Women's Cancer Centre

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Uterus (Endometrial) Cancer

Uterus (Endometrial) Cancer

  • Patient with diagnosis of ovarian cancer
  • Partner, family member or relative of ovarian cancer patient

This information includes common symptoms, type, diagnosis of ovarian cancer and treatment you may be offered. Being diagnosed with ovarian cancer is distressful for patient and her close relatives; our team will guide and support you throughout cancer journey. This leaflet is to supplement the support you will get.  

Uterine cancer is cancer of endometrium which is the inner lining of the uterus. It is one of the most common types of female reproductive organs’ cancer.  There are two types of uterine cancer. Type 1 grows slowly while type 2 grows rapidly. Type 1 uterine cancer is most common out of these two types. Endometrial cancer is different from uterine muscle tumor, which is called sarcoma.

Uterine cancer occurs when cells of endometrium (inner lining of uterus) start to grow rapidly without any control. Uterine cancer most commonly occurs after menopause. Menopause is a term to suggest the time in a woman’s life when she stops having menstruation.

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Atypical hyperplasia (AH) or Endometrial intraepithelial neoplasia (EIN) is a condition which is associated with uterine cancer in 40-50% of cases. It is associated with 14-45 times increased risk for uterine cancer in future. Hence, this condition should be managed as a precancerous or cancerous condition. Abnormal uterine bleeding (AUB) is the most common symptom of EIN.

The most common symptom of uterine cancer is abnormal uterine bleeding (AUB, which patients experience as bleeding through vagina. Abnormal uterine bleeding includes:
  • Bleeding in between two menstrual cycles
  • Heavy bleeding through vagina during periods or menstruation
  • Any vaginal bleeding after attaining menopause

    These symptoms can be associated with other conditions that are not cancer. But if you have these symptoms, inform your doctor.

In most cases, the reason behind uterine cancer is unknown. However, there are factors that can be responsible for uterine cancer (Not having risk a factor doesn’t mean that you won’t get cancer or having risk factors doesn’t mean that you will get cancer).

  • Obesity (BMI >30)
  • Type 2 diabetes mellitus
  • History of polycystic ovarian syndrome
  • History of infertility, late menopause, early menarche
  • Genetic conditions like Lynch syndrome (HNPCC syndrome)
  • Family history of endometrial or colon cancer
  • Endometrial Hyperplasia
  • Hormone replacement therapy (estrogen only)

If you have vaginal bleeding after menopause or bleeding between two menstrual cycles, your doctor might suggest some test called Ultrasonography (USG) and Biopsy  of endometrial tissue.

During the biopsy procedure, the doctor will take a small sample from inner lining of the uterus. This is safe and not much painful. Another doctor (Pathologist) will look at this biopsy tissue under a microscope to see if cancer is present.

Ultrasound (USG) is a non-invasive and painless imaging test to see the uterus. This is to check for increased thickness of uterus lining. Increased thickness of uterine inner lining has more chance of its association with uterine cancer.

Preoperative tests  provide an idea of the cancer stage. But surgery for uterine cancer decides the final stage of cancer. Cancer stage gives an idea of how far the cancer has spread. Further treatment plans depend on the uterine cancer stage and how fast it is growing. Your age and other medical conditions will also influence the treatment plan.

Women with uterine cancer have surgery for treatment and decide on cancer stage. Later on, further treatment with chemotherapy and radiotherapy is based on final cancer staging. Some women will require surgery only while others might need further treatment.

Your doctor will remove the uterus, ovaries and fallopian tubes during surgery. This surgery is called hysterectomy with B/L salphingo-oophorectomy. During surgery, the doctor will also look for other organs around the uterus to look for cancer spread and might remove other organs if necessary.

  • Chemotherapy–Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.
  • Radiation therapy–Radiation is basically X-ray/Photon rays that kill cancer cells. Radiation can be given through a machine that is outside the body or with a radiation source directly into the vagina.

After treatment, you will be checked every 3-month interval for the first 2 years after treatment. This close follow-up visit intended to see if the cancer comes back. Follow-up visits usually include blood tests, examination and imaging tests. If you have symptoms similar to the time of diagnosis, then tell your doctor.

If the cancer comes back or spreads, you might require more surgery, chemotherapy or targeted therapy. Your doctor will give you more information and suitable options for treatment in this situation.

If you have not yet gone through menopause and want to have a baby in future, talk with your doctor. A woman cannot get pregnant after a hysterectomy or radiation. Your doctor can discuss different options with you.

If uterine, colon, rectal, stomach and kidney cancer runs in your family, talk to your doctor. If you or your relatives have a diagnosis of hereditary non-polyposis colorectal cancer (HNPCC), then inform your doctor. There might be things that you can do to keep from getting cancer or early diagnosis.

It is important to follow all your doctors’ instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment. It is important to inform your doctor about any symptoms or side effects to follow his/her instructions carefully. Always express your expectations and feelings about treatment with your doctor. Anytime you are offered treatment plan, it is better to ask:

  • What are the benefits of this cancer treatment? Will it reduce or relieve my symptoms?
  • What are the side effects to this treatment?
  • What other treatment is there beside this plan?
  • What happens if I do not wish to have this treatment?

Uterus (Endometrial) Cancer – Patient Education​

Uterus cancer is a cancer that starts in the uterus. This condition is also referred to as endometrial cancer. Endometrial (Uterus) cancer begins from the cells of uterus inner lining. Watch this video to know about common myths in Endometrial cancer.


Most women have experienced abnormal vaginal bleeding. Hence, uterus (endometrial) cancer is often detected at in early stage. If endometrial (uterus) cancer is detected in early stage, then cure is possible by removing the uterus. Other symptoms are vaginal bleeding after menopause, bleeding between periods, and pelvic pain.

When to see Doctor?

Make an appointment with your doctor if you have any signs or symptoms.

Causes & Risk factors:

Till date, we don’t know what causes uterus cancer (endometrial cancer).

  • The most likely risk factor is genetic mutations. The genetic mutation change normal healthy cells into abnormal cell. The abnormal cells grow & multiply without any control. Additionally, they don’t die at a set time. The accumulating abnormal cells form a mass (tumor). Later on, Cancer cells invade nearby tissue and spread elsewhere in the body. This is called a metastasis of the tumor.

Risk factors are the conditions that increase the chances for development of the uterus (endometrial) cancer.

  • Conditions that increase the level of estrogen in your body.
  • PCOS (polycystic ovary syndrome)
  • Obesity
  • Diabetes
  • Taking hormones after menopause that contain estrogen but not progesterone.
  • Menstruation starts at an early age
  • Never having been pregnant
  • Older age
  • Hormone therapy for breast cancer (Tamoxifen)
  • Hereditary nonpolyposis colorectal cancer (HNPCC) syndrome


  • If you have not undergone a hysterectomy and you are postmenopausal – taking a combination of estrogen and progesterone can reduce the risk.
  • Oral contraceptive pills for atleast one year may reduce risk of uterus (endometrial) cancer.
  • Healthy lifestyle and maintaining a healthy weight.


Pelvis Examination: Your doctor carefully inspects the outer and inner portion of your genitals. He/she also inserts a instrument called a speculum into your vagina.

USG (Ultrasonography): This is noninvasive technique to see texture of endometrium . This will help in detection of uterus (endometrial) cancer.

Hysteroscopy: Hysteroscope is thin, fexible, lighted tube that doctor insert into the vagina. This allow doctor to see inside of the uterus.

Pipelle: It is an OPD procedure with very minimal pain. This include collection of cells from inside of the uterus.

Dilatation and Curettage: This procedure includes removal of tissue from inner lining of the uterus.


Different approaches are: Surgery, Radiation, Chemotherapy, Hormonal Therapy, Targeted Therapy, Immunotherapy, Supportive (Palliative) care, Sexual health and rehabilitation

Surgery: Treatment for uterine (endometrial) cancer is usually with surgery. Treatment for uterus cancer usually involves an operation to remove the uterus (Hysterectomy), fallopian tubes and ovaries (salphingo-oophorectomy). If you have not achieved the menopause, you will experience menopause once your ovaries are removed. You will not be able to become pregnant in the future once uterus is removed.

Radiation Therapy: It is another option. This therapy uses powerful energy beams, like X-rays and protons to kill cancer cells. Radiation therapy may also be recommended even after surgery as per final pathology report. Radiation therapy involves

  • Radiation from a machine outside your body.
  • Radiation placed inside your body.

Some patients require taking drug treatment for endometrial cancer. These treatments include Chemotherapy, Targeted therapy, Immunotherapy and Hormonal therapy.

Chemotherapy: Chemotherapy is a treatment that uses drugs to kill cancer cells. You may receive one or two drugs in combination. Chemotherapy is sometimes recommended after surgery if there are high risk factors. It can be used before surgery in advance stage to shrink the cancer.

Targeted therapy:   Targeted therapy are drugs that attack specific weakness of the cancer cells.

Immunotherapy: Immunotherapy helps Immune cells to fight with cancer cells. Cancer cells produce proteins that blind the immune system cells. Hence, Immune cells do not attack cancer. Immunotherapy works by interfering with protein so that they cannot bind with immune system cells. For uterus (endometrial) cancer, immunotherapy might be considered in advanced and recurrent cases.

Hormone therapy: It involves taking medication to lower the hormone levels in the body. As a result, cancer cells that depend on hormone might die.

Supportive (palliative) Care: Palliative care is specialized medical care that aims to provide relief from pain and other symptoms of illness. Palliative care is used while cancer treatment such as surgery, chemotherapy and radiation therapy. Palliative care team focuses to improve the quality of life for people with cancer and their families.

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