Overview

Uterine cancer is a cancer that develops in the uterus. The most common type is endometrial cancer, which begins in the inner lining of the uterus called the endometrium. A less common type, known as uterine sarcoma, develops in the muscular or supporting tissues of the uterus. Therefore, uterine cancer and endometrial cancer are related terms, but they are not the same.

Abnormal vaginal bleeding, particularly bleeding after menopause, is one of the most important warning signs of endometrial cancer and should not be ignored. Early diagnosis can allow treatment to begin before the disease spreads.

At Sarvodaya Hospital, our multidisciplinary cancer care team provides personalised uterine cancer treatment based on the cancer type, stage, grade, overall health, and individual treatment needs. Treatment may include surgery, minimally invasive or robotic procedures, radiation therapy, chemotherapy, hormone therapy, targeted therapy, or immunotherapy where clinically appropriate.

Symptoms of Uterine Cancer

• Abnormal vaginal bleeding between periods
• Heavier or longer menstrual bleeding than usual
• Vaginal bleeding after menopause
• Unusual vaginal discharge
• Pelvic pain or discomfort
• Pain during sexual intercourse
• Painful urination
• Difficulty or discomfort while urinating
• Unexplained weight loss
• A feeling of fullness or pressure in the pelvis

Causes of Uterine Cancer

• Increased age
• Obesity
• Type 2 diabetes
• Metabolic syndrome
• Endometrial hyperplasia
• Polycystic ovary syndrome (PCOS)
• Early onset of menstruation
• Late menopause
• Never having been pregnant
• Family history of uterine or endometrial cancer
• Lynch syndrome
• Previous pelvic radiation therapy
• Long-term exposure to estrogen without progesterone
• Certain use of tamoxifen for breast cancer

Risk Factors for Uterine Cancer

Certain health and hormonal factors can increase the likelihood of developing endometrial cancer.

• Age: The risk of endometrial cancer increases with age, particularly after menopause.
• Obesity: Excess body fat can increase oestrogen levels, which may stimulate the growth of the uterine lining.
• Hormonal Factors: Long-term exposure to oestrogen without adequate progesterone can increase the risk.
• Diabetes and Metabolic Syndrome: These conditions are associated with a higher risk of endometrial cancer.
• PCOS: Some women with PCOS have prolonged periods without ovulation, which can increase exposure of the endometrium to oestrogen.
• Family History: A first-degree relative with uterine or endometrial cancer may increase risk.

Diagnosis of Uterine Cancer

Accurate diagnosis is essential for confirming cancer, identifying its type, and determining its stage. Your cancer specialist may recommend:

• Pelvic Examination: A physical examination helps assess the uterus, cervix, vagina, and surrounding structures.
• Transvaginal Ultrasound: This imaging test provides detailed views of the uterus and helps assess the thickness and appearance of the endometrium.
• Endometrial Biopsy: A small sample of tissue from the uterine lining is examined under a microscope to identify abnormal or cancerous cells. Tissue sampling is essential for confirming endometrial cancer.
• Hysteroscopy: A thin camera is passed through the vagina and cervix to examine the inside of the uterus. A tissue sample can also be collected when required.

Treatment Options for Uterine Cancer

The most suitable uterine cancer treatment depends on the cancer type, stage, grade, tumour characteristics, and overall health. A multidisciplinary team may combine different treatments to achieve the best possible outcome.

• Surgery for Uterine Cancer: Surgery is the main treatment for many patients with endometrial cancer, particularly when the disease is localised. The surgical approach depends on the cancer stage and other clinical factors.
  
  
• Hysterectomy for Uterine Cancer : A hysterectomy involves removal of the uterus and cervix. Depending on the disease, the surgeon may also recommend removal of the fallopian tubes and ovaries and assessment or removal of nearby lymph nodes.
  
  
• Laparoscopic Hysterectomy: Uses small incisions and a camera to perform surgery. For appropriately selected patients, minimally invasive surgery can reduce incision size and may support earlier recovery compared with traditional open surgery.
  
  
• Robotic Surgery for Uterine Cancer: A minimally invasive approach in which the surgeon controls specialised robotic instruments. It can provide enhanced visualisation and precise instrument movement during selected procedures.
  
  
• Radiation Therapy: Uses high-energy radiation to destroy cancer cells. It may be recommended after surgery for selected patients or as part of treatment when surgery is not appropriate. Radiation may be delivered externally or internally through brachytherapy, depending on the treatment plan.

Benefits of Early Uterine Cancer Treatment

Early diagnosis and appropriate treatment can improve treatment options and outcomes.

• Allows Timely Treatment : Detecting cancer at an earlier stage allows the cancer care team to begin appropriate treatment before the disease progresses.
• May Reduce Treatment Complexity : When cancer is localised, some patients may be treated primarily with surgery rather than requiring multiple treatment modalities.
• Helps Preserve Overall Health : Prompt treatment can reduce the risk of complications associated with advanced disease.
• Supports Better Recovery : Patients receiving appropriate treatment at an earlier stage may have a smoother recovery and rehabilitation journey.
• Enables Personalised Cancer Care : Early assessment provides an opportunity to evaluate the tumour type, grade, stage, and other characteristics before selecting treatment.

Complications if Left Untreated

• Increasing abnormal vaginal bleeding
• Anaemia due to persistent blood loss
• Pelvic pain
• Spread to nearby tissues
• Lymph node involvement
• Spread to distant organs
• Reduced overall health
• Need for more complex cancer treatment
• Cancer recurrence after treatment

When Should You See a Doctor?

Consult a gynaecologist or gynecologic oncologist if you experience:

• Bleeding after menopause
• Unusual vaginal bleeding between periods
• Persistent spotting
• Unusual vaginal discharge
• Heavy or prolonged menstrual bleeding
• Persistent pelvic pain
• Pain during sexual intercourse
• Unexplained weight loss
• Persistent urinary discomfort
• Any new or unexplained gynaecological symptoms

Prevention & Lifestyle Modifications

Uterine cancer cannot always be prevented, but certain lifestyle and healthcare measures may help reduce risk.

• Maintain a Healthy Weight: Maintaining a healthy weight may reduce the risk associated with excess oestrogen exposure.
• Stay Physically Active: Regular physical activity supports healthy weight management and overall health.
• Manage Diabetes : Good control of diabetes and metabolic health may help reduce associated cancer risks.
• Discuss Hormone Therapy :Women considering menopausal hormone therapy should discuss the benefits and risks with their doctor, particularly when the uterus is present.
• Understand Your Family History : A strong family history of endometrial or colorectal cancer may warrant discussion about inherited cancer syndromes such as Lynch syndrome.
• Report Abnormal Bleeding : Any unusual vaginal bleeding, particularly after menopause, should be medically evaluated rather than ignored.

Pre- and Post-Treatment Care

Pre-Treatment

• Gynaecological consultation
• Gynecologic oncology consultation
• Pelvic examination
• Endometrial biopsy
• Hysteroscopy if required
• Blood investigations
• Imaging and cancer staging
• Pathology and molecular testing where appropriate
• Anaesthesia assessment before surgery
• Nutritional and general health assessment
• Multidisciplinary treatment planning

Post-Treatment

• Scheduled oncology follow-up visits
• Physical and pelvic examinations when indicated
• Monitoring for recurrence
• Management of treatment-related side effects
• Medication adherence
• Nutritional guidance
• Physical activity as advised
• Emotional and psychological support
• Rehabilitation when required
• Prompt reporting of new symptoms

Reviewed & Updated On

Reviewed by Dr. (Lt Col) Brahamjit Singh, Director - Medical Oncology on 6-July-2026.

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