What is uterine (endometrial) cancer?
Uterine (endometrial) cancer starts in the inner lining of the uterus and is most common after menopause. Its most important warning sign is vaginal bleeding after menopause — thanks to this symptom, most cases can be found at an early stage. Not all bleeding is cancer, but it should always be evaluated. Diagnosis uses ultrasound and a tissue sample from inside the uterus; treatment and staging usually involve surgery and are planned individually.
Uterine (endometrial) cancer is one of the more common cancers of the female reproductive organs, but it has an important advantage: its most common symptom, abnormal bleeding, allows most cases to be noticed at an early stage. Who is it more common in, how is it diagnosed, and how is treatment planned? Decisions are specific to you and are made together with your doctor.
What is uterine cancer?
Uterine cancer most often starts in the inner lining of the uterus (endometrium), which is why it is usually called "endometrial cancer." It is most often diagnosed after menopause. Its tendency to cause an early symptom (abnormal bleeding) helps it to be found at an early stage in many cases.
Uterine cancer often gives an early warning sign (bleeding). Taking this sign seriously and having it evaluated is the most important step in the process.
What are the symptoms?
The most important symptom is abnormal bleeding:
- Vaginal bleeding after menopause (the most important warning sign),
- Before menopause, a marked change in your menstrual pattern or bleeding between periods,
- Sometimes unusual discharge; in advanced cases, pelvic pain.
Any bleeding after menopause — even a small amount — should be evaluated. Most of the time the cause is not cancer, but only an exam and tests can show that. More details: symptoms of gynecologic cancers.
Risk factors
Some factors can increase the risk (but on their own they do not mean cancer will develop):
- Obesity and unopposed estrogen,
- Late menopause, never having given birth, certain hormonal conditions,
- Certain medications (for example, tamoxifen, used in some breast cancer treatments),
- Certain hereditary/genetic syndromes (for example, Lynch syndrome).
Having a risk factor does not mean "I will get cancer"; it can also occur in someone with no risk factors. What matters is not putting off an evaluation when symptoms appear.
How is it diagnosed?
The diagnostic process usually includes:
- Ultrasound (usually transvaginal) to assess the thickness and structure of the uterine lining,
- If needed, a tissue sample taken from inside the uterus (endometrial biopsy/sampling; in some cases with hysteroscopy),
- Pathology examination of the sample; the diagnosis is made on that basis.
Staging and treatment
In uterine cancer, staging is usually done during surgery; in other words, the extent of the disease is assessed through the operation. Treatment is generally based on surgery (hysterectomy, often with removal of the ovaries and fallopian tubes, and lymph node assessment when needed). Depending on the situation, radiation therapy, chemotherapy or hormonal therapy may be added.
The extent of surgery and the need for additional treatment are decided by a multidisciplinary team, in light of current guidelines, based on the stage, tumor type/grade, age and overall health. Whether surgery is done as open or minimally invasive surgery is decided individually.
Follow-up
Regular follow-up after treatment aims to notice possible changes and recurrence early. How often follow-up visits happen and what they include is decided for each person; they may include an exam and, when needed, imaging. More details: follow-up after treatment.
When should you see a doctor?
- With any bleeding after menopause — without waiting,
- If bleeding between periods or other unusual bleeding continues before menopause,
- If you have unusual discharge or pelvic discomfort that does not go away.
In uterine cancer, taking abnormal bleeding seriously is the most valuable early step. Most bleeding does not turn out to be cancer, but having it evaluated is how a possible problem is caught early.
Frequently asked questions
Is bleeding after menopause always cancer?
No. Bleeding after menopause can have many benign causes. However, this symptom should never be ignored; you should always see a doctor so the cause can be investigated. The evaluation often reveals a cause other than cancer.
What is the most important symptom of uterine cancer?
The most common and most important symptom is vaginal bleeding after menopause. Before menopause, a marked change in your menstrual pattern or bleeding between periods can be a warning sign.
Is there screening for uterine cancer?
Unlike cervical cancer, there is no routine population-wide screening program for endometrial cancer. This is why evaluation is so important when symptoms (especially abnormal bleeding) appear.
How is uterine cancer diagnosed?
Usually the lining of the uterus is assessed with ultrasound and, when needed, a tissue sample is taken from inside the uterus (endometrial biopsy/sampling, sometimes with hysteroscopy) for pathology examination.
What is the treatment for uterine cancer?
Treatment usually involves surgery (including staging); depending on the situation, radiation therapy, chemotherapy or hormonal therapy may be added. The plan is set by a multidisciplinary team based on the stage, tumor type, age and overall health.
Do weight and hormones affect the risk of uterine cancer?
Yes, factors such as obesity and unopposed estrogen can increase the risk. This does not mean cancer will definitely develop; however, a healthy weight and regular checkups are beneficial for overall health.
Sources
- National Cancer Institute (NCI) — Uterine (Endometrial) Cancer
- ESGO — Endometrial cancer guidelines
- ACOG — Women's health patient information
- Republic of Türkiye Ministry of Health / HSGM
Note: This content was written independently, based on current scientific information published by the institutions above; it is not a direct copy of any text.
This article is for general information only; it is not a diagnosis or treatment recommendation and does not replace a medical examination. Please consult your doctor about your own situation. The content reflects scientific knowledge as of the update date above.