ENDOMETRIAL CANCER
Christopher Putney, MD
Strasburg Family Health Center

"Reprinted From Lancaster County Woman Newspaper."

Cancer of the lining of the uterus is called endometrial cancer.  The most common sign of endometrial cancer is unusual bleeding from the vagina, especially bleeding after you have been through menopause.  You can increase the chances that endometrial cancer will be found early by having any unusual bleeding checked by your doctor.  Endometrial cancer can almost always be treated successfully if it is caught early.

There are several risk factors for endometrial cancer. One risk factor is age.  Endometrial cancer is most common in women who are 50 - 60 years of age and older. You may also be at risk if you have high levels of estrogen in your body. Being extremely overweight, having high blood pressure, or having diabetes can all increase your estrogen level. Using estrogen therapy without progestin is also related to a greater risk for endometrial cancer.  Taking progestin seems to offset this risk. In fact, using birth control pills that contain estrogen and progestin during the childbearing years seems to decrease a woman's risk of endometrial cancer.  Other things that may put you at greater risk are having your period before the age of 12 or going through menopause after the age of 52.  Women who have never been pregnant and those who use a drug called Tamoxifen may also be at greater risk.

Endometrial cancer is diagnosed by using endometrial biopsy or by dilatation and curettage (D&C) of the uterus.  Both procedures can be effective in making the diagnosis.

An endometrial biopsy is usually done in the doctor's office.  It involves inserting a very thin suction device into your uterus to remove a bit of the lining.  This sample is then tested in a lab to check it for cancer.  General anesthesia is not needed, but you may be given some non-steroidal medication to help with the possible pain of the procedure.  You may have cramping or spotting after the procedure, which is generally mild.

A D&C can be done as an outpatient procedure at the hospital.  It involves dilating (stretching) the cervix and then scraping or suctioning out the lining of the uterus.  The lining is then sent to the lab to be tested.  This procedure generally involves anesthesia, either local or general.  A D&C is highly useful in diagnosing endometrial cancer and may be helpful as a treatment of abnormal uterine bleeding because it may remove the tissue that is causing problems.  You may bleed for a short while after the procedure, and you may notice some cramping as well.  Your doctor may suggest that you avoid using tampons or having sex for a short time after the D&C.

Treatment for endometrial cancer usually involves removing the uterus, the fallopian tubes, and the ovaries.  Radiation therapy or chemotherapy is also sometimes needed.  Remember, treatment can be highly effective, especially if the cancer is found early.  So, make sure if you have any abnormal bleeding or spotting, talk to your family doctor right away. It may save you life.