Guest Author - A. Maria Hester, M.D.

Endometrial cancer is the malignancy which starts in the inside lining of the womb, called the endometrium. This cancer is not to be mistaken for cervical cancer, which is an entirely different entity. This cancer is the second most common malignancy of the female genital tract. The American Cancer Society estimates that in 2007, over 39,000 women will be diagnosed with endometrial cancer and 7,400 will die from this disease.
Most women with endometrial cancer are between 50 and 70 years old. Therefore, a healthy 22 year old lady who develops some of the common signs of endometrial cancer should not be unduly alarmed, as her risk of this disease is remote.

Who gets endometrial cancer?

1. Having an increased number of menstrual cycles during life increases the risk. For instance, if you started having menses prior to age 12 and did not go thru menopause until relatively late in life, your risk of developing endometrial cancer is increased over the baseline risk.
2. Women with a prior history of using unopposed estrogen are at increased risk. As a result, treatment for menopause usually did not consist of estrogen replacement alone, unless a women had had a hysterectomy in the past. Instead, standard hormone replacement therapy, HRT, utilized both estrogen and progesterone. However, as a result of scientific studies in the past few years, even combined hormone replacement therapy has decreased in popularity among doctors and women. For women who had a uterus who opted to use estrogen replacement alone, this therapy put them at risk for endometrial cancer. Even after stopping estrogen, the increased risk may remain for close to 10 years.
3. Obesity
4. Diabetes
5. Polycystic ovaries
6. High content of animal fat in the diet
7. Family history of ovarian cancer
8. Prior radiation therapy to the pelvis
9. Prior personal history of breast or ovarian cancer
10. Infertility or never giving birth for some other reason
11. Extended use of the drug tamoxifen for breast cancer treatment

How can I decrease my risk of endometrial cancer?

1. Lead a lifestyle that minimizes the risk factors listed above. For instance, eat a low fat diet and get regular exercise. Doing so will decrease your risk of obesity, which in turn will decrease your risk of diabetes.
2. Birth control pill use also decreases the risk of endometrial cancer, though birth control pills are not right for everyone.

What are some signs of endometrial cancer?

1. Vaginal bleeding may occur, but the overwhelming majority of women who have abnormal vaginal bleeding do NOT have endometrial cancer.
2. Abnormal vaginal spotting or discharge also warrant a trip to the doctor.
3. A pelvic mass
4. Lower abdominal pain may occur if there is obstruction of the cervix with pus or blood.

How is endometrial cancer diagnosed?

There is no screening test to detect endometrial cancer early. While the routine Pap smear may detect some cases, the Pap smear is a test for cervical cancer and was not meant to screen for endometrial cancer. However, if you develop abnormal vaginal bleeding you should notify your physician as soon as possible because there are tests to get a sample of endometrial tissue to test for endometrial cancer, such as an endometrial biopsy, hysteroscopy, or a dilatation and curettage.