Endometrial cancer is the most common type, making up 95% of all uterine cancer cases. It starts in the endometrium, the lining of the uterus. Other, rarer types of uterine cancer are called uterine sarcomas, which develop in the muscle tissue of the uterus. These cancers are often diagnosed at an advanced stage and, sadly, have a poor survival rate.

While many people with endometrial cancer have a good chance of survival, factors such as lifestyle, late diagnosis, fertility preservation in younger women, and the rising number of cases increase the overall impact of the disease.

Despite endometrial cancer being our most common gynaecological cancer, it is under-researched and under-funded.

The most common symptom of uterine (endometrial) cancer is abnormal vaginal bleeding, especially after menopause. This may include spotting, bleeding between periods, or heavier-than-usual periods. While irregular bleeding can have other causes, it’s important to see a doctor if you experience any changes in your menstrual cycle or postmenopausal bleeding.

Other symptoms can include:

• Pelvic pain or a feeling of pressure in the lower abdomen

• Unusual vaginal discharge that may be watery, pink, or brown

• Pain during intercourse

• Difficulty urinating, pain when urinating, or frequent urination

While these symptoms don’t always indicate cancer, they shouldn’t be ignored. Many cases of uterine cancer are diagnosed early because women notice unusual bleeding and seek medical advice.

Should you be experiencing any of these symptoms that are not usual for you, please visit your family doctor. If your family doctor suspects your symptoms could be gynaecological cancer, please ensure that they refer you to a gynaecological oncologist as the expert in the management of these cancers. You can find a list of gynaecological oncologists in your Australian state or New Zealand area here.

Know the symptoms of gynaecological cancer, know and listen to your body, take care of your health and do not hesitate to see a doctor or ask for a referral to a gynaecological oncology specialist.

Uterine cancer develops when cells in the lining of the uterus grow abnormally, but the exact cause isn’t always known. However, several factors can increase the risk:

• Hormonal imbalances: High levels of oestrogen over time can contribute to cancer risk. This can be linked to obesity, hormone replacement therapy (without progesterone), early menstruation (before age 12), or late menopause (after age 55).

• Age and menopause: Most cases occur in women over 50, particularly after menopause.

• Obesity: Fat tissue produces oestrogen, which can contribute to abnormal cell growth in the uterus.

• Family history and genetic conditions: A family history of uterine, ovarian, or colorectal cancer (especially Lynch syndrome) may increase the likelihood of developing uterine cancer.

• Other medical conditions: Diabetes, high blood pressure, and polycystic ovary syndrome (PCOS) have been linked to increased risk.

• Lifestyle factors: A sedentary lifestyle and a diet high in processed foods or red meat may also play a role.

While these factors may increase risk, having one or more doesn’t mean you will develop uterine cancer. If you’re concerned, talk to your doctor about ways to lower your risk and any screenings that may be appropriate for you.

To learn more about the risks for all gynaecological cancers click here.

If you experience abnormal bleeding or other symptoms, your doctor may recommend tests to check for uterine cancer. These may include:

• Pelvic examination: A doctor checks for any lumps or abnormalities in the uterus and surrounding organs.

• Transvaginal ultrasound: A small probe is inserted into the vagina to create images of the uterus, helping to assess the thickness of the endometrial lining. A thicker lining may indicate further testing is needed.

• Endometrial biopsy: A small sample of tissue is taken from the uterine lining and examined under a microscope to check for cancerous cells.

• Hysteroscopy and dilation & curettage (D&C): If needed, a doctor may use a thin camera (hysteroscope) to look inside the uterus and collect a more detailed tissue sample for analysis.

• Imaging scans: If cancer is confirmed, CT scans, MRIs, or PET scans may be used to determine the stage of the cancer and whether it has spread to other areas.

Early detection is important, as uterine cancer is highly treatable when caught in its early stages. If you have symptoms, don’t hesitate to speak with your doctor about further testing.

Treatment for uterine cancer depends on factors like the stage of the disease, your overall health, and whether the cancer has spread. The most common treatment approaches include:

• Surgery: Most women with uterine cancer will have a hysterectomy, which removes the uterus. In many cases, the ovaries and fallopian tubes are also removed to reduce the risk of recurrence. If cancer has spread, lymph nodes in the pelvic area may also be removed.

• Radiation therapy: This treatment uses targeted radiation to destroy cancer cells. It may be recommended before surgery to shrink the tumour or after surgery to reduce the risk of the cancer returning.

• Hormone therapy: Some types of uterine cancer grow in response to hormones like oestrogen. In these cases, hormone-blocking treatments may be used, particularly for women who cannot have surgery or have advanced-stage cancer.

• Chemotherapy: If the cancer has spread beyond the uterus, chemotherapy may be used to target cancer cells throughout the body.

• Targeted therapy and immunotherapy: For advanced or recurrent uterine cancer, newer treatments may be available to block specific cancer cell growth signals or boost the immune system’s ability to fight cancer.

We strongly recommending consulting with your healthcare team to discuss the best treatment options for your situation.

ANZGOG, the peak national gynaecological cancer research organisation for Australia and New Zealand, run clinical trials for uterine/endometrial cancer patients. Click here to find out more.