Symptoms Of Endometrial Cancer 

Endometrial cancer often presents with subtle signs that are easy to overlook, but spotting them early can greatly improve outcomes. Common symptoms can include:

• Abnormal vaginal bleeding or spotting, especially after menopause
• Unusual vaginal discharge that is watery, blood-tinged, or foul-smelling
• Pelvic or lower abdominal pain 
• Pain during urination or sexual intercourse
• Unintentional weight loss
• Bloating
• Constipation
• Diarrhea

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Causes Of Endometrial Cancer

Endometrial cancer develops when cells in the lining of the uterus (endometrium) start to grow uncontrollably due to genetic and hormonal changes. If not detected early, it can grow deeper into the muscle wall of the uterus (myometrium) and spread further.

How does endometrial cancer spread in the body?

• Local spread: It may extend into nearby areas, such as the cervix or pelvic tissues.

• Lymphatic spread: Cancer cells can travel through lymph vessels to nearby lymph nodes.

• Ovaries and fallopian tubes: The cancer can also spread upward through lymphatic channels.

• Abdomen and pelvis: In advanced stages, it may reach the peritoneum and other pelvic organs.

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The detailed explanation of what increases this risk is discussed in the next segment.

Risk Factors For Endometrial Cancer

Endometrial cancer risk is shaped by a mix of hormonal, genetic, lifestyle, and metabolic factors, like:

1. Hormone-related

• Estrogen-only replacement therapy (HRT)
• Estrogen-secreting tumors (rare)
• Chronic anovulation (not releasing eggs regularly)
• Tamoxifen therapy (breast cancer drug with estrogen-like effect on the uterus)
• Early menarche (periods starting young)
• Late menopause (menopause happening later)
• Infertility / menstrual disruption/amenorrhea (skipped periods).

2. Metabolic and health conditions

• Obesity 
• Type 2 diabetes 
• Type 1 diabetes
• Polycystic ovary syndrome (PCOS)
• Hyperinsulinemia and metabolic syndrome

3. Genetic and hereditary factors

• Lynch syndrome 
• Cowden syndrome
• Family history of endometrial, ovarian cancer, or colorectal cancer
• History of breast cancer

4. Lifestyle factors

• Increased body mass index (BMI)
• Poor diet
• Sedentary lifestyle
• Alcohol consumption

5. Demographic factors

• Women after menopause (55+)
• People of African descent.
  
  

Diagnosis Of Endometrial Cancer

Detecting endometrial cancer early might impact the prognosis. Diagnosis consists of:

History and physical exam

• Doctors ask about symptoms (like abnormal bleeding), lifestyle, and family cancer history. 

• Genetic counseling may be advised if there’s a strong family link like Lynch syndrome.

Endometrial biopsy 

• This is the gold standard test. 

• A small tissue sample is taken from the uterus lining for lab analysis

When is it recommended?

• Any vaginal bleeding after menopause

• Women ≥35 with persistent irregular bleeding

• Women with risk factors (obesity, PCOS, family history, tamoxifen use, Lynch syndrome)

• Abnormal ultrasound findings (like thickened lining ≥4 mm after menopause)

Imaging tests 

• Ultrasound transvaginal: It checks the thickness and appearance of the uterine lining.

• MRI pelvis: Gives a clear picture of the uterus and nearby tissues to check if the cancer has spread locally.

• CT scan: Shows whether the cancer has spread to lymph nodes, abdomen, chest, or other distant areas.

• PET CT scan: Detects cancer activity in the body by highlighting areas where cancer cells are more active.

Blood tests

• Complete blood count (CBC): This is a simple blood test that checks for anemia or other effects of prolonged bleeding.

• Genetic or molecular tests: This test helps classify the cancer more precisely and guide treatment planning.

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Staging of endometrial cancer

Staging describes how far the cancer has spread: 

• Stage I: Cancer is only in the uterus

• Stage II: Cancer has spread to the cervix

• Stage III: Cancer has reached nearby tissues, ovaries, fallopian tubes, vagina, or lymph nodes

• Stage IV: Cancer has spread to the bladder, bowel, or distant organs like the lungs, liver, etc.

Specialist To Visit

A gynecologist is usually the first doctor to evaluate symptoms like abnormal bleeding. They may refer you to the following specialists:

• Gynecologic oncologist
• Medical oncologist
• Radiation oncologist
• Pathologists
• Genetic counselor
  
  

A gynecologic oncologist is a specialist in cancers of the female reproductive system, best for diagnosis confirmation and treatment planning.

A medical oncologist provides chemotherapy or targeted therapy if needed.

A radiation oncologist manages cases that require radiation therapy.

A pathologist examines tissue samples under a microscope to confirm diagnosis, determine cancer type, and guide the treatment plan for endometrial cancer.

A genetic counselor may be recomended if you have a family history of cancers like Lynch syndrome.

When to see a doctor?

See a doctor if you notice:

• Unusual vaginal bleeding
• Heavy or prolonged periods 
• Abnormal vaginal discharge
• Pelvic pain or pressure that doesn’t go away
• Difficulty urinating, constipation, or bloating with no clear reason.

If these symptoms persist, consult a gynecologist promptly for evaluation.
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Prevention Of Endometrial Cancer

You may not be able to completely avoid endometrial cancer, but small lifestyle and health choices can go a long way in protecting you. Tips that can help:

Stay Active

• Extra body fat increases estrogen levels, which fuels cancer growth in the uterus. 

• Regular exercise and keeping your weight in check greatly reduce this risk.

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Use hormones for protection

• Birth control pills (with both estrogen and progesterone) can lower the risk.

• Hormonal IUDs (like the levonorgestrel IUD) protect the uterus by balancing hormone levels.

Breastfeed your babies

• Having children and breastfeeding reduces lifetime risk by naturally balancing hormone exposure.

Adopt a plant-focused diet

• Eating plenty of vegetables and following a Mediterranean-style dietary pattern have been linked with a lower risk of endometrial cancer. 

Prioritize Vitamin C

• A genetic study found that higher levels of circulating vitamin C are associated with reduced endometrial cancer risk. 

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Consider weight loss

• Significant weight loss, including through bariatric surgery if eligible, can cut the risk by up to 60%.

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Treatment Of Endometrial Cancer

Endometrial cancer treatments are tailored to each individual based on how advanced the cancer is. Early-stage disease is often curable with surgery, while more advanced cases may benefit from additional therapies. These include:

1. Surgery

• Hysterectomy: This is the surgical removal of the uterus, which is where endometrial cancer begins. 

• Bilateral salpingo-oophorectomy (BSO): This procedure removes both ovaries and fallopian tubes. With this, the main source of estrogen is cut off, which can fuel cancer growth. 

• Lymph node sampling/dissection: The surgeon removes a few lymph nodes near the uterus to check if cancer has spread beyond the womb. 

2. Radiation therapy

• External beam radiation: It uses high-energy X-rays from outside the body to target and kill cancer cells in the pelvis.

• Vaginal brachytherapy: In this therapy, a small radiation source is placed inside the vagina to directly treat the area where cancer is most likely to return.

3. Chemotherapy

• Often used along with surgery for high-risk or advanced tumors, and may be administered before surgery to shrink the tumor or afterward to lower recurrence risk. Common drugs include:

  • Carboplatin
  • Paclitaxel
  • Cisplatin
  • Ifosfamide

4. Hormone therapy

• Suitable for select cases where cancer cells are hormone-sensitive

• This treatment lowers estrogen activity to slow tumor growth, especially valuable in advanced or recurrent settings.

5. Newer advancements

• Targeted therapy: this therapy works by blocking the pathways; targeted drugs can slow down or even stop the cancer while usually causing fewer side effects. Examples include:

  • Lenvatinib 
  • Everolimus

• Immunotherapy: It is especially used in tumors with mismatch repair deficiency (dMMR), reducing disease progression significantly. Drugs used are:

  • Pembrolizumab
  • Dostarlimab

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Home-care For Endometrial Cancer

Supportive measures to manage symptoms of endometrial cancer and its treatment should never replace conventional treatment. Always consult your doctor before trying anything new. 

Practical home-care tips include:

1. For nausea and appetite loss 

• Ginger in the form of tea, chews, or capsules has shown effectiveness in reducing chemotherapy-related nausea.

• Eating small, frequent meals and avoiding greasy foods may also help.

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2. For sleep problems 

• Chamomile tea has been studied for sleep improvement in people with cancer.

• Gentle yoga, meditation, or deep-breathing exercises before bedtime can calm the mind and promote better rest.

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3. For pain or pelvic discomfort

• Heat therapy with a warm compress or heating pad can ease cramps or muscle stiffness

• Gentle yoga or stretching may improve mobility and reduce pain perception.

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4. Vaginal dryness

• Use of water-based or silicone lubricants can reduce discomfort

• Pelvic floor exercises like Kegels may help with bladder control and sexual function.
  
  

Complications Of Endometrial Cancer

While treatments like surgery, chemotherapy, and radiation can save lives, they may also cause side effects that impact daily living and long-term health. Some common ones include:

• Lymphedema: Swelling in legs or arms due to fluid build-up after lymph node removal or radiation.

• Neurotoxicity: Nerve damage from chemotherapy, causing numbness, tingling, or pain.

• Fatigue: Persistent tiredness that doesn’t improve with rest.

• Bowel and bladder dysfunction: Changes like diarrhea, constipation, or frequent urination after radiation or surgery.

• Decreased quality of life: Emotional distress, reduced mobility, or challenges in resuming normal activities.

• Osteoporosis: Weakened bones and higher fracture risk after hormone changes or surgery.

• Severe vasomotor symptoms: Hot flashes and night sweats due to surgical menopause.
  
  

Alternative Therapies For Endometrial Cancer

Complementary approaches are meant to support recovery and well-being, and they should never replace conventional treatment for endometrial cancer. Always consult your doctor before starting any complementary therapy. Therapies that can help include:

Massage and integrative rehab approaches

Gentle massage and rehabilitation therapies can ease fatigue, improve circulation, and help relaxation. When done by trained professionals, they may also reduce stress and promote overall comfort.

Physical activity and weight management

Light to moderate exercise like walking or yoga helps fight fatigue, strengthen muscles, and boost mood. Maintaining a healthy weight may also lower recurrence risk and improve treatment tolerance.

Mind–body therapies 

Practices like Cognitive behavioral therapy (CBT) , mindfulness, yoga, and tai chi can calm the mind, reduce anxiety, and improve sleep quality. They also support emotional resilience and help individuals cope better during and after treatment.

Acupuncture and acupressure

By stimulating specific points on the body, acupuncture or acupressure can relieve pain, hot flashes, and nausea. Many individuals also find that it enhances relaxation and reduces stress.

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Living With Endometrial Cancer

Endometrial cancer and its treatment can impact your day-to-day life, affecting physical health, energy levels, and emotional well-being. Living with it may bring challenges and tips that can help include:

Take care of yourself

• Preparing for endometrial cancer treatment can feel overwhelming, but focusing on self-care helps your body cope better

• Maintain a balanced diet rich in fruits, vegetables, and protein

• Ensure you get restful sleep and practice stress-relieving activities like meditation or gentle yoga

• Consult your doctor for personalized tips to prepare your body for surgery, radiation, or chemotherapy.

Conserve your energy

• Fatigue is common during treatment, so managing energy is essential

• Prioritize important tasks and delegate or ask for help from family or friends

• Take short breaks throughout the day and pace activities to avoid overexertion

Cope with emotions

• Endometrial cancer can bring emotional challenges

• Share your feelings with friends, family, or mental health professionals

• Connect with others undergoing similar experiences through support groups or online communities.

Manage the cost of cancer care

• Cancer treatment can be expensive, but planning can reduce stress

• Discuss financial concerns openly with your healthcare provider

• Explore assistance from organizations that provide help with treatment, travel, housing, and related expenses.

Prepare for treatment

• Prehabilitation can help improve outcomes and recovery

• Engage in light physical activity approved by your doctor

• Strengthen mental resilience through counseling, mindfulness, or relaxation exercises.

Continue follow-up care

• First 2 years after treatment: Visits every 3–6 months

• Years 3–5: Visits every 6–12 months

• After 5 years: Annual checkups may be sufficient, depending on your doctor’s advice.

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