Endometrial Cancer

The endometrium is the inner lining of the uterus — the tissue that thickens each month in preparation for a potential pregnancy and sheds during menstruation. Endometrial cancer arises when cells in this lining grow abnormally and form a malignant tumor. The most common type is endometrioid adenocarcinoma, which accounts for roughly 80 percent of cases and tends to be detected at an early, treatable stage. Less common and more aggressive types include serous, clear cell, and carcinosarcoma.

Abnormal vaginal bleeding is the hallmark symptom — particularly any bleeding after menopause, which should always prompt a medical evaluation. Before menopause, irregular, heavy, or unusually prolonged periods can also be a sign. Because this symptom is specific and tends to appear early in the disease course, many endometrial cancers are diagnosed at stage I, when the tumor is confined to the uterus and cure rates are high.

Elevated estrogen exposure — whether from hormone therapy, obesity (fat tissue produces estrogen), or conditions like polycystic ovary syndrome — is a major risk factor. A history of tamoxifen use for breast cancer also modestly increases risk. Lynch syndrome, an inherited DNA-repair disorder, raises lifetime risk substantially and warrants earlier and more intensive screening. Diagnosis is usually confirmed by endometrial biopsy or a procedure called dilation and curettage (D&C).

Endometrial cancer is the most frequently diagnosed gynecologic cancer in the United States, with roughly 66,000 new cases each year, so understanding it is genuinely relevant to many women. The good news is that most cases are caught early, and early-stage disease has an excellent prognosis — five-year survival rates above 95 percent for stage I. Surgery (usually hysterectomy) is the primary treatment for localized disease, and many women are cured without needing additional therapy.

What this means practically is that postmenopausal bleeding should never be dismissed as normal aging or assumed to be harmless. Any unexplained bleeding after your periods have stopped deserves a prompt conversation with your doctor. Maintaining a healthy weight, discussing the risks and benefits of hormone therapy carefully, and informing your provider if you have a family history of Lynch syndrome are all meaningful steps toward protecting your health.