Uterine/Endometrial – Foundation for Women's Cancer
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Uterine/Endometrial Cancer

This section will take you through the basics of what you need to know about endometrial cancer. It will introduce you to the people who may be part of your treatment team. Also, it will identify the different types of treatments for endometrial cancer. Hopefully, this information will help prepare you to talk with your treatment team and to feel more confident about your treatment plan.

Download a printable version of the information in this section with our brochure, Endometrial Cancer: Your Guide.

Endometrial Cancer Overview

Cancer occurs when cells in an area of the body grow abnormally. Endometrial cancer is cancer of the lining of the uterus (called the endometrium). The uterus (or womb) is where a baby grows during pregnancy. The fallopian tubes and ovaries are on both sides of the uterus. The cervix is the mouth of the uterus (or womb) that connects it to the vagina. These reproductive organs are located in the pelvis, close to the bladder and rectum.

The endometrium is the inside lining of the uterus that grows each month during the childbearing years. It does this so that it will be ready to support an embryo if a woman becomes pregnant. If pregnancy does not occur, the endometrium is shed during the menstrual period.

Symptoms

The most common warning sign for uterine cancer, including endometrial cancer, is abnormal vaginal bleeding. Recognition of this symptom often affords an opportunity for early diagnosis and treatment. In older women, any bleeding, spotting, or brownish discharge after menopause may be a symptom of endometrial cancer. Younger women are also at risk and should note irregular or heavy vaginal bleeding as this can be a symptom of endometrial cancer.

Medical Evaluation and Diagnosis

When a woman experiences concerning symptoms, a pelvic exam, including a rectovaginal exam, and a general physical should be performed. If the exam is abnormal or she presented for abnormal vaginal bleeding, the woman should undergo an endometrial biopsy, an ultrasound and/or a D&C (dilation and curettage) procedure.

If endometrial cancer is suspected or diagnosed, it is important to seek care first from a gynecologic oncologist—medical doctors with specialized training in treating gynecologic cancers who can manage your care from diagnosis to completion of treatment. Use our Seek a Specialist tool to find a gynecologic oncologist in your area.

Seek a Specialist

During your treatment, you will come in contact with many health care professionals—these people make up your treatment team. They will work with each other and you to provide the special care you need. Learn more about your treatment team.

Surgical Staging

Though the majority of endometrial cancers are confined to the uterus, your treatment team may recommend more tests to determine if the cancer has spread. Additionally, specific procedures during surgery may be performed to determine the extent of disease. This process is called staging. Staging helps to determine the exact extent of your cancer and the best treatment plan for you.

Following surgery, your cancer will be categorized into Stage I, II, III, or IV. The cancer will also be assigned a grade. Grade refers to how abnormal the cells appear under a microscope. Low grade tumors, also called grade 1, have features that resemble normal endometrium cells. In contrast, in high grade tumors (grade 3) the microscopic appearance is greatly altered from normal.

Endometrial Cancer Stages

Stage I: The cancer is found only in the uterus. It has not spread to the cervix (opening of the uterus).

Stage II: The cancer has spread from the uterus to the cervix (opening of the uterus), but it has not gone any farther.

Stage III: The cancer has spread outside the uterus itself. It may have spread to nearby lymph nodes, ovaries, fallopian tubes, and vagina, but it has not gone outside the pelvic area. It has not spread to the bladder or rectum.

Stage IV: The cancer has spread into the bladder or rectum and/or to other body parts outside the pelvis, such as the abdomen or lungs.

Treatment Types and Side Effects

Endometrial cancer may be treated with surgery, radiation therapy, chemotherapy, or hormonal therapy. Depending on your situation, your treatment team may recommend using a combination of therapies to treat your cancer.

All treatments for endometrial cancer have side effects, but most side effects can be managed or avoided. Treatment may affect various aspects of your life, including your function at work, home, intimate relationship, and deeply personal thoughts and feelings.

Before beginning treatment, it is important to learn about the possible side effects and talk with your treatment team members about your feelings or concerns. They can prepare you for what to expect and tell you which side effects should be reported to them immediately. They can also help you find ways to manage the side effects that you experience.

Understanding the goals of treatment

As you begin your treatment, make sure that you understand what to expect. Is this for cure? What are the chances of cure? If there is no cure, will the treatment make me live better or longer? It is very important to understand the truth about what to expect from the treatment—and what are the potential costs of side effects, expenses, etc.—so that you can make the best decisions for yourself and the life you want to lead.

Importance of participation in clinical trials

There are many ongoing clinical trials studying new and better ways to treat endometrial cancer. Many treatment options are available today because women diagnosed with endometrial cancer were willing to participate in prior clinical trials.

Clinical trials are designed to test some of the newest and most promising treatments for endometrial cancer. The Foundation for Women’s Cancer (FWC) partners with NRG Oncology (formerly Gynecologic Oncology Group), part of the National Cancer Institute cooperative group working only on gynecologic cancer clinical trials, and others to make information about current clinical trials available. For more information about clinical trials available for enrollment, visit ClinicalTrials.gov.

Endometrial Cancer Treatment Types

Follow up after treatment

The frequency of exams, imaging, and blood tests varies because of many factors. Typically, you will be followed every 3 to 6 months for the first 2 years with at least an examination of the vagina and rectum to detect any recurrences early at the most curable stage. These examinations will occur less frequently thereafter. In addition, imaging studies such as x-rays, CT scans, or MRIs may be periodically performed, especially if you have any new pains or symptoms. The top of the vagina is the most common site of recurrent endometrial cancer, and patients will typically present with vaginal bleeding.

Recurrent disease

If your cancer recurs, there are several options for treatment. These include repeat surgery, re-treatment with the same chemotherapy given initially, treatment with a different type of agent (chemotherapy, hormonal, or targeted therapy) and sometimes radiation therapy. As each recurrence will be different, it is important to discuss your individual situation with your team. It is also important to investigate whether there is a clinical trial that is appropriate for you. Don’t be afraid to seek a second opinion.

Isolated vaginal recurrences can often be cured so early detection and recognition of abnormal symptoms is critical. Notify your physician if you develop abnormal bleeding or other unusual pelvic symptoms following treatment for endometrial cancer.

It’s up to you to take charge of your reaction even as you face the unknown of cancer—nurturing hope helps you see the positive aspects of life.