At the Saint John’s Cancer Institute, we employ a multi-disciplinary approach and personalized care to diagnose and treat endometrial cancer. Our care teams are ready to support you and answer any questions you may have.
What is Endometrial Cancer?
Endometrial cancer and uterine cancer are often used interchangeably, but they have subtle differences. Endometrial cancer refers to cancer that begins in the uterus’s lining, called the endometrium. Uterine cancer, on the other hand, is a broader term that includes any cancer occurring within the uterus, including cancers that start in the muscular layer of the uterus called the myometrium.
The most common type of uterine cancer is endometrial cancer, but there are also other rare types, such as uterine sarcomas, which develop in the muscle layer. While all endometrial cancers are uterine cancers, not all uterine cancers are endometrial cancers. The distinctions in treatment and prognosis can vary depending on the specific type of uterine cancer.
Causes of Endometrial Cancer
While a definitive cause of endometrial cancer remains elusive, research indicates that it is linked to changes in the DNA of endometrial cells. Mutations in general are the cause of many cancers including the changes caused by viruses. These changes cause the cells to multiply rapidly and live longer than they should, forming a tumor. Risk factors include obesity, hormone therapy for breast cancer, never having been pregnant, and inherited conditions like Lynch syndrome.
Signs and Symptoms of Endometrial Cancer
The most common symptom of endometrial cancer is abnormal vaginal bleeding, especially after menopause. Other symptoms include pelvic pain, pain during intercourse, and watery or blood-tinged discharge. Each can present independently or may be combined.
Abnormal Vaginal Bleeding
Vaginal bleeding is the most common symptom of endometrial cancer. It often manifests after menopause, which is particularly concerning because postmenopausal women typically do not experience menstrual periods. The bleeding can be sporadic and may vary in intensity, ranging from light spotting to heavy. In premenopausal women, abnormal bleeding might include unusually heavy or irregular menstrual periods or bleeding between periods.
Pelvic Pain
Pelvic pain is another symptom that can occur with endometrial cancer. The pain may be persistent or intermittent and can be localized to one area or spread throughout the pelvic region. It might be described as a dull ache or a sharp pain and can sometimes be mistaken for other conditions like gastrointestinal issues.
Pain During Sexual Intercourse
Pain during sexual intercourse (dyspareunia) can be a symptom of endometrial cancer. This pain may be due to the presence of a tumor or inflammation in the endometrial lining, which can cause discomfort or pain during sexual activity.
Watery or Blood-Tinged Discharge
Women with endometrial cancer may experience watery or blood-tinged vaginal discharge. The discharge can vary in consistency and color, ranging from pink and watery to thick and brown. It may also have an unusual odor. This symptom can be particularly alarming and should prompt a medical evaluation.
It is important to note that while these symptoms can be indicative of endometrial cancer, they can also be caused by other, less serious conditions. If you experience any of these symptoms, consulting a healthcare professional and performing appropriate tests are essential. Seeing a doctor early is the first opportunity for early intervention—a hallmark of successful cancer treatment.
Diagnosis of Endometrial Cancer
Diagnosis typically involves a pelvic exam, transvaginal ultrasound, and biopsy to examine the endometrial tissue. If a biopsy is performed, a pathologist will be able to confirm the presence of cancer, and the type of cancer, while a complete profile of the cancer at the genetic level will be most definitive. Your doctor will review the results of the biopsy and discuss next steps.
Though a stage of cancer will be assigned, it is possible that the stage can be modified, such as if cancer is found to occupy other areas including nearby lymph nodes or other organs. There are also levels of staging in between each stage as appropriate. Your gynecologic oncologist will explain your condition, providing an overview of how treatment will progress based on your stage and preferences.
What are the stages of Endometrial Cancer?
Endometrial cancer is staged based on how far it has spread. Stage I is confined to the uterus, Stage II involves the uterus and cervix, Stage III spreads to nearby tissues or lymph nodes, and Stage IV spreads to other parts of the body.
Stage I
In Stage I, the cancer is confined to the uterus and has not spread to nearby lymph nodes or distant parts of the body1. Stage I is further divided into two sub-stages:
- Stage IA: The cancer is in the inner lining of the uterus (endometrium) and may have grown less than halfway through the muscle layer of the uterus (myometrium).
- Stage IB: The cancer is in the endometrium and has grown halfway or more through the myometrium.
Stage II
In Stage II, the cancer has spread from the body of the uterus to the cervix but has not spread outside the uterus. It also has not spread to lymph nodes or distant parts of the body1.
Stage III
Stage III indicates that the cancer has spread to nearby tissues or lymph nodes but has not reached distant parts of the body. It is further divided into three sub-stages:
- Stage IIIA: Cancer has spread to the outer layer of the uterus (serosa) and/or the tissues around the uterus.
- Stage IIIB: Cancer has spread to the vagina or other nearby pelvic organs.
- Stage IIIC: Cancer has spread to pelvic and/or para-aortic lymph nodes.
Stage IV
Stage IV is the most advanced stage, where the cancer has spread to other parts of the body. It is divided into two sub-stages:
- Stage IVA: Cancer has spread to the bladder or bowel mucosa.
- Stage IVB: Cancer has spread to distant organs, such as the lungs, liver, bones, or brain.
Each stage of endometrial cancer requires different treatment approaches and has varying prognoses. Early detection and treatment are crucial for improving outcomes.
Treatment of Endometrial Cancer
Treatment options depend on the stage and may include surgery (such as a hysterectomy), radiation therapy, chemotherapy, and hormone therapy. Early detection significantly improves the prognosis, as endometrial cancer is highly treatable when found early.
Learn more about treatment for Uterine and Endometrial cancer.
If you have questions regarding Endometrial or uterine cancer or would like an expert second opinion, please call today or click here to schedule an appointment.
