The women is a pear-shaped female organ in your pelvis where a baby grows during pregnancy. It’s mostly muscular, and the lining is called the endometrium. Endometrial cancer begins in the lining and can spread to the body of the womb and is sometimes referred as uterine cancer. When discovered early enough, removal of the womb can cure the cancer. It’s the 4th most common cancer in women in the UK. Most women get symptoms and therefore present at an early stage, giving a good chance that any treatment will succeed. The chances of survival are fairly good, with 90% surviving the first year after diagnosis, and more than 70% surviving 10 years or more.
For those women who have gone through the menopause, any vaginal bleeding, even once, should be checked out at by your GP, as this could be a sign of endometrial cancer. If you have not gone through the menopause, you should see your doctor if you get bleeding between periods. Endometrial cancer can also cause heavy vaginal periods, different to your normal periods or a change to your vaginal discharge, but there are many more common reasons for this (fibroids, endometriosis, polyps), so book an appointment and don’t panic. If endometrial cancer has spread to involve or impact other organs, you may experience pain during sex, blood in your urine, pain in your lower back or pelvis, or even a lump in your abdomen or pelvis.
You should book an urgent appointment for any vaginal bleeding after the menopause. Your doctor will ask about your symptoms, any risk factors and any relevant family history. With your permission, they will examine your vagina. They will use a speculum (a small plastic device) to look inside your vagina to the cervix, or neck of the womb, and they may take some swabs. They can also feel for any lumps, bumps or painful points, by using a gloved finger to examine inside the vagina. Depending on the findings, your GP may refer you for an ultrasound of your pelvis (transvaginal ultrasound) and blood tests. If they have concerns of cancer, they will refer you urgently to a specialist called a gynaecologist.
High levels of oestrogen can increase your chance of endometrial cancer. This can occur in any woman with a womb that has never given birth or those who have gone through the menopause after the age of 55, people with polycystic ovary syndrome, people who are overweight and people who take certain medications like hormone replacement therapy (HRT). You are also at higher risk if a family member has had endometrial cancer, or cancer of the bowel or ovary, if you have a genetic condition that causes Lynch syndrome, if you take Tamoxifen, an oral medication used to treat breast cancer, or if you have had radiotherapy to your pelvic area for any reason.
A hysterectomy - surgery to remove the womb – is the mainstay of treatment. Depending on the type and stage of cancer, and any spread, chemotherapy and radiotherapy might be considered alongside a hysterectomy. If your general health or your own preference is that surgery is not the best option, you may be offered one or both of these alone. A hysterectomy may have been carried out previously for a number of reasons, including fibroids or endometriosis. If you have had your womb completely removed, you will not be at risk of endometrial cancer.