Although it’s the most common cancer of the female reproductive system, endometrial cancer (cancer of the uterine lining) is also one of the most treatable. Chalk up the high cure rate to abnormal vaginal bleeding, which acts as a sort of early-warning system that prompts women to get help before the cancer has spread.
Because estrogen plays a role in the development of endometrial cancer, anything that tips a woman’s hormonal scale in favor of estrogen makes her more vulnerable to the disease. Risk factors include:
- Early onset of menstruation. Starting periods before age 12 prolongs the endometrium’s exposure to estrogen.
- Late menopause. Women who are still menstruating at age 52 are significantly more likely to develop endometrial cancer than their peers who have stopped menstruating.
- Having never given birth. Pregnancy drives progesterone levels up and keeps estrogen levels low.
- Diabetes, gallbladder disease or hypertension.
- Obesity. Because fat cells transform other hormones into estrogens, overweight women have higher estrogen levels.
- Estrogen therapy. Estrogen-only menopausal hormone therapy raises endometrial-cancer risk.
- Age. The cancer commonly strikes women ages 50 to 70.
- Race. White women are 70 percent more likely than African-American women to develop the disease.
- Family history. The cancer tends to run in families.
Abnormal vaginal bleeding is usually the earliest symptom of endometrial cancer. What’s abnormal? If you’re premenopausal, it’s any bleeding that occurs between periods or unusually heavy periods. After menopause, any vaginal bleeding (other than that caused by hormone therapy) is abnormal. And if you’re approaching “the change,” be careful not to mistake abnormal bleeding for a normal sign of menopause. Keep in mind that abnormal bleeding may appear as a pink, watery vaginal discharge.
A complete physical exam, a pelvic exam, a Pap smear, an endometrial biopsy and a D&C are some tools that may be used to evaluate your condition. If tests show the presence of cancerous cells, the illness will be “staged.” In other words, it will be determined how far the disease has progressed.
Before a treatment plan can be recommended, several factors—such as the disease’s stage, your overall health, your age and your childbearing plans—must be carefully weighed.
A total hysterectomy (removal of the uterus, ovaries and fallopian tubes) is frequently recommended to treat endometrial cancer, especially when it has not spread beyond the uterus. And depending on the stage of the illness, radiation and chemotherapy may be used in addition to or instead of surgery. In advanced cases, progesterone therapy may be used to slow the cancer’s spread.
Help yourself get better by eating right, exercising when you feel up to it, avoiding tobacco and alcohol, getting adequate rest and discussing any bothersome side effects with your doctor. And perhaps most important, remember to keep follow-up appointments.