Womb Cancer

Womb cancer 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 8,400 women diagnosed every year in the UK.

How does it develop?

Most womb cancers begin in the endometrial (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 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.

Key signs and symptoms

The most common symptom of womb cancer is abnormal bleeding from the vagina – especially in those who have already been through the menopause. Around 90% of womb cancer diagnoses are reported due to post-menopausal or irregular vaginal bleeding. Although please note that most people with abnormal bleeding will not have a gynaecological cancer.

This irregular bleeding can be:

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

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 womb cancer. 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 womb 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 womb cancer, it’s best to be sure.

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 your 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 womb cancer is the surgical removal of the womb (hysterectomy).

A hysterectomy can cure womb cancer in its early stages, but you will no longer be able to menstruate or get pregnant. Surgery for womb cancer 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 symptoms and prolong your life.