Uterine cancer: How to spot the signs and reduce your risk

August 17, 2017 | by Katie Neith

Thanh H Dellinger Thanh H. Dellinger, M.D.
Each year, more than 60,000 women are diagnosed with uterine cancer in the United States. While it’s not a particularly common cancer, rates are rising – and so, too, are mortality rates associated with the disease, said Thanh H. Dellinger, M.D., a gynecologic oncologist and assistant professor in the Division of Gynecologic Oncology in the Department of Surgery at City of Hope.
 
The most common types of uterine cancer begin in the endometrium or the lining of the uterus. For that reason, the terms “uterine cancer” and “endometrial cancer” are often used interchangeably.
 
The good news: When it’s caught early, treatments for uterine/endometrial cancer tend to be very successful. Read on to learn how to reduce your risk and spot the warning signs.
 
Diagnosing uterine cancer
Uterine cancer usually affects women after menopause. Being overweight or obese increases the risk, Dellinger said.
 
Unlike ovarian cancer, which is often called a “silent disease” because it develops with few symptoms, uterine cancer usually exhibits warning signs. “Most women who develop uterine cancer have vaginal bleeding that is abnormal,” said Dellinger. Irregular bleeding means either unexpected bleeding after menopause or irregular or heavier bleeding in women who still have periods, she explained.
 
If a woman has abnormal bleeding, she can be tested for signs of cancer or pre-cancerous changes with an endometrial biopsy, Dellinger said. The five-minute procedure involves taking a sample of cells from the uterine lining and can be done during a regular office visit.
 
In postmenopausal women, ultrasounds can also help detect a thickened uterine lining, which can be a warning sign of the disease. (Ultrasounds are less effective for diagnosing uterine cancer in younger women since menstrual periods can cause the uterine lining to thicken.)
 
Treating uterine cancer
Most of the time, women are diagnosed with uterine cancer in the early stage of the disease, Dellinger said. The typical treatment involves a hysterectomy to remove the uterus, cervix and usually both ovaries and fallopian tubes.
 
“Frequently we’re able to do a robotic-assisted, or laparoscopic, surgery," a minimally invasive approach that reduces postoperative pain and improves recovery time, Dellinger said.
 
Depending on the stage of the cancer, some women might require radiation or chemotherapy after surgery. But that’s the exception rather than the rule.
 
“The vast majority of patients are treated and diagnosed at stage one endometrial cancer, and they’re cured with the hysterectomy and the removal of the ovaries and tubes alone,” she said.
 
Novel treatments
Surgery isn’t always the first line of care. In some young women who have signs of pre-cancerous cells in the endometrium and want to preserve their fertility, doctors may prescribe the hormone progesterone to slow the development of the cancer.
 
Researchers at City of Hope are also developing new therapies for patients who have more advanced uterine cancer. Those novel treatments include immunotherapy, which aims to harness the body’s own immune system to fight the cancer, Dellinger said.
 
You can reduce your risk of uterine cancer by maintaining a healthy weight and keeping an eye out for abnormal bleeding. Because it’s so hard to treat in later stages, prevention and early detection are key, Dellinger added.
 
“If your menstrual cycles are abnormal – especially if you’re overweight – or if you’re menopausal and you have bleeding again, that’s not something that should wait. That’s something that should be evaluated by a gynecologist,” she said. 
 

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