What is Endometrial Cancer?

Endometrial cancer develops in the lining of the uterus (endometrium), which is typically shed during menstruation. It’s the most common type of uterine cancer, and while cancer rates for many other types are decreasing, endometrial cancer is on the rise. Some suspect that endometrial cancer might become the third most common cancer among women in the next decade, even surpassing ovarian cancer in mortality rates.

What’s more concerning is that the survival rates are worsening, particularly among Black women. Understanding these growing disparities and improving treatment options for all women is essential to combating this trend.

Signs & Symptoms of Endometrial Cancer

Postmenopausal bleeding is the most common and crucial symptom to watch out for, occurring in 90% of patients with endometrial cancer. Unfortunately, many women aren’t aware of this fact, and less than half of postmenopausal women report that their healthcare provider has discussed postmenopausal bleeding with them. If you notice any of the following symptoms, don’t hesitate to reach out to your doctor:

• Postmenopausal bleeding: Even a tiny bit of spotting after menopause is a big red flag!
• New pelvic pain: Any sudden, persistent pain in the lower abdomen or pelvis.
• Unexplained weight gain: Rapid weight gain without any significant changes to your lifestyle.
• Increased urinary frequency: Feeling the need to urinate more often without any other known cause.
• Changes in bowel function: If you’re experiencing new or unexplained changes in your bowel habits.
• Bleeding during or after intercourse: This could signal something abnormal, especially if it’s paired with foul-smelling discharge.

While 85% of endometrial cancers occur in postmenopausal women aged 65-75, it can still affect younger women. So, if you’re experiencing abnormal bleeding before menopause, it’s worth getting checked out.

When to Call Your Doctor

If you’re postmenopausal and notice any bleeding — even light spotting — it’s time to call your doctor. This is a huge sign that something might be wrong, and you don’t want to wait until it gets worse. A quick call now could save you from much more serious issues later.

Even if you’re premenopausal and experiencing abnormal bleeding or any other symptoms, it’s important to get evaluated. As Dr. Joshua Cohen from City of Hope points out, while cancer is less likely to be the cause before menopause, it’s still worth investigating.

Risk Factors for Endometrial Cancer

There’s no guaranteed way to prevent endometrial cancer, but some factors can increase your risk, including:

• Obesity: Excess body fat produces estrogen, which can stimulate the uterine lining and increase cancer risk.
• PCOS and abnormal bleeding: People with polycystic ovarian syndrome or a history of abnormal uterine bleeding are at higher risk.
• Tamoxifen: Women who’ve had breast cancer and take tamoxifen have a two- to three-fold increased risk, although the overall risk is still relatively low.
• Family history: Around 3-5% of endometrial cancers are hereditary. If you have a family history of gynecologic cancers or Lynch syndrome (a genetic condition that increases the risk of several types of cancer), you should talk to your doctor about genetic testing.

Lowering Your Risk

According to Dr. Cosgrove, living a healthy lifestyle can go a long way in reducing your risk. Here are a few things you can do:

• Maintain a healthy weight: Keeping a healthy weight can lower your estrogen levels and reduce your risk.
• Exercise regularly: Physical activity is a great way to keep your body and hormones in balance.
• Limit red meat and alcohol: Consider a Mediterranean diet, which is high in fruits, vegetables, and whole grains and low in red meat and alcohol.
• Avoid smoking: We all know it’s bad for your health, but it also increases your cancer risk.
• Talk to your doctor: If you’re on hormone therapy or tamoxifen, make sure to discuss your risk factors and options with your healthcare provider.

When It’s Time to Get Checked

If your doctor suspects endometrial cancer, they’ll likely order an endometrial biopsy — a quick procedure that removes a small sample of the uterine lining for evaluation. They may also recommend imaging tests to see if the cancer has spread.

Early detection is key: Endometrial cancer caught in stage 1 has a survival rate of 95%. However, if it has spread beyond the uterus, the average life expectancy drops significantly.

Newer Treatments for Endometrial Cancer

Exciting things are happening in the world of cancer treatment, especially for patients with Lynch syndrome. Immunotherapy and innovative drugs like antibody-drug conjugates (ADCs) are offering new hope, with some patients experiencing responses we’ve never seen before in endometrial cancer.

While endometrial cancer is on the rise, advancements in treatment are giving patients more options than ever before. Maintaining a relationship with your gynecologist and staying on top of your health is the best way to catch any potential issues early.

The Bottom Line

Endometrial cancer is serious, but the more you know, the better equipped you’ll be to catch it early and beat it. If you experience postmenopausal bleeding or any other unusual symptoms, don’t wait — call your doctor.

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