Womb cancer Dr Trisha Macnair Cancer of the womb (uterus) is also known as uterine or endometrial cancer. It affects around 6,400 women every year in the UK and is most common after the age of 50, with symptoms including post-menopausal bleeding. The majority of cases, if caught early, are successfully treated by surgery.

In this article

Symptoms

Causes and risk factors

Treatment and recovery

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.

The exact cause of uterine 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 uterine 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 uterine 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.

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 uterine 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.

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.

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This article was last medically reviewed by Dr Khizar Hayat of the Clatterbridge Centre for Oncology in March 2009.