Endometrial cancer develops in the endometrium, the lining of the uterus (womb). It is the most common type of uterine cancer and often detected early due to noticeable symptoms like abnormal bleeding.
Causes & risk factors
- Hormonal Imbalance: Excess oestrogen without enough progesterone increases risk (e.g., obesity, hormone therapy without progesterone).
- Other Risks:
- Age (most common in women over 50).
- Obesity, diabetes, or high blood pressure.
- Never having been pregnant.
- Late menopause (after age 55).
- Genetic conditions (e.g., Lynch syndrome).
- Use of tamoxifen (a breast cancer drug).
Symptoms
- Abnormal vaginal bleeding (e.g., postmenopausal bleeding, bleeding between periods, or unusually heavy periods).
- Pelvic pain or pain during intercourse.
- Watery or blood-tinged vaginal discharge.
- Unexplained weight loss.
Prevention
- Maintain a Healthy Weight: Obesity is a major risk factor.
- Manage Chronic Conditions: Control diabetes and hypertension.
- Hormone Balance: If using oestrogen therapy, ensure it is combined with progesterone.
- Stay Active: Regular exercise lowers risk.
- Discuss Risks: If you have a family history of Lynch syndrome or cancer, talk to your gynaecologist about genetic testing.
Screening
- Routine Screening: Unlike cervical cancer, there’s no agreed national standard test for asymptomatic individuals.
- WID-Easy Test: Newer DNA methylation test available in private, is a breakthrough cervico-vaginal swab test to detect endometrial cancer in women with abnormal uterine bleeding.
- High-Risk Patients: Transvaginal ultrasound or endometrial biopsy is recommended.
Diagnosis & Treatment
- Diagnosis:
- Pelvic Exam: To check for abnormalities.
- Transvaginal Ultrasound: Measures endometrial thickness.
- Biopsy: Obtain a tissue sample for testing.
- Treatment Options:
- Surgery: Hysterectomy (removal of the uterus) is common. Lymph nodes may also be removed.
- Radiation/Chemotherapy: Used for advanced cases or recurrence.
- Hormone Therapy: For hormone-sensitive cancers and fertility preservation may be desired
Living with endometrial cancer
- Emotional Support: Counselling or groups like the Macmillan Cancer Support can help.
- Follow-Up Care: Regular check-ups to monitor recovery and detect recurrence.
- Healthy Habits: Balanced nutrition, exercise, and mental health care aid healing.
eGynaecologist Advice
- Report abnormal bleeding immediately to your gynaecologist if you are at high risk of developing endometrial cancer.
- If you have family history of endometrial or bowel cancers or have genetic risks, then you must consult gynaecologist for genetic screening and/or other preventive treatment plans.
- You should discuss fertility sparing treatment with your gynaecologist if you desire to achieve pregnancy.
- Regular follow up checks after treatment with your gynaecologist are important to monitor your health and prevent complications of recurrence of cancer.
Frequently Asked Questions
Is endometrial cancer linked to HPV?
No – unlike cervical cancer, HPV is not a cause.
Can a Smear test detect it?
Rarely. Smear test screens for cervical, not endometrial, cancer. However, you may choose to have WID-Easy cervico-vaginal swab to detect endometrial cancers.
Is it hereditary?
5–10% of cases link to genetic syndromes like Lynch syndrome. You should discuss your family history with your gynaecologist.
What’s the survival rate?
Early-stage diagnosis has a 95% 5-year survival rate.
Can it recur?
Yes, follow-up care is critical.
