Endometrial / Uterine Cancer

We provide compassionate care for people with endometrial cancer, uterine sarcoma, and other cancers of the uterus. Our highly skilled team uses the latest imaging and testing to develop an individualized care plan that prioritizes your comfort, goals, and priorities.

What Is Endometrial / Uterine Cancer?

Uterine cancer is cancer that begins in the uterus, the organ in the pelvis where a baby grows during pregnancy. The most common type of uterine cancer is endometrial cancer, which starts in the lining of the uterus known as the endometrium. More than 40,000 women in the United States are diagnosed with endometrial cancer each year. Because it often causes symptoms early, such as abnormal vaginal bleeding, it is frequently diagnosed at an early stage and can often be treated successfully.

Less common types of uterine cancer include serous carcinoma and clear cell carcinoma, which tend to be more aggressive and are more likely to have spread beyond the uterus. Uterine sarcomas, which develop in the muscle or connective tissues of the uterus, are also uncommon but generally more aggressive than endometrial cancer. Different types of uterine cancer can have very different outlooks.

What Causes Endometrial / Uterine Cancer?

Endometrial cancer develops when cells in the lining of the uterus, known as the endometrium, grow abnormally and begin to multiply out of control. The exact cause is not always known, but several factors can increase the risk of developing the disease.

Many cases are linked to an imbalance between the hormones estrogen and progesterone. When the body is exposed to too much estrogen without enough progesterone, the uterine lining can become thicker than normal. Over time, these changes may lead to abnormal cells and, in some cases, cancer.

Some endometrial cancers are linked to inherited genetic conditions, such as Lynch syndrome. Most endometrial cancers develop from a precancerous condition called endometrial hyperplasia, which causes the uterine lining to become abnormally thick. Certain forms of endometrial hyperplasia, especially atypical hyperplasia, carry a higher risk of progressing to cancer.

What Are the Risk Factors for Endometrial / Uterine Cancer?

Risk factors may include:

• Older age
• Obesity
• Irregular periods or ovulation
• Polyendocrine Metabolic Ovarian Syndrome (PMOS)
• Never being pregnant
• Starting periods early
• Late menopause
• Estrogen therapy without progesterone in patients with a uterus
• Tamoxifen use
• Diabetes
• High blood pressure
• Lynch syndrome
• A family history of uterine, colon, ovarian, or other cancers

These factors can raise risk, but they do not mean cancer will develop.

What Are the Symptoms of Endometrial / Uterine Cancer?

For many people, the first sign of uterine cancer is abnormal bleeding. That symptom can be scary, but it can also help doctors find the cancer earlier.

Other symptoms may include:

• Bleeding after menopause
• Bleeding between periods
• Very heavy periods
• Periods that last longer than usual
• Watery, pink, or bloody vaginal discharge
• Pelvic pain
• Pain during sex
• Unexplained weight loss
• Abdominal pain
• Nausea, vomiting
• Weight loss
• Bloating

Any bleeding after menopause should be checked by a doctor.

When Should I See a Doctor?

You should see a doctor if you have bleeding after menopause, bleeding between periods, very heavy bleeding, or unusual vaginal discharge.

These symptoms can have many causes, but they should not be ignored.

How Is Endometrial / Uterine Cancer Diagnosed?

Endometrial and uterine cancers are diagnosed with exams, imaging tests, and tissue testing.

Depending on your symptoms and family history, tests may include:

• Pelvic exam
• Transvaginal ultrasound
• Endometrial biopsy
• Dilation and curettage, also called D&C
• Hysteroscopy, which uses a thin camera to look inside the uterus
• CT scan, MRI, or PET scan
• Genetic testing or tumor testing

How Is Endometrial / Uterine Cancer Treated?

Treatment depends on the type of cancer, the stage of the disease, your overall health, and your treatment goals. Your care team will develop a personalized treatment plan based on your specific diagnosis.

Treatment may include:

• Surgery
• Minimally invasive or robotic-assisted surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• Immunotherapy
• Targeted therapy
• Fertility-preserving treatment
• Clinical trials

Surgery is often the primary treatment for endometrial cancer. Depending on the extent of the disease, surgery may involve removing the uterus, cervix, fallopian tubes, ovaries, and nearby lymph nodes.

At Columbia, we use minimally invasive and robotic-assisted surgical techniques whenever possible. These approaches use several small incisions rather than a large abdominal incision and typically result in less pain, a shorter hospital stay, faster recovery, an earlier return to normal activities, and smaller scars.

For some younger patients who wish to preserve fertility, other treatment options may be available. In some cases, the ovaries can be preserved, or very early-stage endometrial cancer may be treated with hormone therapy using progesterone instead of immediate surgery.

Many patients with early-stage endometrial cancer that has not spread beyond the uterus only need surgery. For patients with higher-risk disease or cancer that has spread, treatment may also include radiation therapy, chemotherapy, targeted therapy, immunotherapy, or a combination of these approaches.