Endometrial cancer, also known as uterine cancer, is a type of cancer that originates in the lining of the uterus, called the endometrium. The endometrium undergoes cyclical changes throughout a woman’s menstrual cycle, thickening and shedding in response to hormonal fluctuations.
Endometrial cancer typically develops when there is an abnormal growth of cells in the endometrium. These cancerous cells can form a tumour within the uterus and, in some cases, may metastasize to nearby tissues of the body.
Endometrial cancer is common in the United States. Approximately 67 thousand new cases of uterine cancer (including endometrial cancer) are diagnosed yearly. It is more common in postmenopausal women, with the average age of diagnosis being in the early 60s. However, it can occur at any age.
Symptoms
Endometrial cancer can present with various symptoms, and it’s essential to recognize them because early detection can lead to better outcomes. Here’s an explanation of the symptoms you mentioned:
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Abnormal Vaginal Bleeding
Abnormal vaginal bleeding is one of the hallmark symptoms of endometrial cancer. It is often the most noticeable and concerning sign that prompts women to seek medical attention. Here’s a more detailed explanation of how abnormal it can be a symptom of endometrial cancer:
- Postmenopausal Bleeding: The most significant red flag for endometrial cancer is vaginal bleeding after menopause. Menopause is the cessation of menstrual cycle for at least 12 consecutive months. Any bleeding or spotting after this amenorrhea period should be investigated promptly, as it is considered a sign of endometrial cancer.
- Irregular Menstrual Bleeding in Pre-menopausal Women: In women who have not reached menopause, endometrial cancer can lead to irregular and often heavy menstrual bleeding that is unusual for their typical menstrual patterns. This bleeding may be characterized by prolonged periods or spotting between periods.
- Other Patterns of Abnormal Bleeding: Abnormal bleeding associated with endometrial cancer can take various forms, including:
- Heavy menstrual bleeding (menorrhagia).
- Bleeding between periods (metrorrhagia).
- Bleeding after sexual intercourse (postcoital bleeding).
- Abnormal bleeding in younger women who have not yet reached menopause.
It’s important to note that while abnormal vaginal bleeding can be an indication of endometrial cancer, it can also be caused by other conditions, such as uterine fibroids, hormonal imbalances, polyps, or infections. However, any unusual or persistent bleeding should be evaluated by a gynecologist to determine the underlying cause. Early detection and treatment of endometrial cancer can lead to better treatment outcomes.
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Pelvic Pain
Pelvic pain can be a symptom of endometrial cancer, although it is not always present, and its severity can vary among individuals. Here’s an explanation of how pelvic pain may be associated with endometrial cancer:
- Localized Discomfort: Women with endometrial cancer may experience a dull, aching, or cramping pain in the lower abdomen or pelvis. This discomfort is often localized around the uterus and may persist for an extended period.
- Pain During Menstruation: Some women with endometrial cancer report increased pelvic pain during their menstrual periods, particularly if the cancer has caused irregular or heavy bleeding.
- Pain During Intercourse (Dyspareunia): Pelvic pain can also occur during sexual intercourse, a condition known as dyspareunia. This pain may be related to the tumour’s presence or nearby tissues’ involvement.
- Advanced Disease: In advanced stages of endometrial cancer, pelvic pain may become more pronounced when the cancer has spread beyond the uterus and into surrounding structures. This can happen when the tumour infiltrates nearby organs like the bladder, rectum, or pelvic lymph nodes.
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Unexplained Weight Loss
Unexplained and sudden (over 6 months or fewer) weight loss can be a symptom of endometrial cancer, particularly when the cancer has reached more advanced stages. While it is not one of the most common symptoms associated with endometrial cancer, it can occur as the cancer progresses and affects the body’s metabolism and overall health.
Cancerous cells can alter the body’s metabolism, unintentionally causing the affected person to lose weight. The cancer may consume energy and nutrients, leading to weight loss even when the individual is not trying to lose weight. Advanced endometrial cancer can lead to a loss of appetite or changes in taste preferences, resulting in anorexia (anorexia (loss of appetite) and weight loss.
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Watery Vaginal Discharge
Watery vaginal discharge can sometimes be a symptom of endometrial cancer, although it is less common than other symptoms like abnormal vaginal bleeding. The watery discharge associated with endometrial cancer may be mixed with blood and have a foul odour. It typically occurs when cancerous cells within the endometrial lining or cervix cause changes in the normal vaginal secretions.
If you experience watery vaginal discharge, especially if it is persistent, unusual, or accompanied by other concerning symptoms like abnormal vaginal bleeding, or pelvic pain – it is essential to consult a gynecologist for a thorough evaluation.
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Pain during sex
Painful sex, also known as dyspareunia, can be a symptom associated with various medical conditions, including endometrial cancer. While a range of factors can cause pain during sex, it’s essential to consult with a gynecologist for a proper evaluation and diagnosis if you experience this symptom. Here are some potential reasons for painful sex in the context of endometrial cancer:
- Tumor Growth: Endometrial cancer can cause tumors to grow within the uterus. These tumors can affect the normal anatomy of the pelvic area and may lead to pain or discomfort during sexual intercourse.
- Vaginal Dryness: Cancer treatments such as radiation therapy and certain medications can lead to vaginal dryness. This dryness can make sex painful or uncomfortable.
- Scar Tissue Formation: Surgery to remove the uterus or other reproductive organs as part of cancer treatment can result in scar tissue formation (adhesions). These adhesions may cause pain during sexual activity.
- Hormonal Changes: Endometrial cancer and its treatments can cause hormonal imbalances. Hormonal changes can affect sexual desire and vaginal lubrication, potentially leading to pain during intercourse.
- Psychological Factors: A cancer diagnosis and treatment’s emotional and psychological impact can also contribute to sexual difficulties, including pain during sex.
If you are experiencing painful sex while undergoing treatment for endometrial cancer or have a history of this cancer and are experiencing such symptoms. In that case, it’s crucial to communicate with your healthcare team. They will identify the specific cause of your discomfort and provide appropriate treatment options.
Additionally, healthcare professionals can offer guidance on ways to manage sexual discomfort, including the use of lubricants and other strategies to enhance comfort and intimacy.
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Feeling a Mass (Tumor)
In some cases, a woman may be able to feel a lump or mass in her lower abdomen or pelvis. This can be a palpable tumour that has grown large enough to be noticeable. Feeling a mass or tumour in the lower abdomen or pelvis typically indicates that cancer has reached a more advanced stage. When endometrial cancer has grown and invaded surrounding tissues, it can cause the formation of a palpable mass or lump in the pelvic area. This mass may be noticeable to the woman or gynecologist during a physical examination.
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Fatigue
Fatigue can be secondary to various medical conditions, including endometrial cancer, but it is not specific to this cancer alone. While fatigue may not be one of the hallmark symptoms of endometrial cancer, some individuals with this cancer may experience fatigue as a secondary symptom or as a result of the cancer and its treatment.
Fatigue in the context of endometrial cancer may be related to several factors:
- Anemia: Endometrial cancer can sometimes lead to anemia, which can cause fatigue, weakness, and shortness of breath.
- Cancer Treatment: Treatment for endometrial cancer, such as surgery, radiation therapy, and chemotherapy, can be physically and emotionally draining, leading to fatigue as a common side effect.
- Stress and Anxiety: A cancer diagnosis and the associated treatments can be stressful and emotionally challenging, leading to feelings of fatigue and exhaustion.
- Pain and Discomfort: Endometrial cancer can cause pelvic pain and discomfort, which may contribute to overall feelings of fatigue.
- Sleep Disturbances: Many cancer patients experience sleep disturbances, which can exacerbate feelings of fatigue.
It’s important to note that fatigue can result from various causes, and it’s not exclusive to endometrial cancer. If you or someone you know is experiencing persistent fatigue, especially in conjunction with other symptoms or a history of endometrial cancer, it is essential to seek medical evaluation and discuss the symptoms with a healthcare provider. Proper diagnosis and optimal treatment are crucial to treat fatigue and provide appropriate care.
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Bloating or abdominal discomfort
Bloating or abdominal discomfort can be symptoms of endometrial cancer, although they are not the most common or specific symptoms associated with this type of cancer. In some cases, abdominal bloating or a feeling of fullness in the lower abdomen may occur. This sensation may be similar to the bloating experienced during menstruation or due to gastrointestinal issues.
Endometrial cancer can spread to nearby structures in the pelvis, including the ovaries, fallopian tubes, and the peritoneum. When this happens, it can cause pelvic pain, discomfort, or bloating. In advanced cases of endometrial cancer, the cancer cells can seed the peritoneal cavity, accumulating fluid called ascites. Ascites can cause abdominal distension, discomfort, and a feeling of fullness or bloating.
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Changes in bowel habits
While changes in bowel habits are not a direct or common symptom of endometrial cancer, they can occasionally occur due to advanced disease or when the cancer has metastasized (spread to nearby organs. As endometrial cancer progresses, it can invade nearby tissues and organs, including the colon and rectum. When the tumor affects these areas, it may change bowel habits. For example, it could cause constipation, diarrhea, or a feeling of incomplete bowel movements.
The growing tumor may pressure the nearby structures in the pelvic area, including the intestines. This pressure can affect bowel function and cause changes in bowel habits. In some cases, endometrial cancer can metastasize (spread) to other body parts, including the gastrointestinal tract. When cancer cells reach the colon or rectum, they can cause changes in bowel habits, such as bleeding, abdominal pain, and altered stool consistency.
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Pelvic Pressure or Fullness
Pelvic pressure or fullness can be a symptom of endometrial cancer, but it’s essential to understand that not everyone with endometrial cancer will experience these symptoms. As the cancer grows and progresses, it can cause various symptoms, including pelvic pressure or fullness. Here’s why these symptoms can occur in endometrial cancer:
- Tumor Growth: As cancer cells multiply and form tumors within the uterus, they take up space. This growth can create pressure or fullness sensations in the pelvic area.
- Enlarged Uterus: The cancer can cause the uterus to become enlarged. This can lead to a feeling of fullness in the lower abdomen or pelvis.
- Compression of Nearby Organs: As the tumor grows, it can compress or push against nearby organs, such as the bladder or rectum. This pressure can cause discomfort or a feeling of fullness.
- Fluid Accumulation: In some cases, endometrial cancer can accumulate fluid within the uterus or the space between the uterus and rectum (the pouch of Douglas). This can contribute to the sensation of fullness in the pelvis.
Of note, these symptoms can be caused by various conditions, and having one or more symptoms does not necessarily mean you have endometrial cancer. However, suppose you experience any of these symptoms. In that case, especially if they are persistent or unusual for you, it’s crucial to consult a gynecologist or oncologist for a thorough evaluation and appropriate testing, such as a pelvic examination, imaging studies, and endometrial biopsy, to determine the underlying cause and rule out or diagnose endometrial cancer. Early detection and tailored treatment (radiotherapy and chemotherapy) can significantly improve endometrial cancer prognoses.