endometrial cancer

overview

Endometrial cancer is cancer of the lining of the uterus, or endometrium. It’s the most common type of uterine cancer. Most of these cancers are found before spreading outside of the uterus and are considered highly curable.

symptoms

Endometrial cancer symptoms include: 

  • Unusual vaginal bleeding, spotting or discharge (especially after menopause)
  • Painful urination and unusual pelvic pain
  • Unexplained weight loss
  • Painful intercourse
  • A lump or mass in your abdomen that you can feel. 
Even if you don’t have symptoms, if you’re at high risk for endometrial cancer (or hereditary nonpolyposis colorectal cancer), ask about getting an annual endometrial biopsy to check for endometrial cancer. A typical screening may include a biopsy, in which a sample of uterine cells is taken through a thin, flexible tube inserted through your vagina and then examined under a microscope. It may also include a transvaginal ultrasound, in which an ultrasound probe is inserted into your vagina to detect abnormalities in your uterus.

diagnosis

If your doctor suspects you have endometrial cancer, he or she may recommend some tests, which may include:

Hysteroscopy, where a tiny viewing scope is inserted through your vagina and cervix to view the inside of the uterus.

Dilation and curettage (D&C), a biopsy in which an instrument is inserted through your vagina into the uterus, where it scrapes away the inside lining of the uterus.

Ultrasound measures the thickness of the uterine lining.

Cystoscopy or proctoscopy checks if cancer has spread to your urethra, bladder or rectum.

Computed tomography scan (CT) can confirm the presence of a tumor and also show its precise location, size and whether it’s spread to other tissue.

Magnetic resonance imaging (MRI) images are used to view biochemical changes in the body to detect cancerous tumors, particularly those that have spread outside the uterus. 

Positron emission tomography (PET), where a specific dye injected into your vein highlights cancer cells growing anywhere in the body.

CA-125 test, a blood test looks for elevated levels of a substance that could indicate the presence of cancer.

Other tests include chest X-rays, a special X-ray of the urinary system (intravenous pyelogram) and various blood tests.

treatment options

Endometrial cancer treatment options include surgery, radiation and chemotherapy. Your doctor will discuss a treatment plan that best suits your needs.

Surgical treatment options include:

  • Open surgery: A several-inch long incision in your abdomen is made. We can then do a simple hysterectomy, which removes your uterus and cervix; a total hysterectomy, which removes your uterus, cervix, fallopian tubes and ovaries; or a radical hysterectomy, which removes your uterus, cervix, fallopian tubes, ovaries and tissue around the uterus and cervix.
  • Vaginal hysterectomy: The uterus is removed through a small incision at the top of your vagina.
  • Laparoscopy: This minimally invasive procedure can be done to remove some cancers or sample lymph nodes to see if the cancer has spread. Because it involves only a few very small incisions to allow a viewing scope, camera and special surgical instruments to be inserted, it causes less pain and faster recovery. Your uterus may still be removed through a small incision at the top of the vagina.
  • Robotic surgery: This minimally invasive procedure is similar to a laparoscopy, but your doctor will be using robotic arms and a greatly magnified view on a computer screen.  

After surgery, you may have chemotherapy or radiation therapy to kill any remaining cancer cells. Or, you may have chemo or radiation before surgery, to shrink the tumor first. Your doctor may also recommend hormone therapy, which is injections or pills that work to prevent or slow the growth of endometrial cancer, by blocking the hormones it needs to grow. 

Types of radiation used include:

  • External beam radiation: A special machine sends beams of high-energy X-rays through your skin to target and kill cancer cells. 
  • Brachytherapy: Small amounts of radioactive material are inserted into or around the cancer, typically through the vagina. It is more targeted, so it affects less healthy tissue than external beam radiation. 
  • Chemotherapy (systemic anti-cancer) drugs can be given by mouth or injected through a vein. They affect your whole body to help control the spread of cancer to other organs.

what to expect

Most often, endometrial cancer treatment prevents women from getting pregnant later. Talk to your doctor if fertility is important to you. He or she will discuss options that may help preserve your fertility. 

Also, it’s important to note that removing your ovaries and uterus – via surgery – will cause the onset of menopause. Your doctor can help address any concerns you may have about this.

treating your cancer, caring for you.

Our musculoskeletal oncology program is located at Aurora St. Luke's Medical Center in Milwaukee. We treat all kinds of musculoskeletal cancer, including adult and pediatric bone and soft-tissue tumors and metastatic bone disease.

Team members include an orthopedic surgical oncologist, radiologist, radiation oncologist, medical oncologist, plastic surgeons and a physical therapist.

In addition to top-notch medical care, Aurora offers patients:

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