As one of the few cancers on the rise , it’s important to know the facts about endometrial cancer—especially if you are a postmenopausal woman. (Women 45 and younger are rarely diagnosed.) When caught early, endometrial cancer is highly treatable.
Here’s what oncologists want everyone to know about endometrial cancer, including what it is, what causes it and what treatment looks like.
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What Is Endometrial Cancer?
Dr. Debbie Chirnomas, MD, MPH , an oncologist and the Chief Medical Officer at Faeth Therapeutics, explains that endometrial cancer develops when the cells that make up a woman’s uterus (endometrial cells or tissue) start to grow in an uncontrolled and unregulated way, ignoring normal cell signals to stop dividing.
“There are many possible ways that a cell can become unregulated and for endometrial cells, there may be a combination of genetic mistakes that occur as well as hormonal factors,” Dr. Chirnomas says. She explains that while the exact cause of endometrial cancer is unknown, certain risk factors have been identified through scientific research.
According to Dr. Chirnomas, inherited or acquired genetic mutations and hormonal imbalances increase the risk of endometrial cancer. As with other cancers, if endometrial cancer runs in your family you are at an increased risk.
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Dr. Pedro Ramirez, MD, FACOG, the Chair of the Department of Obstetrics and Gynecology at Houston Methodist and a gynecologic oncologist, says that one of the biggest risk factors of endometrial cancer is obesity. “This is due to the fact that obesity is associated with excess estrogen which leads to stimulation of the lining of the uterus, [which then can lead] to endometrial cancer,” he explains.
When there is an excessive amount of estrogen in the body, it can lead to tumor growth , which is what causes endometrial cancer. Excessive estrogen can also lead to breast cancer and ovarian cancer.
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What Are the Signs of Endometrial Cancer and What Does Treatment Look Like?
Both doctors say that the first symptom of endometrial cancer is typically vaginal bleeding that occurs between periods or post-menopause. Dr. Chirnomas says that other symptoms can include pelvic pain, bloating or changes in bowel or bladder habits. “It's crucial to note that these symptoms can be associated with other conditions as well. If a patient experiences any of these symptoms, particularly unexpected bleeding, they should consult their healthcare provider promptly,” she says.
If left untreated, endometrial cancer can have dire consequences. Dr. Ramirez says that this can include uncontrollable bleeding as well as the cancer spreading to other parts of the body. “This progression can lead to chronic pain, fatigue, weight loss and a range of complications depending on which organs are affected,” Dr. Chirnomas adds. When this happens, palliative care becomes the focus rather than treating the cancer.
The good news is that, when caught early, endometrial cancer is highly treatable. “Treatment for endometrial cancer typically involves surgery and may be followed by radiation therapy, chemotherapy or hormone therapy, depending on the stage and characteristics of the cancer,” Dr. Chirnomas says.
When endometrial cancer is caught in stages one or two, Dr. Ramirez says that treatment typically involves a total abdominal hysterectomy as well as a bilateral oophorectomy (a surgical procedure to remove both ovaries) with sentinel lymph node mapping (a procedure in which the sentinel lymph node is identified, removed and examined to determine whether cancer cells are present). “Most patients require only surgery and adjuvant treatment in the form of radiation is only recommended in about 15 to 20% of patients based on risk factors for recurrence,” Dr. Ramirez says.
If endometrial cancer is caught at an advanced stage, Dr. Ramirez says that treatment typically entails chemotherapy and immunotherapy with surgery as a consideration in the setting of favorable response to therapy.
Again, endometrial cancer is highly treatable when caught early. “There have been major strides in the research for treatment for endometrial cancer in the past five years and even patients with advanced disease have very favorable outcomes,” Dr. Ramirez says.
If you have a family history of endometrial cancer, obesity or a health condition connected to hormonal imbalance (like PCOS), talk with your healthcare provider about what you can do to mitigate your risk. Prevention and early detection are key!
Next up, learn more about what it means to have a hormone imbalance and the signs to look out for.
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