Understanding this cancer
Endometrial cancer begins in the lining of the uterus. Most present with abnormal bleeding and are diagnosed at an early stage. Histologic type, grade, stage and molecular classification increasingly guide treatment.
Signs to discuss with a doctor
Any bleeding after menopause needs prompt assessment. Bleeding between periods, unusually heavy bleeding, watery discharge or pelvic pain also need evaluation.
Risk factors
Risk is associated with excess body weight, long exposure to oestrogen without progesterone, some medicines, diabetes, age and Lynch syndrome.
Tests and diagnosis
Transvaginal ultrasound may assess the uterine lining, but tissue sampling by endometrial biopsy or hysteroscopy confirms diagnosis. Imaging helps assess spread. Tumour testing can identify mismatch-repair or other molecular features.
Treatment approaches
Surgery is the main treatment for many localized cancers. Radiotherapy, chemotherapy, hormone therapy, immunotherapy or targeted treatment may be recommended according to recurrence risk, stage and molecular findings.
Prevention and screening
Maintaining a healthy weight and addressing metabolic health may reduce risk. There is no routine screening for average-risk people, so abnormal bleeding should not be ignored. Lynch syndrome carriers need specialist surveillance advice.
Questions for your care team
What are the type, grade, stage and molecular group? Is fertility-sparing treatment medically appropriate? Do I need lymph-node assessment, radiotherapy or drug treatment after surgery?