Endometrial Cancer – What is it and what to look for?

In the last 3 weeks I have been told about two acquaintances diagnosed with endometrial cancer. One has excellent chances and the other is preparing to die. The endometrium is the layer in your uterus that grows up then sheds during your period. Endometrial cancer is the cancer of this layer and is quite common in the United States. It is most often thought of as a post-menopausal cancer; however younger women should be aware too.

The most common symptom in women is bleeding. In a woman who is post-menopausal, she might bleed or spot again when she hadn’t bled in 12 months or she may experience thin white or clear discharge.

In a woman who is still cycling, she may experience very heavy or prolonged periods, multiple periods in a month, or spotting between periods. This could be due to other reasons such as thyroid abnormalities, hormone imbalance, or clotting disorders, however if this has been ruled out then ask for additional work-up.

Diagnostically, a pelvic ultrasound and sampling of the endometrial layer through a biopsy is important. Routine Pap smear tests and pelvic exams may not show any abnormality in the early stages. An ultrasound will show a thickening in the lining while the endometrial biopsy will give an actual diagnosis of the cells inside the uterus.

Risk factors for any woman are as follows: high levels of estrogen, low levels of progesterone, unopposed estrogen (ie. estrogen therapy without progesterone), obesity, prior diagnosis of endometrial hyperplasia, never having been pregnant, starting your period at a very young age, menopause begins after 55 years old, polycystic ovarian disease, irregular ovulation or not ovulating, and a personal history of diabetes, breast cancer and/or ovarian cancer.

The good news is many women are diagnosed early and stage I endometrial cancer has a 75%-95% 5-year survival rate. If you are experiencing any of the symptoms listed in this article and you haven’t been worked up, or if you begin bleeding or experiencing discharge again after your periods have stopped, please talk with your healthcare provider.