Endometrial cancer

Endometrial cancer symptoms

The most common symptom is abnormal vaginal bleeding, either after the menopause or between periods. Occasionally, women complain of blood-stained vaginal discharge, lower abdominal pain or pain during sex.

In more advanced stages of the disease, tiredness, nausea, loss of appetite, weight loss, constipation or pain in the back may occur.

Endometrial cancer causes

The exact cause of endometrial cancer isn't known. However, certain factors may increase a woman's risk, in particular being exposed to higher levels of the female hormone oestrogen due to various reasons.

Other risk factors linked to endometrial cancer include:

• Being overweight (fatty tissue converts other hormones into oestrogen)
• How many times you've been pregnant (oestrogen levels are low in pregnancy)
• The pattern of your periods (starting periods early, frequent periods or a late menopause all increase oestrogen exposure)

Treatment with tamoxifen - a hormonal treatment for breast cancer and infertility - can slightly increase the risk of endometrial cancer as it has the same effect as oestrogen on the womb, as can long-term use of HRT, particularly if it is high in oestrogen content. Most modern contraceptive pills, however, reduce the risk.

A minority of cases are inherited, particularly if a parent is diagnosed with bowel cancer at a younger age. In these cases patients may benefit from genetic counselling.

Endometrial cancer is most common after the age of 50.

Diagnosing endometrial cancer

Your doctor may take a careful history and carry out an internal examination to check for abnormalities in the neck of the womb.

If they are concerned about endometrial cancer, you would be referred to a specialist and seen within two weeks. Further tests, including an ultrasound and tissue sample of the lining of the womb to look for abnormal cells, are recommended.

Screening isn't routine, although women known to be at high risk with a family history may be offered regular check-ups with ultrasound scans and biopsies of the uterus.

Endometrial cancer treatments

Treatment depends on how far the cancer has spread and the general fitness of the patient. In majority of cases, surgery is the treatment of choice, involving removal of the womb and ovaries, which may be all that is needed.

In selected cases radiotherapy is offered after surgery to reduce the risk of recurrence. Chemotherapy and hormonal treatment is usually used in more advanced cases. The role of chemotherapy, in combination with radiotherapy is tested in clinical trials in women with high risk of recurrence following surgery.

It's important to know there is very high cure rate after surgery in early stage endometrial cancer.