What is Endometrial cancer?
Endometrial cancer starts when cells in the lining of the uterus become abnormal. This type of cancer is most often seen in women who are post-menopausal, and is more common in Black women.
Signs and Symptoms
The most common symptom of endometrial cancer is abnormal vaginal bleeding. Bleeding can range from light spotting to heavy bleeding. This can include bleeding between menstrual cycles, or bleeding after menopause, after menstrual cycles have stopped. Other symptoms of endometrial cancer include:
- Pelvic pain
- Unintentional weight loss
- Pelvic mass
Diagnosis
If someone presents with symptoms concerning for endometrial cancer, testing will likely be done to evaluate the cause. This can start with a pelvic exam, where the practitioner examines the vagina and uterus, looking for signs of a tumor.
An ultrasound is a commonly ordered test. This can be done externally as well as through the vagina, to fully evaluate the uterus. The ultrasound waves can evaluate the thickness of the uterine lining and measure the size of the uterus and any masses, if present.
Ultimately a biopsy will need to be done of any abnormal tissue, to test for the presence of cancer cells. A biopsy can be done in a number of ways. One way can be done in the gynecologist office, where a sampling tool is placed into the uterus through the vagina and cervix. The tool then suctions some of the abnormal tissue out to be evaluated for cancer.
Another way to biopsy the uterine lining is through dilation and curettage (D&C). During this procedure, often done with anesthesia, the cervix is dilated and more uterine lining is scraped away for testing.
Once a diagnosis of endometrial cancer is made, the cells are further tested for genetic changes that may or may not be present, that can help the oncologist develop a treatment plan.
Imaging tests such as x-rays, CT scans, or PET scans may be done to see if endometrial cancer has spread into lymph nodes or other areas of the body.
CA-125 is a substance that can be released by endometrial cancers, and may be evaluated through a blood test. This may be part of the workup for endometrial cancer, and may be followed after treatment has been given. An elevated CA-125 is not diagnostic of endometrial cancer on its own, so it is used in combination with imaging studies to evaluate the presence of endometrial cancer.