Uterine (Endometrial) Cancer; Symptoms, Causes, Diagnosis, and Treatments

Introduction

Uterine cancer, most often called endometrial cancer, is among the most common gynecologic cancers. It typically affects women after menopause, though it can occur earlier. Early detection is crucial: when found at an early stage, the chances of complete cure are high.

Symptoms of uterine cancer

Symptoms often appear gradually, but paying attention to them can be life-saving:

• Abnormal vaginal bleeding (especially after menopause)
• Heavier or longer periods than usual
• Spotting between menstrual cycles
• Pelvic pain or pressure
• Pain during intercourse
• Unusual, sometimes foul-smelling vaginal discharge

Causes and risk factors

Endometrial cancer begins when cells in the uterine lining grow abnormally and form a malignant tumor. Risk factors include:

• Increasing age (most common over age 50)
• Late menopause or very early first period
• Obesity (due to higher estrogen levels)
• Family history of uterine or colorectal cancer
• Never having been pregnant
• Long-term use of estrogen without progesterone
• Polycystic ovary syndrome (PCOS)
• Diabetes and high blood pressure

How uterine cancer is diagnosed

For a definitive diagnosis, clinicians may use:

• Pelvic examination to assess the uterus and surrounding organs
• Transvaginal ultrasound to measure endometrial thickness
• Endometrial biopsy (sampling the uterine lining)
• Hysteroscopy to directly view the uterine cavity
• MRI or CT scans when needed to evaluate spread

Treatment options

1. Surgery

• Hysterectomy: removal of the uterus
• In more advanced cases, removal of the ovaries and pelvic lymph nodes may also be recommended

2. Systemic therapies

• Chemotherapy: used after surgery or for advanced disease to kill cancer cells
• Hormone therapy: for those who cannot undergo surgery or in specific tumor types and stages
• Immunotherapy: considered in selected, advanced cases

3. Radiation therapy

• External beam radiation or internal brachytherapy to destroy cancer cells and reduce recurrence risk

Prevention and self-care

Uterine cancer is not always preventable, but risk can be lowered with the following steps, especially for those at higher risk (such as with obesity or family history), and generally as part of women’s health maintenance.

1. Weight control and healthy nutrition

Obesity is a major risk factor because it raises circulating estrogen.

• Emphasize fruits, vegetables, and whole grains
• Limit red meat, high-fat, and processed foods
• Reduce added sugars to help keep insulin and hormones in balance

2. Regular physical activity

Exercise supports a healthy weight and hormonal balance.

• Aim for at least 30 minutes of moderate activity (brisk walking, cycling, swimming) on most days
• Add strengthening activities (resistance training or yoga) to build muscle and reduce inflammation

3. Manage menstrual and hormonal irregularities with medical guidance

If you have irregular periods or endocrine conditions such as PCOS, seek evaluation. Timely treatment helps prevent abnormal changes in the endometrium.

4. Avoid unsupervised hormone use

Long-term estrogen without progesterone increases risk.

• Do not start hormonal medications or herbal products with estrogen-like effects without medical advice
• If you are on hormone replacement therapy, keep regular checkups and monitoring

5. Pregnancy and breastfeeding as protective factors

A full-term pregnancy and breastfeeding are associated with lower risk because the body is exposed to less continuous estrogen during these periods.

6. Stop smoking and limit alcohol

Both harm overall reproductive health and raise the risk of several cancers. Quitting and cutting back provide meaningful protection.

7. Routine checkups

There is no universal screening test for endometrial cancer (Pap tests screen for cervical cancer, not endometrial).

• Any postmenopausal bleeding or unexpected spotting warrants prompt evaluation
• Annual gynecologic visits can help detect issues early

8. Control underlying conditions

Chronic conditions such as diabetes and hypertension may raise risk. Work with your clinician to keep blood sugar and blood pressure controlled through medication, nutrition, and exercise.

Clinical cases

Case 1

A 56-year-old, postmenopausal woman presented with spotting. Ultrasound showed abnormally thick endometrium. Biopsy confirmed stage I endometrial cancer. She underwent total hysterectomy and recovered without recurrence.

Case 2

A 45-year-old woman with obesity and diabetes reported prolonged, heavy periods. Endometrial sampling revealed cancer. She had surgery followed by chemotherapy.

Case 3

A 60-year-old woman presented with postmenopausal bleeding. Workup showed advanced disease. She received combined treatment with hysterectomy and radiation therapy.

Conclusion

Endometrial cancer commonly presents with abnormal uterine bleeding. Early recognition and evaluation lead to high cure rates. Paying attention to symptoms, seeking timely medical care, and regular checkups are the best ways to prevent progression and improve outcomes.

Similar Articles

1. Mayo Clinic – Endometrial cancer
2. WebMD – Uterine (Endometrial) cancer
3. UpToDate – Clinical features and diagnosis of endometrial carcinoma