Doctor's Notes on Endometrial Cancer
Endometrial cancer is a type of cancer that begins in the lining tissue of the uterus. This lining tissue is known as the endometrium. While the exact cause of endometrial cancer is not understood, it is believed to be related to elevated levels of estrogen. Conditions known to increase a woman's risk of endometrial cancer include obesity, having given birth to few or no children, menstruation beginning at a young age, late menopause, a family history of uterine cancer, radiation to the pelvis, and taking estrogen therapy.
Abnormal vaginal bleeding after menopause is the most common symptom of endometrial cancer. Other associated signs and symptoms can include pelvic pain, pain during sexual intercourse, vaginal discharge, and painful urination.
Endometrial Cancer Symptoms
By far, the most common symptom of endometrial carcinoma is abnormal bleeding from the vagina.
- In women who have been through menopause, any vaginal bleeding is abnormal and should be evaluated by a doctor.
- In women who have not been through menopause or who are currently going through menopause, distinguishing normal menstrual bleeding from abnormal bleeding may be difficult. A heavier or more frequent period or bleeding between periods is sometimes linked to cancer in menstruating women. During the transient period of going through menopause, the menstrual period should become shorter and shorter and the frequency should become farther apart. Any other bleeding should be reported to a doctor.
The following symptoms are much less common and usually indicate fairly advanced cancer:
Endometrial Cancer Causes
The exact cause of endometrial carcinoma remains unknown, although several risk factors have been identified. Possessing one of these risk factors does not mean that a woman will develop endometrial cancer but rather that her risk of developing endometrial cancer is higher than that of another woman without the risk factor. Risk factors for endometrial cancer include the following:
- Obesity: Women who are more than 50 pounds over ideal weight have a 10-times greater risk of developing endometrial cancer than women of ideal weight. Body fat contains an enzyme which converts other hormones to estrogen, and women with excess fat have a higher level of estrogen than women without excess fat. The higher level of estrogen is believed to increase the risk of endometrial cancer.
- No pregnancies: Women who have never been pregnant have a two to three times higher risk than women who have been pregnant.
- Early puberty: Women who begin their periods before 12 years of age are at an increased risk. Early puberty increases the number of years that the endometrium is exposed to estrogen.
- Late menopause: Women who go through menopause after 52 years of age are at a higher risk of developing endometrial cancer than women who go through menopause earlier in life. Like early puberty, late menopause increases the number of years that the endometrium is exposed to estrogen.
- Treatment with unopposed estrogen: The risk of developing endometrial cancer is increased by several times in women who take estrogen replacement therapy without added progesterone.
- High level of estrogen: Women who have a high level of unopposed estrogen in the body are also at an increased risk. Several different conditions, such as polycystic ovarian syndrome, can cause a woman to have a high unopposed estrogen level.
- Treatment with tamoxifen: Women who have been treated with tamoxifen, a drug used to prevent and treat breast cancer, have an increased risk of developing endometrial cancer.
- Other cancers: Cancers of the breast, ovary, and colon are linked with an increased risk of endometrial cancer.
- Family history: Women who have a close relative with endometrial cancer have an increased risk of the disease.
The use of combination oral contraceptives (birth control pills) decreases the risk of developing endometrial cancer.
- Women who use oral contraceptives at some time have half the risk of developing endometrial cancer as women who have never used oral contraceptives.
- This protection occurs in women who have used oral contraceptives for at least 12 months.
- The protection continues for at least 10 years after oral contraceptive use. The protection is most notable for women who have never been pregnant.
Uterine fibroids are noncancerous tumors that grow along or within the walls of the uterus. They are primarily made up of smooth muscle cells, along with small amounts of other tissues. They range dramatically in size. Some fibroids are microscopic, whereas others may be eight or more inches across. On average, these tumors range from about the size of a large marble to a bit smaller than a baseball.
Sometimes fibroids are found alone, and other times they grow in clusters. Many of them grow, but others shrink or remain the same size as time passes.
To understand this most common noncancerous tumor in women of childbearing age, read along as we provide medically-reviewed information about symptoms, treatments, and pictures. Along the way you will learn sometimes surprising facts about these growths, arming yourself with useful information.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.