Endometriosis Vs. Endometrial Cancer — What’s the Difference?

How Are Endometrial Cancer and Endometriosis Different?

• Endometriosis is a benign (non-cancerous) condition that occurs when tissue similar to the tissue that normally lines the inside of the uterus, known as the endometrium, grows on the outside of the uterus. Symptoms include pelvic pain, pain during sex, and heavy vaginal bleeding.
• Endometrial cancer begins when cancerous cells form in the tissues of the endometrium or lining of the uterus. Symptoms typically associated with this type of cancer include vaginal bleeding and pelvic pain — similar to endometriosis.
• Although endometriosis and endometrial cancer cause similar symptoms, they are not the same because, in endometrial cancer, the endometrial cells lining the uterus are malignant; those cells remain benign with endometriosis.
• Gynecologic oncologist Dr. Bobbie Rimel notes that having endometriosis doesn’t necessarily put someone at risk for endometrial cancer or vice versa.

Endometriosis and endometrial cancer are health conditions that may sound similar and share some characteristics, but they are not the same. Endometrial cancer (also called uterine cancer) originates from the tissue lining the inside of the uterus, while endometriosis affects tissue similar to the lining of the uterus growing outside the uterus. Although endometriosis may present symptoms similar to endometrial cancer , it is “not cancer,” gynecologic oncologist at Cedars-Sinai Medical Center Dr. Bobbie Rimel tells SurvivorNet. “The endometrium, which is the medical term for the lining of the uterus, is made of a very particular type of cell that grows in response to estrogen hormones. This is a normal part of the female reproductive cycle and is part of the menstrual cycle,” Dr. Rimel explains. “Endometriosis is the term for whenever those endometrial cells, those lining of the uterus cells, are outside of their normal place, which is inside the uterus." She adds that it is a benign condition, meaning it’s not cancerous. WATCH: How to spot the signs and symptoms of endometrial cancer. Though endometriosis isn’t cancerous, it can spread and cause severe pain that may require surgical or medical interventions to relieve. “Endometrial cancer is actually when cells of the lining of the uterus become cancerous and begin to invade the uterus wall…[The cancer cells] may spread to the fallopian tubes, to the ovaries or the lining of the pelvis or elsewhere in the body,” Dr. Rimel adds. Endometrial cancer is believed to be linked to changes in hormonal balance in the body, particularly estrogen and progesterone, which influence the growth of the endometrial lining. The imbalance, such as too much estrogen without enough progesterone, can cause the endometrium to grow too much, leading to the development of cancer cells. It’s important to note that having endometriosis doesn't necessarily make someone at risk for endometrial cancer or vice versa.

Knowing What to Look For

Endometrial cancer and endometriosis share symptoms such as:

• Pelvic pain
• Heavy bleeding during periods
• Pain during or after intercourse
• Pain when urinating

However, distinct differences also exist between the two conditions. According to the Office of Women’s Health, endometriosis tends to impact women in their 30s and 40s and can impact their ability to get pregnant. Although heavy periods are a shared symptom, painful periods may be more associated with endometriosis. “It’s important for women that haven’t gone through menopause yet … like if you’ve always had normal periods, they’ve always come every 28 days, for example, and all of a sudden for the last couple months you’re having bleeding in between periods. I would encourage you to go to the doctor and discuss that because that could lead them to want to do an endometrial biopsy,” says Dr. Dana Chase , an associate professor of UCLA Obstetrics and Gynecology in the Division of Gynecologic Oncology. Irregular bleeding is the most identifiable symptom of endometrial cancer. In addition, post-menopausal women who’ve stopped having periods yet are experiencing vaginal bleeding should consider the symptom a red flag for endometrial cancer. Other symptoms of endometrial cancer may include:

• Pelvic pain
• Pain during intercourse
• Unusual vaginal discharge
• Weight loss
• Urinary problems

Many of these symptoms could also be a sign that something is wrong and not necessarily linked to endometrial cancer. Talking to your doctor about testing can help you better understand your situation.

How is Treatment Different?

Endometriosis Treatment

One of the signature identifiers for endometriosis is the severe pain it brings. Although endometriosis isn’t curable, its symptoms can be managed for a better quality of life. According to the National Institutes of Health, hormone therapy can be an effective treatment option to manage pain. “Hormone treatments stop the ovaries from producing hormones, including estrogen, and usually prevent ovulation,” the NIH explains. By cutting off estrogen, the activity of the endometrium and endometrial lesions slows down. Surgery is an option for severe cases where pain is intolerable. Surgeons can remove endometriosis lesions (also called patches) of endometrial tissue often found in the pelvis. Pain medications are also an option to manage symptoms. WATCH: How endometrial cancer surgery can help determine your treatment journey.

Endometrial Cancer Treatment

Surgery is usually the first treatment considered for endometrial cancer when the disease is localized, and that alone may be all that’s necessary. However, more advanced stages of endometrial cancer may require a more targeted treatment approach. Patients whose cancer is confined to the uterus are considered low risk for recurrence and are likely to be treated with surgery alone. However, patients with advanced cancer that has metastasized beyond the uterus are considered at higher risk. These patients will likely need additional treatments beyond surgery, such as chemotherapy, immunotherapy, or radiation. A minimally invasive surgery called laparoscopic surgery is an option for patients. It uses small incisions in the abdomen. The surgeon uses an affixed camera during the procedure to look inside the abdomen and remove the organs that need to be taken out. These organs may include the cervix, uterus, fallopian tubes, and ovaries. “The procedure can also include removal of the necessary lymph nodes,” Dr. Rimel explains. WATCH: Choosing the right surgeon. Dr. Rimel says patients will likely experience some discomfort for the first few days after surgery. Most of the pain will be around the incisions. “They may feel really tired after their surgery, but they’re generally able to get up, make a sandwich, check email, that kind of thing,” Dr. Rimel said. After surgery, patients can return to normal activities within about a week or two; however, each patient’s recovery time may vary.