Womb Cancer (Endometrial Cancer)

Womb cancer usually begins in the endometrium, the lining of the uterus, and abnormal bleeding is a frequent presentation.

It may also be called endometrial cancer or uterine cancer. The endometrium responds to hormone signals across the menstrual cycle. Cancer occurs when cells in this lining develop changes that allow uncontrolled growth. Less commonly, cancers begin in other tissues of the uterus and are assessed differently.

Bleeding after menopause is a very common presentation of womb cancer. Bleeding between periods and persistent pelvic pain are also common presentations. Other changes can include watery or blood-stained discharge, pain during sex, or a change in usual vaginal bleeding. These symptoms do not by themselves identify the cause, but they should be checked.

Arrange a prompt appointment for bleeding after menopause, unusual bleeding that continues, or pelvic symptoms that do not settle. Urgent assessment is appropriate for very heavy bleeding, faintness, severe pain or fever with feeling unwell.

The exact cause is often unknown. Changes within endometrial cells can disrupt normal controls on growth. Long-term exposure to oestrogen without enough progesterone can contribute to some types. Endometrial hyperplasia means the lining is thicker than expected; some forms need monitoring or treatment because they can be associated with later cancer risk.

Many womb cancers are found while they are confined to the uterus because abnormal bleeding prompts assessment. A cancer can grow into the uterine muscle, reach nearby lymph nodes or spread to more distant areas. Staging uses examination, imaging, tissue findings and surgical results to describe the extent and guide the treatment plan.

Factors that can influence risk include increasing age, higher body weight, diabetes, some hormone treatments, a history of endometrial hyperplasia and certain inherited conditions such as Lynch syndrome. Having one or more risk factors does not mean that cancer will develop. Discuss a strong family history of womb, bowel or related cancers with a clinician.

The clinician will ask about bleeding, periods, menopause, medicines and family history, then may perform a pelvic examination. A transvaginal ultrasound can measure the lining and look at the uterus and ovaries. An endometrial biopsy removes a small sample of the lining for laboratory examination. Further imaging may be used after diagnosis for planning.

Surgery to remove the uterus, called a hysterectomy, is a common treatment. The operation may include removal of the fallopian tubes and ovaries and assessment of lymph nodes, depending on the cancer type and stage. A radical hysterectomy is used in selected situations where more tissue around the uterus needs to be removed.

Radiotherapy can be given after surgery or to control disease when surgery is not suitable. Chemotherapy and hormone therapy for cancer may be considered for particular tumour types, more extensive disease or recurrence. The team will discuss fertility, menopause effects, recovery and symptom support before treatment begins.

Recovery can involve tiredness, changes in bowel or bladder habits, vaginal dryness, emotional distress or sexual concerns. Tell the care team about these effects; support may include pelvic health physiotherapy, menopause care, counselling and advice on returning to activity. Keep all follow-up visits and report new bleeding, pelvic pain, cough, unexplained weight loss or swelling.

A gynaecological cancer team coordinates diagnosis and treatment, often with surgeons, medical oncologists, radiation oncologists, nurses and allied health professionals. At your consultation, ask about the cancer type, stage, treatment goal and the practical help available during recovery.