What Are the Warning Signs for Endometrial Cancer?by Rachel Zohn Health Writer
Endometrial cancer is the most common type of cancer that affects female reproductive organs, with an estimated 61,300 new cases diagnosed annually. About 10,900 women will die from these cancers during that same time. However, there are no standard screening tests to catch this disease and some women may not be aware of the symptoms and the warning signs to prompt them to seek medical care that can save their life.
Who is at risk for endometrial cancer?
Most endometrial cancers occur in women between 45 and 74 years old, but women of any age can be at risk. Fluctuations in hormone levels can cause changes within the endometrium, or the lining of a woman’s uterus. The levels of estrogen and progesterone in a woman’s body can affect her chances of getting endometrial cancer. Some women with a family history of endometrial cancer may be at increased risk.
Symptoms of endometrial cancer
Endometrial cancer begins as malignant cells that form in the uterus’ lining. The most common warning signs are abnormal vaginal bleeding or discharge. If you’re postmenopausal, any bleeding or spotting is abnormal, so if you suddenly find you need a panty liner, tell your doctor. In younger women, symptoms may include irregular or heavy periods that last longer than you’re used to, bleeding between periods, or unusual discharge.
Other red flags to be aware of
Some women have constant pelvic discomfort or may feel full quickly during meals. Others have pain during sex or when they use the bathroom. Some have abnormal discharge that doesn’t appear to have blood in it, but may be foul smelling. Other symptoms include feeling pressure on the bladder or bowels, which may result in the urge to use the bathroom more frequently, or finding blood in urine or stools.
Because many women have symptoms that prompt them to see a doctor, endometrial cancer is often caught early on, when it’s highly treatable. However, there is no simple or easy screening tests to detect endometrial cancer for women with no symptoms. Pap tests are for cervical cancer and don’t specifically check for endometrial cancer, and pelvic exams primarily look for cervical cancer.
Diagnostic tools can be helpful
If you’re at high risk or suspect you may have endometrial cancer, doctors can use several diagnostic tools to see if you have signs of the disease. Dilation and curettage (D&C) is a procedure that removes tissue samples from the uterus and may be used with a hysteroscopy to allow a doctor to see inside the uterus during the procedure. A transvaginal ultrasound, CT scan, or MRI are other tools that give doctors different types of images inside the uterus and of the endometrium.
Staging for endometrial cancer
Stage 1 endometrial cancer is contained within the uterus. At stage 2, the cancer has started growing into the connective tissues of the cervix. By stage 3, the cancer has spread outside the uterus, into the ovaries or fallopian tubes and may be in nearby tissues or lymph nodes in the pelvic area. In stage 4, the cancer has spread to the bladder, rectum, or other areas of the abdomen and possibly to distant organs, bones, or lymph nodes.
Signs that endometrial tumors are growing
As a uterine tumor grows in size, it can cause a variety of problems such as increasing pelvic, back, or abdominal pain, bloating, nausea, vomiting, or blood in urine, bowl, or stool. Symptoms that persist or worsen for longer than a few weeks should be evaluated. Feeling a mass in your abdomen or losing weight without trying can also be later stage symptoms.
Risk factors for endometrial cancer
Factors that may increase the risk of endometrial cancer include:
- Being overweight
- Having diabetes
- Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone)
- Never giving birth
- Having polycystic ovarian syndrome
- Beginning menstruation at an early age or reaching menopause at an older age
- Family history (having close relatives who have been diagnosed with endometrial or colorectal cancers)
A hereditary risk for some
About 3-5 percent of endometrial cancers can be attributed to a hereditary condition known as Lynch syndrome. This condition is passed generationally within a family and puts family members with certain gene mutations at risk for a number of different cancers, including endometrial and colorectal cancers.
Determining the best treatment
Surgery is the most common treatment for endometrial cancer. Radiation is sometimes used before surgery to shrink cancer tumors and occasionally used in early stages instead of surgery. Surgery usually consists of removing the uterus and ovaries. A surgeon may also remove lymph nodes from the areas where the cancer is most likely to have spread outside the uterus. In some cases, hormone therapy may be an alternative to surgery, especially for women who aren’t yet done having children.