Am Fam Physician. 1999;59(11):3077
See related article on endometrial cancer.
What is endometrial cancer?
Endometrial cancer is an out-of-control growth of the lining of the uterus. It happens most often in women 50 to 60 years old. It is the fourth most common cause of cancer in women, after breast, lung and colon cancer.
What increases the risk of getting endometrial cancer?
Some of the risk factors for this cancer are:
High blood pressure
Obesity (being very overweight)
Diabetes
Problems with fertility (not being able to get pregnant)
Use of the medicine tamoxifen
Taking estrogen without progestin (in women who still have a uterus)
How does the doctor find out I have endometrial cancer?
Right now, there is no test that can find endometrial cancer at an early stage. However, these symptoms might suggest it:
Vaginal spotting or bleeding after menopause
Heavier vaginal bleeding
Bleeding between periods in women who are about to go through menopause
If you have gone to your doctor because of these problems, your doctor will probably do a pelvic exam to check for problems in your uterus. He or she will also want to take a sample of the lining of your uterus to look at under a microscope. The sample will show if you have any abnormal cells. This procedure is called an endometrial biopsy.
How does an endometrial biopsy work?
An endometrial biopsy is most often done in the doctor's office. A speculum is put into your vagina so that your doctor can see your uterus. A thin tube is put into your uterus, and a sample of the lining is taken. Most women have only a little pain during the procedure. Ibuprofen taken one hour before the biopsy helps.
The biopsy takes about five minutes. You may notice some bleeding afterward, and that is normal. If you have any pain, bleeding that doesn't stop or a bad-smelling discharge, call your doctor right away.
Pregnant women shouldn't get a biopsy. If you think you could be pregnant, tell your doctor.
How is endometrial cancer treated?
Endometrial cancer is usually treated with surgery to take out the uterus and the ovaries. During the surgery, the doctor will look to see if the cancer has spread outside the uterus. If it has, your doctor may treat you with hormones, radiation or chemotherapy.
When the cancer is found and treated early, the cure rate is better than 90%.