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Conditions

Gynecology · Cancer care

Endometrial cancer

Understand which bleeding needs assessment, how endometrial cancer is diagnosed and which care options may be discussed.

Editorial publication · Medical review pending.

Understand

Endometrial cancer develops in the lining inside the womb. It is the most common cancer of the body of the womb. It differs from uterine sarcomas and from endometrial hyperplasia without cancer.

Possible symptoms

The most common sign is unusual vaginal bleeding: after menopause, between periods or as heavier periods. Unusual discharge, pelvic pain or a mass, pain during sex, or bladder or bowel changes may also occur.

Causes and associated factors

There is no single cause. Risk increases with factors including age, prolonged oestrogen exposure without opposition, excess weight, diabetes, Lynch syndrome, some family histories, tamoxifen or previous pelvic radiotherapy. Having a risk factor does not mean cancer will occur.

Diagnosis

A transvaginal ultrasound can examine the womb lining, but it cannot confirm cancer on its own. Hysteroscopy may view the womb cavity. Examination of an endometrial tissue sample confirms the diagnosis; cervical screening does not replace this sample.

Tests

After diagnosis, the team may offer an examination, MRI, CT or other imaging to assess spread. Tumour analysis may establish type, grade, molecular or hormone features and sometimes lead to genetic counselling. Not everyone needs every test.

Course of the condition

Stage, grade, type and certain molecular features describe the cancer and guide care. Many cases are noticed because of early bleeding, but the course varies. Recurrence remains possible and calls for individual follow-up.

Care options

Surgery to remove the womb, often with the fallopian tubes and ovaries, is frequently offered when appropriate. Depending on the assessment, radiotherapy, chemotherapy, hormone therapy, targeted treatment or immunotherapy may be discussed. Pregnancy plans, menopause, sexual health and long-term effects should be addressed before care.

When to consult

Any bleeding after menopause needs assessment, even if it happens once or is only a small amount. Also seek advice for bleeding between periods, newly unusual heavy periods, persistent discharge or unexplained pelvic pain.

Urgent help

Seek immediate medical help for heavy bleeding, severe or worsening pelvic or abdominal pain, faintness, difficulty breathing or loss of consciousness. Fever with persistent vomiting or inability to keep fluids down also needs prompt assessment.

Questions for your doctor

  • What do the type, grade, stage and molecular results show?
  • What is the aim of the proposed treatment, and which alternatives fit my situation?
  • Which organs would surgery remove, and what would that mean for me?
  • Can we discuss fertility, menopause and sexual health before care starts?
  • What follow-up is planned, and which symptoms should I report?

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A procedure linked to a condition does not establish an indication for your individual situation.

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