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Overview
What Is Endometrial Cancer?
Endometrial cancer is cancer that begins in the endometrium, the inner lining of the uterus. It is the most common type of uterine cancer and is often found after unusual vaginal bleeding. It most often affects people after menopause, although it can occur before menopause as well. Learning about endometrial cancer can help you recognize symptoms and discuss evaluation with a health care professional.
Symptoms
Symptoms of Endometrial Cancer
- Bleeding after menopause should be medically evaluated, even if it happens only once.
- Periods that become unusually heavy, prolonged, or irregular may be a symptom.
- Bleeding between periods or after sexual activity can require assessment.
- Watery, pink, or blood-tinged vaginal discharge may occur.
- Pelvic pain, pressure, or discomfort can develop.
- Pain during sex may occur.
- Unexplained changes in urination or bowel habits should be discussed with a clinician.
When to act
Do not ignore unusual uterine bleeding
Any bleeding after menopause should be evaluated promptly. These symptoms can have noncancerous causes, but only a clinical assessment can identify the reason.
Causes
Causes of Endometrial Cancer
Endometrial cancer develops when cells in the uterine lining acquire genetic changes that allow them to grow and divide without normal control. The exact initiating cause is often unknown. Over time, abnormal cells can form a tumor and may invade nearby tissues or spread elsewhere.
How estrogen can affect the uterine lining
Risk Factors
Risk Factors for Endometrial Cancer
NONMODIFIABLE FACTORS
Risk can be influenced by increasing age, later menopause, a family history of endometrial or colorectal cancer, inherited Lynch syndrome, and a previous diagnosis of endometrial hyperplasia. These factors cannot usually be changed, but they can help guide conversations about symptoms, genetic counseling, and follow-up.
MANAGEABLE FACTORS
Obesity, diabetes, limited physical activity, estrogen-only hormone therapy, and tamoxifen use can affect risk. Weight and diabetes management, regular activity when appropriate, and individualized discussions about hormone therapy or tamoxifen may help address these risks.
Risk context
Risk factors are not a diagnosis
Having one or more risk factors does not mean that someone will develop endometrial cancer. People with a strong family history or possible inherited risk may benefit from genetic counseling.
Side Effects & Complications
Complications and Treatment Side Effects
Possible complications and treatment effects
| Treatment | Potential effects to discuss with the care team |
|---|---|
| Surgery | Recovery discomfort, changes related to removal of the uterus or ovaries, possible menopause effects, and loss of fertility. |
| Radiation therapy | Bowel or bladder changes, skin irritation, fatigue, vaginal changes, and possible effects on sexual health. |
| Chemotherapy | Fatigue, nausea, hair loss, changes in blood counts, and increased infection risk. |
| Hormone therapy | Hot flashes, mood or sexual-health changes, and other medicine-specific effects. |
| Immunotherapy or targeted therapy | Inflammation affecting organs such as the skin, bowel, liver, lungs, thyroid, or other tissues. |
Diagnosis & Staging
Diagnosis and Staging
- A pelvic examination may help the clinician look for changes in the vagina, cervix, or uterus.
- Transvaginal ultrasound can assess the uterine lining and look for masses or other abnormalities.
- An endometrial biopsy collects cells or tissue from the uterine lining for laboratory examination.
- Hysteroscopy or dilation and curettage may be used when a biopsy is not adequate or more tissue is needed.
- Imaging tests can help assess nearby structures, lymph nodes, or possible distant spread.
- Pathology review identifies the tumor type, grade, and other features that guide treatment.
Tumor type and grade
Treatment Options
Endometrial Cancer Treatment Options
LOCAL AND SYSTEMIC CARE
Surgery is common for operable disease and may include hysterectomy with removal of the fallopian tubes and ovaries. Radiation therapy may be given externally or as brachytherapy. Chemotherapy treats cancer throughout the body and may be used for higher-risk or advanced disease.
PERSONALIZED OPTIONS
Hormone therapy may help selected hormone-sensitive cancers. Immunotherapy or targeted therapy may be appropriate based on biomarkers and previous treatment. Carefully selected fertility-sparing treatment may be considered in some people with early, low-risk disease who wish to preserve fertility.
Hysterectomy with removal of the fallopian tubes and ovaries is common for operable endometrial cancer. Lymph-node assessment and additional treatment depend on the pathology, grade, stage, molecular features, overall health, and fertility goals.
Prevention
Endometrial Cancer Prevention
- Maintaining a healthy weight, when possible, may reduce risk.
- Managing diabetes and other metabolic conditions can support overall health and may reduce risk.
- Discussing abnormal bleeding promptly can help identify precancerous changes or cancer earlier.
- Reviewing the benefits and risks of hormone therapy with a clinician is important, especially when considering estrogen-only therapy.
- People taking tamoxifen should discuss its risks, benefits, and any abnormal bleeding with their clinician.
- Genetic counseling may be appropriate for people with Lynch syndrome or a concerning family history.
Screening
Know the limits of screening
Pap tests do not reliably screen for endometrial cancer. Routine screening is generally not recommended for people at average risk who have no symptoms, so unusual bleeding should be evaluated rather than waiting for a screening test.
Outlook and Prognosis
Outlook and Prognosis
Many endometrial cancers are found at an early stage and can be treated successfully. Prognosis varies substantially according to stage, grade, tumor subtype, molecular findings, overall health, recurrence, and response to treatment. A diagnosis name alone cannot predict whether one person can be cured or how long treatment will take.
Varies
Localized disease: outcomes are generally more favorable when cancer remains in the uterus.
Varies
Regional disease: prognosis depends on nearby tissue or lymph-node involvement and tumor biology.
Varies
Distant disease: outlook depends on the organs involved, molecular features, and treatment response.
Individual
Population statistics cannot predict an individual outcome; ask the oncology team for context.
Survivorship & Follow-up
Survivorship and Follow-Up
Recurrence awareness
Report new or changing symptoms
Tell your care team about new vaginal bleeding, pelvic pain, unexplained weight loss, persistent cough, or other concerning changes instead of waiting for the next routine visit.
