Endometrial cancer
The womb is a pear-shaped female organ in your pelvis where a baby grows during pregnancy. It’s mostly muscular, and its lining is called the endometrium.
Endometrial cancer begins in the lining of the womb and can then spread to the body of the womb and is sometimes referred to as uterine cancer. When discovered early enough, removal of the womb can cure the cancer.
It’s the 4th most common cancer in women in the US with over 65,000 women developing it each year. Most cases occur over the age of 50 with the peak incidence being between the ages of 75 and 80. Most women get symptoms and therefore present at an early stage, giving a good chance that any treatment will succeed. The chances of survival are fairly good, and – taking into account all the different levels of endometrial cancer - more than 81% survive 5 years or more.
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What symptoms does endometrial cancer cause?
For those women who have gone through menopause, any vaginal bleeding, even once, should be checked by your doctor, as this is the most common symptom of endometrial cancer.
If you haven’t gone through menopause, you should see your doctor if you get bleeding between periods. Endometrial cancer can also cause heavy vaginal periods, different to your normal periods or a change to your vaginal discharge, but there are many more common reasons for this (fibroids, endometriosis, polyps), so book an appointment and don’t panic.
If endometrial cancer has spread to involve or impact other organs, you may experience pain during sex, blood in your urine, pain in your lower back or pelvis, or even a lump in your abdomen or pelvis.
When should I see my doctor?
You should book an urgent appointment for any vaginal bleeding after menopause.
Your doctor will ask about your symptoms, any risk factors and any relevant family history. With your permission, they will examine your vagina. They will use a speculum (a small plastic device) to look inside your vagina to the cervix, or neck of the womb, and they may take some swabs. They can also feel for any lumps, bumps or painful points, by using a gloved finger to examine inside the vagina.
Depending on the findings, your doctor may refer you for an ultrasound of your pelvis (transvaginal ultrasound) and blood tests. If they have any concerns about the possibility of cancer, they will refer you urgently to a specialist.
What causes endometrial cancer?
High levels of estrogen can increase your chance of endometrial cancer.
Risk is increased in any woman with a womb that has never given birth or those who have gone through menopause after the age of 55, people with polycystic ovary syndrome, people who are overweight and people who take certain medications like hormone replacement therapy (HRT).
You are also at higher risk if a family member has had endometrial cancer, or cancer of the bowel or ovary, if you have a genetic condition that causes Lynch syndrome, if you take tamoxifen, an oral medication used to treat breast cancer, or if you have had radiotherapy to your pelvic area for any reason.
What’s the treatment for endometrial cancer?
A hysterectomy - surgery to remove the womb – is the mainstay of treatment. Depending on the type and stage of cancer, and any spread, chemotherapy and radiotherapy might be considered alongside a hysterectomy. Depending on your general health or your own preference, if surgery is not the best option, you may be offered one or both of these alone.
A hysterectomy may have been carried out previously for a number of reasons, including fibroids or endometriosis. If you have had your womb completely removed, you will not be at risk of endometrial cancer.
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