Endometrial Cancer

The Endometrium is the lining of the uterusย  —ย  see Diagram: Female Genital System.ย  Up to 2% of women in the U.S. will develop cancer there, usually after 60 years-old.ย  Itโ€™s rare before menopause, but does occur, especially in women with obesity, diabetes, those whoโ€™ve never been pregnant, or who go months without periods (not from birth control methods), and some very rare congenital conditions (Lynch or Cowden Syndromes).

The main symptom of Endometrial Cancer is abnormal bleeding.  After menopause, any bleeding at all is abnormal.  Before menopause, the main symptom is bleeding between periods, although for women >45, regular periods that become unusually heavy may be cause for concern.

Diagnosis is made by an endometrial biopsy, which is done in a regular office or clinic.ย  Itโ€™s somewhat uncomfortable or painful.ย  After menopause, one way to avoid it is to do an ultrasound, maybe even by injecting saline (normal fluid) into the uterus, to measure endometrial thickness (called a โ€œstripeโ€ in medical jargon).ย  If the thickness is <3-4 mm., and completely smooth, cancer would be very unlikely.ย  Endometrial thickness isnโ€™t reliable for women before menopause.

There are different ways to perform a biopsy.  The most common is by simple suction.  However, if thereโ€™s an abnormality in one spot on the ultrasound, suction may not work, and the woman would require scraping the endometrium by dilation & curettage (D&C).  This can be done in a hospital, or office / clinic, depending on the type of anesthesia used.  Another technique with the D&C is hysteroscopy, which is able to see the abnormal spot and obtain a biopsy directly from it.

As with all Cancer, treatment depends on the stage. It may include hysterectomy, radiation, and/or chemotherapy.  For the uncommon case of endometrial cancer in a young woman who still wants to have children, there are various options possible.

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