommend the approach that is right for you.

Surgery

Most women with endometrial cancer have surgery to remove the uterus, called a hysterectomy. During the procedure, your surgeon may also remove the ovaries, fallopian tubes and nearby lymph nodes. Removing the ovaries will trigger menopause if it has not begun already.

"Surgery is often the first step of the treatment plan and is individualized on a patient-to-patient basis. We will create an individualized plan for each patient and explain what to expect throughout each step of the journey,” added Dr. McEachron.

Radiation Therapy

Radiation uses high-energy beams to destroy cancer cells. Your care team may recommend it before or after surgery. Or they may use it if surgery is not an option.

Chemotherapy

Chemotherapy uses medications that travel through the bloodstream to kill cancer cells throughout the body, usually given through a vein. For endometrial cancer, it is most often used after surgery when the tumor is more advanced or aggressive, or if the cancer comes

Hormone Therapy

Some endometrial cancers rely on hormones to grow. Progestin therapy can slow or stop that growth, and it is often the preferred option for women who want to preserve fertility or who cannot safely have surgery.

Targeted Therapy

Targeted therapy medications attack specific proteins that help cancer cells multiply. For endometrial cancer, your provider may test the tumor for genetic changes to see whether a targeted option, often paired with chemotherapy or immunotherapy, makes sense for a recurrent or advanced diagnosis.

Immunotherapy

Immunotherapy helps your immune system recognize and attack cancer cells. Endometrial tumors with a genetic feature called mismatch repair deficiency (dMMR) tend to respond especially well to this approach, so your provider may test for it when weighing your options.

Can You Prevent Endometrial Cancer?

While there is no guaranteed way to prevent endometrial cancer, these healthy lifestyle choices may help lower your risk:

• Ask your provider before starting hormone replacement therapy
• Keep up with routine gynecologic care
• Maintain a healthy weight
• Manage diabetes and other chronic conditions
• Stay physically active

Most importantly, you know your body best. Bleeding that is not typical for you is worth a call to your provider, not a wait-and-see approach.

“It is scary to hear the word ‘cancer,’” said Dr. McEachron. “But we often find endometrial cancer before it spreads because symptoms prompt many women to seek care early. That means we can begin treatment sooner and work toward the best possible outcome.”

Learn more about the Women's Health services at Catholic Health.