Symptoms

Signs and symptoms of endometrial cancer may include:

• Vaginal bleeding after menopause
• Bleeding between periods
• Pelvic pain

Diagnosis

Diagnosing endometrial cancer

Tests and procedures used to diagnose endometrial cancer include:

• Examining the pelvis.During a pelvic exam, your doctor carefully inspects the outer portion of your genitals (vulva), and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand on your abdomen to feel your uterus and ovaries. He or she also inserts a device called a speculum into your vagina. The speculum opens your vagina so that your doctor can view your vagina and cervix for abnormalities.
• Using sound waves to create a picture of your uterus.Your doctor may recommend a transvaginal ultrasound to look at the thickness and texture of the endometrium and help rule out other conditions. In this procedure, a wandlike device (transducer) is inserted into your vagina. The transducer uses sound waves to create a video image of your uterus. This test helps your doctor look for abnormalities in your uterine lining.
• Using a scope to examine your endometrium.During a hysteroscopy, your doctor inserts a thin, flexible, lighted tube (hysteroscope) through your vagina and cervix into your uterus. A lens on the hysteroscope allows your doctor to examine the inside of your uterus and the endometrium.
• Removing a sample of tissue for testing.To get a sample of cells from inside your uterus, you’ll likely undergo an endometrial biopsy. This involves removing tissue from your uterine lining for laboratory analysis. Endometrial biopsy may be done in your doctor’s office and usually doesn’t require anesthesia.
• Performing surgery to remove tissue for testing.If enough tissue can’t be obtained during a biopsy or if the biopsy results are unclear, you’ll likely need to undergo a procedure called dilation and curettage (D&C). During D&C, tissue is scraped from the lining of your uterus and examined under a microscope for cancer cells.

If endometrial cancer is found, you’ll likely be referred to a doctor who specializes in treating cancers involving the female reproductive system (gynecologic oncologist).

Treatment

Treatment for endometrial cancer is usually with surgery to remove the uterus, fallopian tubes and ovaries. Another option is radiation therapy with powerful energy. Drug treatments for endometrial cancer include chemotherapy with powerful drugs and hormone therapy to block hormones that cancer cells rely on. Other options might be targeted therapy with drugs that attack specific weaknesses in the cancer cells and immunotherapy to help your immune system fight cancer.

Surgery

Treatment for endometrial cancer usually involves an operation to remove the uterus (hysterectomy), as well as to remove the fallopian tubes and ovaries (salpingo-oophorectomy). A hysterectomy makes it impossible for you to become pregnant in the future. Also, once your ovaries are removed, you’ll experience menopause, if you haven’t already.

During surgery, your surgeon will also inspect the areas around your uterus to look for signs that cancer has spread. Your surgeon may also remove lymph nodes for testing. This helps determine your cancer’s stage.

Chemotherapy

Chemotherapy uses chemicals to kill cancer cells. You may receive one chemotherapy drug, or two or more drugs can be used in combination. You may receive chemotherapy drugs by pill (orally) or through your veins (intravenously). These drugs enter your bloodstream and then travel through your body, killing cancer cells.

Chemotherapy is sometimes recommended after surgery if there’s an increased risk that the cancer might return. It can also be used before surgery to shrink the cancer so that it’s more likely to be removed completely during surgery.

Chemotherapy may be recommended for treating advanced or recurrent endometrial cancer that has spread beyond the uterus.

Hormone therapy

Hormone therapy involves taking medications to lower the hormone levels in the body. In response, cancer cells that rely on hormones to help them grow might die. Hormone therapy may be an option if you have advanced endometrial cancer that has spread beyond the uterus.

Targeted drug therapy

Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy for treating advanced endometrial cancer.

Immunotherapy

Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body’s disease-fighting immune system might not attack cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process. For endometrial cancer, immunotherapy might be considered if the cancer is advanced and other treatments haven’t helped.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy

When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.