The uterus, or womb, lies between the bladder and rectum. The inner layer of the uterus is the endometrium. Endometrial cancer is cancer of this layer.
Untreated endometrial cancer spreads and causes problems in the pelvic area, including bowel and urinary disorders. If the spread continues, swollen glands (lymph nodes), an abdominal (belly) mass, and eventually liver, lung, and bone disease can result.
More than 30,000 new cases cancer are diagnosed each year in the United States.
The cause is unknown. It usually occurs in women between 55 and 70 years old, but can occur in younger women before they go through menopause. Women at increased risk are overweight, have diabetes, have never been pregnant or given birth, or took estrogen for effects of menopause.
Bleeding from the vagina after menopause is the main symptom. For women who haven’t gone through menopause, abnormal vaginal bleeding—heavy bleeding, minimal bleeding, bleeding between menstrual cycles—is the main symptom.
The health care provider will ask about symptoms and do a physical examination, including a pelvic examination. Vaginal ultrasonography may also be done.
To confirm the diagnosis, the doctor may take a biopsy specimen from the uterus by dilation and curettage (D&C). To do this, the cervix is dilated (widened) and a curette (a small spoon-shaped instrument) is inserted into the uterus to remove tissue.
The cancer is then classified into stages. Staging tells whether and how much the cancer spread. Stage I means tumor is only in the uterus; stage II, tumor invaded the cervix; stage III, tumor involved the vagina, ovary, or abdomen; and stage IV, tumor invaded the bladder and intestine. Blood tests, chest x-rays, and computed tomography (CT) of the abdomen and pelvis are studied to look for cancer spread.
Surgery, radiation, hormones, and chemotherapy are used for treatment, which depends on the cancer’s stage. Most endometrial cancers are diagnosed in early stages (I or II), and an operation to remove the uterus, fallopian tubes, and ovaries (hysterectomy and bilateral salpingo-oophorectomy) is usually suggested. Radiation may then be given if needed. Both surgery and radiation have side effects.
Hormones or chemotherapy may be recommended for cancer that has spread or returned after other treatment. Both these treatments also have side effects.
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