Endometrial Cancer – Symptoms and Causes
What Is Endometrial Cancer?
Endometrial cancer starts in the cells lining the uterus (the endometrium). The uterus is a hollow, pear-shaped organ in the pelvis where babies develop during pregnancy.
This cancer type is the most common form of uterine cancer. Other uterine cancers like uterine sarcoma exist but occur much less frequently.
Early detection of endometrial cancer is common because it typically causes noticeable symptoms.
Irregular vaginal bleeding is often the first warning sign that prompts women to seek medical care. Other symptoms may include:
- Pelvic pain
- Bleeding between periods
- Bleeding after menopause
When found early, endometrial cancer has a high cure rate. The main treatment involves surgical removal of the uterus (hysterectomy), which is often enough to eliminate the cancer completely in early stages.
Signs of Disease
Endometrial cancer can cause several symptoms. These include bleeding from the vagina after menopause has ended. You might also see bleeding between your regular periods. Some people feel pain in the pelvic area.
When You Should Contact a Doctor
It’s important to schedule an appointment with your doctor if you notice any concerning symptoms.
Don’t ignore unusual bleeding or pelvic pain, as early detection is valuable. Your healthcare provider can determine if your symptoms need further evaluation.
Causes
Scientists don’t yet know exactly what causes endometrial cancer. Research shows that this cancer begins when normal cells in the uterine lining (endometrium) develop DNA changes that transform them into cancer cells.
These DNA changes give abnormal instructions to the cells. The damaged cells multiply rapidly and don’t die when they should during the body’s natural cell replacement process. This uncontrolled growth creates an excess of cells that may form a tumor.
The cancer cells can:
- Invade nearby healthy tissue
- Destroy normal body tissues
- Eventually spread to other parts of the body
The abnormal cells grow in the endometrium, which is the tissue lining the inside of the uterus. Without proper cellular regulation, these cells continue to divide and spread, potentially moving beyond the uterus if the cancer advances.
Risk Factors
Several factors may increase a person’s chances of developing endometrial cancer:
Hormone Imbalances
When estrogen levels increase without enough progesterone to balance them, the endometrium may grow too much, raising cancer risk. This can happen with:
- Obesity
- Diabetes
- Irregular ovulation (as in polycystic ovary syndrome)
- Post-menopausal estrogen therapy without progestin
- Certain rare ovarian tumors that produce estrogen
Menstrual History
Women who have more menstrual cycles throughout their lifetime face higher risk because:
- Starting periods before age 12
- Entering menopause later in life
- Having more total lifetime periods exposes the endometrium to more estrogen
Pregnancy Status
Women who have never been pregnant have a higher risk than those who have had at least one pregnancy.
Age
The risk of endometrial cancer increases with age. Most cases occur after menopause.
Weight
Obesity significantly increases endometrial cancer risk. Extra body fat can:
- Change hormone levels in the body
- Produce excess estrogen
- Create an imbalance between estrogen and progesterone
Breast Cancer Treatment
Taking tamoxifen for breast cancer treatment can increase endometrial cancer risk. However, for most patients, tamoxifen’s benefits against breast cancer outweigh this risk. Anyone taking tamoxifen should discuss this risk with their healthcare provider.
Genetic Factors
Lynch syndrome is an inherited condition that increases the risk of several cancers, including:
- Colon cancer
- Endometrial cancer
- Other cancers
This syndrome results from genetic mutations passed from parents to children.
Prevention
Taking steps to reduce the risk of endometrial cancer can be an important part of a woman’s health plan. Several strategies may help lower the chance of developing this disease.
Hormone Therapy Considerations
Women considering hormone therapy after menopause should discuss options with their healthcare providers.
Using estrogen alone can raise endometrial cancer risk for women who still have their uterus. A combination of estrogen and progestin reduces this risk. However, all hormone therapies have potential benefits and risks that need careful evaluation.
Birth Control Pills
Using oral contraceptives for at least one year may provide protection against endometrial cancer. This protective effect can last for several years after stopping the pills.
Common birth control pills contain hormones that help regulate the uterine lining, potentially reducing cancer risk. Before starting any contraceptive, women should talk with their healthcare provider about possible side effects.
Weight Management
Maintaining a healthy weight is crucial for reducing endometrial cancer risk.
Excess body fat can increase estrogen levels in the body, which may stimulate the endometrial lining.
Women who need to lose weight should:
- Increase physical activity
- Reduce daily calorie intake
- Set realistic weight goals
- Work with healthcare providers on a sustainable plan
Regular Medical Check-ups
Women should not ignore unusual symptoms such as:
- Abnormal vaginal bleeding
- Spotting between periods
- Bleeding after menopause
- Pelvic pain
Early detection through regular check-ups can help identify problems before they develop into cancer.
Risk Factor Awareness
Understanding personal risk factors helps women make informed decisions about prevention.
Risk increases with:
| Risk Factor | Prevention Approach |
|---|---|
| Older age | Regular check-ups |
| Obesity | Weight management |
| Hormone imbalances | Medical monitoring |
| Family history | Genetic counseling if appropriate |
Women with known risk factors should work closely with their healthcare providers to develop personalized prevention plans.
