What is Endometrial Cancer?

Cancer is caused by malignant (cancerous) cells that grow and multiply without control. When cancer begins in the tissues lining the uterus, it is called endometrial cancer. (Learn about uterine sarcoma, a different form of cancer that affects the muscle of the uterus.)

Endometrial cancer is the most common cancer of the female reproductive organs. The American Cancer Society estimates that 66,200 new cases of cancers of the uterus would be diagnosed in the United States in 2023, and that these diseases would cause about 13,030 deaths.

Endometrial Cancer Symptoms

The symptoms of endometrial cancer may look like those associated with other medical conditions. Talk to your doctor if you notice any:

  • Bleeding or discharge not related to menstruation (your periods). Over 90% (9 out of 10) of women diagnosed with endometrial cancer have abnormal vaginal bleeding
  • Postmenopausal bleeding
  • Difficult or painful urination
  • Pain during sex
  • Pain and/or a mass in the pelvic area

Diagnosing Endometrial Cancer

The first step in diagnosing any disease is to complete a medical history and physical examination. In order to diagnose endometrial cancer, your doctor may also order tests and procedures including:

  • Pap test (Pap smear): This test involves the microscopic examination of cells collected from the cervix (the lower end of the uterus). It may be ineffective in detecting endometrial cancer because the disease begins inside the uterus
  • Internal pelvic exam: The doctor feels for any lumps or changes in the shape of the uterus
  • Endometrial biopsy: During this procedure, which is often done in a doctor's office, a sample of endometrial tissue is collected by inserting a small, flexible tube into the uterus. A pathologist then views the sample under a microscope to check for cancer
  • Dilation and curettage (D&C): Your doctor may recommend a D&C if an endometrial biopsy is not possible or if further diagnostic information is needed. During this minor operation, the cervix is dilated (opened) so that the cervical canal and uterine lining can be scraped with a curette (spoon-shaped instrument). The pathologist examines the tissue for cancer cells
  • Transvaginal ultrasound (ultrasonography): A small probe called an ultrasound transducer is placed in the vagina. The device makes high-frequency sound waves to create images of the body tissues and identify tumors (abnormal growths)
  • Computed tomography (CT) scan: A series of X-ray images of inside the body are combined to produce cross-sectional views of the pelvic area. This test can show a tumor in the uterine lining along with its spread elsewhere in the body

Treating Endometrial Cancer

If you are diagnosed with endometrial cancer, your care team will work with you to develop a treatment plan that is right for you.  This plan will depend on factors such as type and stage (extent) of endometrial cancer, your general health, and your treatment preferences. Endometrial cancer is highly curable when found early.

Surgery is the first treatment option for most women with endometrial cancer. Types of surgery include:
  • Total hysterectomy: Removal of the uterus, including the cervix. Advanced approaches to this procedure include:
    • Robotic-assisted hysterectomy
    • Laparoscopic hysterectomy (in which a narrow viewing tube is inserted through a small incision in the abdomen to remove the uterus)
  • Radical hysterectomy: Removal of the uterus, including the cervix, and part of the vagina
  • Unilateral salpingo-oophorectomy: Removal of an ovary and fallopian tube (known as bilateral salpingo-oophorectomy if both ovaries and both fallopian tubes are removed). Nearby lymph nodes and part of the vagina may also be removed
  • Pelvic lymph node dissection: Lymph nodes are removed from the pelvis and then dissected (cut up) to identify the microscopic spread of cancer that imaging tests such as a CT scan might miss
  • Laparoscopic lymph node sampling: A laparoscope is inserted through a small incision in the abdomen to remove lymph nodes

Some women who have had surgery for endometrial cancer may need more types of treatment. Other treatment options include:

  • Radiation therapy uses high-energy radiation beams to kill or shrink tumors while saving healthy tissue. The radiation source can come from outside the body (external radiation therapy) or from implants inside the body (internal radiation therapy)
  • Chemotherapy kills cancer cells through the use of intravenous (IV) or oral drugs
  • Hormone therapy blocks the action of or stops the body from producing certain hormones that can cause cancer cells to grow

Some hospitals also offer clinical trials that may provide access to new and promising therapies for endometrial cancer.

Endometrial Cancer Related Factsheets:

The National Cancer Institute has more information on Endometrial Cancer Treatment.