Am Fam Physician. 2003;67(11):2369-2370
What should I watch for?
Cancer of the lining of the uterus (or womb) is called endometrial cancer. The most common sign of endometrial cancer is unusual bleeding from your vagina, especially bleeding after you have already gone through menopause.
You can increase the chances that endometrial cancer will be found early by having any unusual bleeding checked by your doctor right away. Endometrial cancer can almost always be treated successfully if it is caught early.
Am I at risk for endometrial cancer?
Certain things may put you at greater risk for getting endometrial cancer. One thing is age. Endometrial cancer is most common in women who are 50 to 60 years of age and older.
You also may be at greater risk if you have had high levels of estrogen in your body. Many things can increase your estrogen level. These include being extremely overweight, having high blood pressure, or having diabetes.
Using estrogen therapy without taking progestin is also related to a greater risk for endometrial cancer. Taking progestin seems to offset this risk from the estrogen. In fact, using birth control pills that contain estrogen and progestin during the childbearing years seems to decrease a woman's risk of endometrial cancer.
Other things that may put you at greater risk for endometrial cancer include having your first period before the age of 12 or going through menopause after the age of 52. Women who have never been pregnant and women who use a medicine called tamoxifen also may be at greater risk.
How is endometrial cancer diagnosed?
Endometrial cancer can be diagnosed by using endometrial biopsy or by dilatation and curettage (D & C) of the uterus. Both procedures can be effective.
What is an endometrial biopsy?
An endometrial biopsy is usually done in your doctor's office. It involves inserting a very thin suction device into your uterus to remove a bit of the lining. This sample is then tested in a lab to check it for cancer.
General anesthesia is not needed, but you may be given a mild sedative to help you relax. You may have cramping or spotting after the procedure. Your doctor may give you medicine for these problems.
Pregnant women should not have an endometrial biopsy. Tell your doctor if you think you could be pregnant.
What does a D & C involve?
A D & C can be done in your doctor's office or as an outpatient procedure at the hospital. It involves dilating (stretching) the cervix (the opening to the uterus) and then scraping or suctioning out the entire lining of the uterus. The lining is then sent to a lab to be tested.
You may be given a local anesthetic (numbing medicine) or general anesthesia (puts you into a sleep-like state) for a D & C. This procedure is highly useful in diagnosing endometrial cancer. D & C can sometimes even be helpful as a treatment of abnormal uterine bleeding because it may remove the tissue that is causing problems.
You may bleed for a short while after the procedure, and you may notice some cramping. Your doctor may suggest that you not use tampons during this time and that you avoid having sex for a short while.
What is the treatment for endometrial cancer?
Treatment usually involves removing the uterus, the fallopian tubes, and the ovaries. You also may need to take progestin to offset high levels of estrogen. Sometimes radiation therapy or chemotherapy is needed. Treatment can be highly effective, especially if the cancer is found early.