Endometrial cancer

Overview

Endometrial cancer, also referred to as uterine cancer, occurs in the endometrium, which lines the inside of your uterus. It is typically found in women over the age of 50, but can occur in younger women as well. Endometrial cancer is the most common gynecologic cancer, with more than 200,000 cases in the U.S. each year.

Most women experience abnormal vaginal bleeding in the cancer’s early stages, making it easy to detect before it spreads outside of the uterus.

Endometrial cancer is highly curable when detected early. Surgery is the most common treatment, though chemotherapy and hormone therapy may also be options. 

Causes and risks

Endometrial cancer occurs when healthy cells mutate into abnormal cells in the endometrium. The exact cause of this mutation remains unknown, though there are a number of factors that may put you at a higher risk, including:

  • Obesity
  • Diabetes
  • High amounts of estrogen and low amounts of progesterone
  • Never having a pregnancy
  • Beginning menstruation early
  • Being above the age of 50
  • Lynch syndrome

Symptoms

Endometrial cancer is normally discovered in women experiencing specific symptoms, such as:

  • Irregular vaginal bleeding, including heavy irregular periods, bleeding in between periods and bleeding after menopause
  • Pain or bleeding during sexual intercourse
  • Pain in the pelvic area

These symptoms could be due to conditions other than endometrial cancer, so it’s best to see a doctor right away.

Diagnosis and testing

The first step in diagnosing endometrial cancer is usually a physical, during which a doctor will perform a pelvic exam and review your personal and family medical history. If endometrial cancer is suspected, you will be referred for further tests.  

Specialists use a variety of tests, which are typically outpatient procedures to deliver an accurate diagnosis. These include:

  • Endometrial biopsy — An endometrial tissue sample is taken by inserting a small, flexible plastic tube into the uterus. A pathologist examines the tissue under a microscope to determine if cancer is present.
  • Ultrasound — This imaging test uses sound waves to create images of internal organs and structures.
  • Dilation and curettage (D&C) — During this minor surgical procedure, the cervix is expanded (dilated), and the cervical canal and uterine lining is scraped with a spoon-shaped instrument (curette). The sample is examined under a microscope by a pathologist to determine if cancer or other abnormal cells are present.
  • CT or CAT scan — A combination of X-rays and computer technology that produces detailed cross-sectional images of the structures inside of the abdomen and pelvis.

Staging

Once an endometrial cancer diagnosis has been confirmed, your doctor may conduct one or more of the diagnostic imaging tests listed above to determine the location of the cancer and how far it has spread, followed by surgery if feasible. This process is called staging. The stages of endometrial cancer include:

  • Stage I — Cancer is found in the uterus only.
  • Stage II — Cancer has spread into the connective tissue of the cervix, but has not spread outside the uterus.
  • Stage III — Cancer has spread beyond the uterus and cervix, with possible spreading to the lymph nodes, but has not spread beyond the pelvis.
  • Stage IV — Cancer has spread beyond the pelvis and possibly to other organs. 

Staging is necessary in order to design the most effective treatment plan.

Multidisciplinary endometrial cancer treatment

Within the first several days of a visit to the Gynecologic Oncology Center, the multidisciplinary team will conduct comprehensive cancer testing, the results of which are used to develop a treatment plan personalized to your unique case.

Highlights of the full range of endometrial cancer treatments and services are:

  • World-class gynecologic services
  • Minimally invasive robotic and laparoscopic surgical procedures 
  • Fertility-sparing therapies 
  • Cutting-edge approaches to delivering radiation therapy and chemotherapy 
  • Hormone therapies that block the growth and spread of cancer

Each endometrial cancer diagnosis is unique. That’s why your team meets weekly to discuss your treatment during multidisciplinary treatment planning conferences where physicians discuss the best practices for delivering an excellent treatment plan. A team of radiation oncologists from the Northwell Health Cancer Institute may also be involved with your treatment if there is a need for additional therapy beyond surgery.

At every phase of your treatment, our specialists review their approach to constantly evaluate and improve care to make sure you are on the best possible path to a cure.

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