The most common type of uterine cancer develops in the functional layer of cells that forms the inner lining of the uterus (endometrium). This dynamic tissue continually adjusts to hormonal changes that occur during a woman’s menstrual cycle. During reproductive years, the endometrium increases in thickness each month to prepare for the implantation of a fertilized egg. If pregnancy does not occur, the endometrium later sheds during menstruation. Outside of the reproductive years (menopause), it should be inactive and the bleeding should stop.
The symptoms of endometrial/uterine cancer are not always noticeable, and when they are, they can be like those of other, less serious conditions. For these reasons, it is important for a woman to become familiar with her body and what is normal for her, and to talk with a physician right away if she notices any unusual changes.
Early warning signs
The most common symptom of endometrial/uterine cancer is abnormal vaginal bleeding, which may occur in between menstrual periods or after menopause. Other symptoms include:
- Unusual vaginal discharge or spotting
- Pelvic pain or pressure
- Pain during urination
- Pain during sexual intercourse
- Unexplained weight loss
- Anemia
Risk factors
Endometrial/uterine cancer develops when cells in the uterine lining undergo abnormal changes that interfere with their ability to control their division and growth. The precise causes of these changes are not yet well understood within the medical community. Through research, however, scientists have identified certain factors that may increase a woman’s risk of developing endometrial/uterine cancer, including:
Increased estrogen exposure
A hormone that regulates the female reproductive system, estrogen can also fuel the growth of endometrial/uterine cancer. During each menstrual cycle, the endometrium is normally exposed to a controlled amount of estrogen. This is then balanced by another hormone in the second half of the cycle called progesterone, which protects the uterus and is necessary to have a normal period. Some premenopausal women may lack the correct production of progesterone due to obesity, hormonal disorders, or other medical conditions. This can lead to overgrowth by estrogen and the possible transformation into cancer. Women who are in menopause may be exposed to excess estrogen if her body produces too much (as in obesity or some estrogen producing tumors), has a uterus and uses estrogen-only therapy (rather than combined estrogen and progesterone) to relieve menopause symptoms, or takes tamoxifen to prevent or treat breast cancer.
Excess body weight
Being overweight or obese has been definitively linked to an increased risk of many types of cancer, including endometrial/uterine cancer. While the ovaries normally create and release sufficient amounts of estrogen, fatty tissue can also convert other naturally occurring hormones into estrogen, thereby increasing a woman's endometrial/uterine cancer risk. Furthermore, overweight individuals often have chronic low-level inflammation, causing DNA damage that may lead to the development of cancer over time.
Hereditary nonpolyposis colorectal cancer (HNPCC)
Also known as Lynch syndrome, HNPCC is an inherited condition that increases the risk of colon cancer as well as endometrial/uterine cancer and several other types of cancer. If a woman has a close relative who has been diagnosed with HNPCC, she should discuss her endometrial/uterine cancer risk profile with a physician and perhaps consider genetic testing.
Prevention
There are several proactive steps a woman can take to help prevent or reduce her risk of developing endometrial/uterine cancer, including:
- Bleeding that becomes irregular during the reproductive years, or that occurs at all during the menopausal years
- Maintaining a healthy, stable body weight throughout her life
- Exercising regularly
- Seeing a physician for routine gynecological checkups
- Using a hormone-based birth control method, such as oral contraceptives that combine estrogen and progesterone or a progestin-secreting intrauterine device (IUD)
- Using the correct post-menopausal hormone replacement therapy. For some women, even with a uterus, it may be reasonable to use estrogen-only therapy rather than by the combination, but the appropriateness, risks, and benefits need to be discussed with a physician before pursuing that option
- Learning about her family medical history and reviewing her cancer risk profile with a physician
Moffitt Cancer Center’s approach to endometrial/uterine cancer
If you have endometrial/uterine cancer symptoms, you are welcome to consult with a specialist in the Gynecologic Oncology Program at Moffitt Cancer Center. To ensure a streamlined patient experience, we offer comprehensive diagnostic, treatment and supportive care services in a single location.
As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt offers the latest options in endometrial/uterine cancer treatment, including a robust portfolio of clinical trials. As we continually contribute to the growing body of medical research, we are gaining a better understanding of endometrial/uterine cancer and achieving breakthroughs that directly lead to better patient outcomes and quality of life.
Medically reviewed by Robert Wenham, MD, Chair, Gynecologic Oncology Program
To learn more or request an appointment, please call 1-888-663-3488 or complete our new patient registration form online.