What is endometrial (uterine) cancer?

Endometrial cancer is the growth of abnormal cells in the lining of the uterus. The lining is called the endometrium. Endometrial cancer is also called cancer of the uterus, or uterine cancer.

Endometrial cancer usually occurs in women older than 50. The good news is that it is usually cured when it is found early. And most of the time, the cancer is found in its earliest stage, before it has spread outside the uterus.

When endometrial cancer comes back after treatment, you will probably have symptoms. These include:

• Bleeding from the vagina, bladder, or rectum.
• Decreased appetite.
• Weight loss.
• Pain in your belly, hip, or back.
• Cough.
• Shortness of breath.
• Swelling in your belly or legs.

If you have any of these symptoms, see your doctor right away and don't wait for your next scheduled appointment.

To check your symptoms, your doctor will ask about your medical history and do a physical exam. This will include a pelvic exam.

An endometrial biopsy is needed to confirm a diagnosis of endometrial cancer. A biopsy removes a small sample of the lining of the uterus (endometrium) to be looked at under a microscope.

Other tests may include:

• A transvaginal pelvic ultrasound. This uses sound waves to create images of the uterus. The images can show how thick the endometrium is. A thick endometrium can be a sign of cancer in postmenopausal women. Ultrasound also can help show whether cancer has grown into the uterine muscle.
• A hysteroscopy. This allows your doctor to view the inside of the uterus and get an endometrial tissue sample.
• Dilation and curettage (D&C). This test is done to get a sample of tissue from the inside of the uterus. It may be done at the same time as a hysteroscopy.

Testing for endometrial cancer may show that you have endometrial hyperplasia. This is not cancer but may develop into cancer.

Tests if cancer is found

If cancer is found, surgery is done to find out how much the cancer has grown (stage and grade) and to treat it at the same time.

Before surgery, an imaging test may be done to see if cancer has spread to the abdomen and pelvis. This helps with planning for treatment. Imaging tests may include a CT scan or an MRI.

Other tests done before surgery may include:

• A complete blood count (CBC) to check for anemia and other abnormal blood values.
• A cancer antigen (CA) 125 test. This test helps to identify cancer that has or may spread (metastasize).
• A chest X-ray to check for cancer cells that have spread (metastasized) from the uterus.

Treatment for endometrial cancer is based on the stage of the cancer and other things, such as your overall health. The main treatment is:

Surgery.

The most common type removes the uterus (hysterectomy) plus the fallopian tubes and ovaries (salpingo-oophorectomy). The doctor may also remove nearby lymph nodes and check other tissues for cancer.

Other treatment options may include:

Chemotherapy.

These medicines kill fast-growing cells, including cancer cells and some normal cells.

Radiation therapy.

This uses high-dose X-rays to destroy cancer cells and shrink tumors.

Hormone therapy.

These medicines block hormones that cause certain cancers to grow. This helps slow or stop cancer growth.

Targeted therapy.

These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading.

Immunotherapy.

This treatment helps your immune system fight cancer. It may be given in several ways.

Your doctor will talk with you about your options and then make a treatment plan.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Follow your doctor's instructions to relieve pain. Pain from cancer and surgery can almost always be controlled. Use pain medicine when you first notice pain, before it becomes severe.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss.
• Get some physical activity every day, but do not get too tired.
• Get enough sleep, and take time to do things you enjoy. This can help reduce stress.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.
• If you are vomiting or have diarrhea:
  • Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • When you are able to eat, try clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Take care of your urinary tract to prevent problems that can be caused by endometrial cancer and its treatment. Limit drinks with caffeine, drink plenty of fluids, and urinate every 3 to 4 hours.
• If you have not already done so, prepare a list of advance directives. Advance directives are instructions to your doctor and family members about what kind of care you want if you become unable to speak or express yourself.