Endometrial Cancer: What You Need to Know
Endometrial cancer starts in the lining of the uterus. It’s one of the most common gynecologic cancers, and the good news is many cases are found early because of noticeable symptoms. If you notice unusual bleeding or spotting after menopause, get checked—early action changes the whole outcome.
Symptoms and diagnosis
The most common warning sign is abnormal vaginal bleeding. For people past menopause, any bleeding is a red flag. Before menopause, heavier or irregular periods, pelvic pain, or unexpected discharge also deserve attention. Your doctor will usually start with a pelvic exam and then move to an ultrasound or an endometrial biopsy to get tissue for testing.
Diagnosis also includes checking how far the cancer has spread. That may mean imaging tests like CT or MRI and, in some cases, surgical evaluation. Pathology results tell your team the tumor type and grade, which guide treatment choices. If you have a strong family history of colon or endometrial cancer, ask about genetic testing for Lynch syndrome—this affects both treatment and future cancer screening for family members.
Treatment choices and fertility
Treatment depends on stage, grade, overall health, and whether you want to have children. For early-stage disease, the most common approach is a hysterectomy (removal of the uterus) with removal of ovaries and fallopian tubes in many cases. Surgeons now often use minimally invasive techniques and sentinel lymph node checks to limit side effects.
If the cancer is higher risk or spread, doctors add radiation or chemotherapy. A common chemo combo is carboplatin plus paclitaxel. Newer options for advanced or recurrent cases include hormone therapy (progestins or aromatase inhibitors) and targeted immunotherapy when tumors have specific markers like MSI-high.
Worried about fertility? For very early, low-grade disease, some patients can try fertility-sparing treatment with high-dose progestin or a levonorgestrel IUD and close monitoring. This is a careful, time-limited choice and needs a team that follows you closely.
Other practical points: tamoxifen, used for breast cancer, can raise endometrial cancer risk, so women on tamoxifen should have regular check-ups. Lifestyle changes help too—maintaining a healthy weight, managing diabetes, and staying active lower overall risk. After treatment you’ll have scheduled follow-ups to watch for recurrence and manage side effects.
If you or someone you love faces an endometrial cancer diagnosis, ask for clear explanations about stage, grade, and molecular tests. Get a treatment plan that fits your goals—medical teams can often tailor therapy around fertility, work, and quality of life. If you want help finding resources, clinical trials, or second opinions, bring that up; it’s your care and your choice.
