How Do I Know If I Have Uterine Cancer?

There are two primary types of uterine cancer: endometrial cancer and uterine sarcoma. Endometrial cancer, which develops in the lining of the uterus, accounts for about 90% of uterine cancer diagnoses.  

There is no routine screening for uterine cancer in women without symptoms. Screenings, such as an annual transvaginal ultrasound and endometrial biopsy, are only recommended for those at high risk.  

Erin George, MD

“For most women, cancer is most commonly detected after symptoms appear (especially abnormal bleeding) or after they have an incidental finding on imaging of an abnormality in the endometrial lining of the uterus,” said Erin George, MD, a gynecologic oncologist at Moffitt Cancer Center.  

Due to the lack of standard screening protocols for those not considered high risk, women need to be aware of symptoms and early warning signs of uterine cancer.  

“The most common symptom of endometrial cancer is abnormal vaginal bleeding, especially bleeding or spotting after menopause, bleeding between periods or having heavier or irregular periods,” George said.  

Less common symptoms that may overlap with other benign conditions include abnormal vaginal discharge, pelvic or lower abdominal pain, unexplained weight loss, and difficulty or pain while urinating.   

What Are the Risk Factors? 

• Obesity 
• Unopposed estrogen therapy after menopause
• Tamoxifen use (antiestrogen drug)
• Nulliparity (never carrying a pregnancy)
• Late menopause
• Type 2 diabetes
• Family history of endometrial cancer particularly with Lynch syndrome
• History of pelvic radiation
• Being older than 50 

“When it comes to obesity, it leads to higher levels of estrogen produced by fat tissues, which stimulates the uterine lining and increases cancer risk,” George said. “It is the strongest modifiable risk factor for endometrial cancer.”   

How Is the Disease Treated? 

Treatment for uterine cancer commonly involves surgery. Typically, patients receive a hysterectomy (removal of the uterus, cervix and fallopian tubes) as well as removal of the ovaries. Lymph nodes are also monitored to make sure the cancer has not spread.   

“In addition, there are advances in molecular profiling to personalize therapy, new targeted drugs, immunotherapies, and clinical trials for aggressive and rare subtypes, all of which are significant advances on the horizon when it comes to treating patients with uterine cancer,” George said. “Research is ongoing to improve early detection, reduce disparities, and find better treatment options for all uterine cancer patients.”