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What is endometrial cancer and what should I watch for?
Endometrial cancer is cancer of the endometrium. The endometrium is the lining of the uterus (sometimes called the womb). Endometrial cancer can almost always be treated successfully if it's caught early. You can increase the chances that endometrial cancer will be found early by telling your doctor about any unusual bleeding.
Causes & Risk Factors
Am I at risk for endometrial cancer?
Certain things may put you at greater risk for getting endometrial cancer. One risk factor is age. Endometrial cancer is most common in women who are older than 50 years of age.
You may also be at greater risk if you have had high levels of estrogen in your body. Many things can increase your estrogen level. These include being extremely overweight, having high blood pressure or having diabetes.
Using estrogen replacement therapy without taking progestin may also increase the risk for endometrial cancer. For this reason, women who use hormone replacement therapy (HRT) usually take a combination of estrogen and the hormone progestin. While estrogen stimulates growth of the endometrium, progestin seems to protect the lining of the uterus from the estrogen. In fact, using birth control pills that contain both estrogen and progestin during the childbearing years seems to decrease a woman's risk of endometrial cancer.
Other things that may put you at greater risk for endometrial cancer include having your first period before 12 years of age or going through menopause after 50 years of age. Women who have never been pregnant and women who use a medicine called tamoxifen may also be at greater risk.
Diagnosis & Tests
How is endometrial cancer diagnosed?
Your doctor will diagnose endometrial cancer by performing one or more of the following procedures:
- Endometrial biopsy is usually done in your doctor's office. It involves inserting a narrow tube into the uterus through the vagina and removing a small amount of tissue from the uterine wall. This tissue is tested in a lab for cancerous or precancerous cells. The procedure usually takes just a few minutes.
- Dilatation and curettage (D & C) involves dilating (widening) the cervix (the opening of the uterus) and inserting an instrument to scrape or suction the uterine wall and collect tissue. D & C is also an outpatient procedure. It takes about an hour and usually requires general anesthesia (puts you in a sleep-like state).
- Imaging tests are used in patients who have certain medical conditions such as severe high blood pressure, obesity, diabetes, or other types of cancer. These patients may not be able to safely have anesthesia. In these patients, imaging tests such as an MRI scan, CT scan, or ultrasound may help diagnose cancer of the uterus.
Your doctor will talk to you about which procedure is right for you.
What is the treatment for endometrial cancer?
Treatment usually involves removing the uterus, the fallopian tubes and the ovaries. You may also need to take progestin to balance out high levels of estrogen. Sometimes radiation therapy or chemotherapy is also needed. Treatment can be very effective, especially if the cancer is found early.
Questions to Ask Your Doctor
- I've gone through menopause and I'm still bleeding. Could I have endometrial cancer?
- I have endometrial cancer. Is there a higher risk that my daughter could get it, too?
- Will I have to have a hysterectomy?
- If I have a hysterectomy, will I have to take hormones afterward?
- How long will my treatment last?
- I once took tamoxifen for breast cancer. Should I be tested for endometrial cancer on a regular basis?
- How often after my treatment ends will I have to come in to see the doctor for follow-up exams?
- What are some of the side effects of hysterectomy?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.