Womb Cancer

Cancer of the womb can be called several different names by your healthcare professional including uterine cancer because this is the medical name for the womb, or endometrial cancer which is cancer within the lining of the womb. The latter is the most common type of womb cancer.

Womb cancer is the fourth most common cancer in women in the UK and is on the increase each year due to changes in our lifestyles, with over 9,300 women diagnosed every year in the UK.

How does it develop?

Most womb cancers begin in the endometrium (womb lining), where the cells that grow are then shed each month as menstrual loss or period.

When a cancer starts, these cells change from their normal appearance, appearing to increase in size until they begin to develop into a tumour.

As the cancer grows, it often causes an unexpected vaginal bleed, which is why any unexpected bleeding is an indicative womb cancer symptom and should be reported to your GP straight away.

If the cancer is identified at an early stage (e.g. in the lining of the womb) then it is most often cured with surgery alone, and if it has grown a little further into the next layer of the womb can still be managed by further treatment e.g. radiotherapy.

Uterine cancer symptoms – Key signs

The most commonly experienced of a just few womb cancer symptoms is abnormal bleeding from the vagina – this is especially the case in those who have already been through the menopause. Around 90% of endometrial cancer diagnoses are reported due to post-menopausal or irregular vaginal bleeding.

Please note though that most people with abnormal bleeding will not have a gynaecological cancer.

This irregular bleeding might be:

  • Vaginal bleeding after the menopause
  • Bleeding between periods
  • Bleeding that is unusually heavy
  • Vaginal discharge – from pink and watery to brown, or even prune-coloured occasionally

Another way irregular bleeding might be described is “unusual vaginal discharge”. Because women are different and menstrual cycles are different, this means anything that is not “your normal”.

In post-menopausal women, it is harder to work out what “normal” is. If you are uncertain, the best course of action is to approach your doctor or nurse to ask: “Is this normal or not?” Presented with suspected uterine cancer symptoms, your doctor will be happy to rule out this diagnosis or discover other causes of your symptoms; and the earlier the better.

Spotting might also be a signal; some women might also get pain or slight pain during sex; but these womb cancer symptoms are not as prevalent as abnormal bleeding – which is the key sign – and they may instead be related to other gynae problems

Risk Factors

There are many different types of womb cancer. Some are linked to genetic causes, others to hormones, but the majority occur with no obvious cause.

A hormone imbalance is one of the most important risks for developing this condition. Specifically, your risk is increased if you have high levels of a hormone called oestrogen in your body.

A number of things can cause this hormone imbalance, including being overweight. It’s not always possible to prevent endometrial cancer, but some things are thought to reduce your risk. This includes maintaining a healthy weight and the long-term use of some types of contraception.

How is it diagnosed?

You should visit your GP if you have abnormal vaginal bleeding. While it’s unlikely to be caused by cancer of the womb, it’s best to be sure.

Sometimes women will ignore their uterine cancer symptoms because they have recently had a cervix cancer smear and it was clear. However, the condition cannot be picked up by the cervical smear because the smear test only looks for abnormalities at the neck of the womb, looking for problems with the cervix; whereas womb cancer develops deeper into the body in the womb lining: the endometrium.

So even if you have recently had a clear smear test, if you are bleeding erratically or experiencing unusual discharge, your womb could be signalling there’s a problem, so it’s important to get it checked.

To do so, your GP will most probably carry out a physical examination of your pelvic area, including your vagina, womb, ovaries, and bladder. They will ask about the nature of your womb cancer symptoms, when they happen, and how often.

You may be referred for further tests which include a Transvaginal Ultrasound and a biopsy:

Transvaginal ultrasound (TVU)
Another test you may have is called a transvaginal ultrasound (TVU). TVU is a type of ultrasound scan that uses a small scanner.

Placed directly into the vagina to obtain a detailed picture of the inside of the uterus, the probe can feel a little uncomfortable for those yet to have sex or women with vaginismus, but shouldn’t be painful.

The TVU checks whether there are any changes to the thickness of the lining of your uterus that could be caused by the presence of cancerous cells.

Biopsy
If the results of the TVU detect changes in the thickness of the lining of the womb, you will usually have a biopsy to get a diagnosis.

A biopsy involves removing a sample of cells from the inside of the womb (the endometrium). The sample is then checked at a laboratory to get a diagnosis.

This involves a minor surgical procedure carried out under general anaesthetic, where some tissue from the womb lining is biopsied. Sometimes it is not possible to take a biopsy in the outpatient clinic and some women choose to have this done with an anaesthetic.

In some cases, a hysteroscopy (internal examination of the womb) may be conducted before under-going dilation and curettage.

Treatment

The most common treatment for endometrial cancer is the surgical removal of the womb (hysterectomy). If you report your uterine cancer symptoms soon enough treatment can be curative because the cancer will not have invaded the womb lining. When diagnosed early, cancer of the womb can often be cured by surgery alone, without the need for chemotherapy.

A hysterectomy can cure womb cancer in its early stages, but you will no longer be able to menstruate or get pregnant. Surgery for cancer of the womb is also likely to include the removal of the ovaries and fallopian tubes.

Radiotherapy or chemotherapy are also sometimes used, often in conjunction with surgery.

A type of hormone therapy may be used if you are yet to go through the menopause and would still like to have children. Although this is not normal practice, it can be used for a type of womb cancer and only after you’ve fully understood the risks.

Even if your cancer is advanced and the chances of a cure are small, treatment can still help to relieve the uterine cancer symptoms and prolong your life.