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.

Womb cancer is the fourth most common cancer in women in the UK and the most common of the five gynaecological cancers, with over 9,300 women diagnosed every year in the UK.

We have developed a resource for women and families if they have been recently diagnosed with womb cancer or are worried about the signs and symptoms.

Please click here to find out more.

How does it develop?

Most womb cancers begin in the endometrium (womb lining), where the cells shed each month when menstruating (a period).

Womb cancer is more common among post-menopausal women, although it can affect anyone with a womb at any age, and 1 in 4 women diagnosed are pre-menopausal.

The most common symptoms of womb cancer are abnormal bleeding, remember that any post-menopausal bleed is abnormal, and although its unlikely to be womb cancer, do get the bleed checked out by a GP. 

Key signs and symptoms

The most common symptom of womb cancer is abnormal vaginal bleeding – especially for women who have 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, but it is important to get checked out, just in case it is, and womb cancer when diagnosed early is often curable.

This irregular bleeding might be:

  • Vaginal bleeding after the menopause
  • Bleeding between periods
  • Bleeding that is unusually heavy
  • Vaginal discharge – from blood-stained to a light or dark brown

For post-menopausal women it can take a while to adjust to what is now ‘normal’ in terms of your vaginal discharge. If you are uncertain, do speak to your GP or nurse.

Risk Factors

There are many different types of womb cancer. The majority occur with no obvious cause, however we know that an excess of oestrogen (female hormone) increases your risk as it can actively promote unwanted cell changes.

A number of things can cause excess oestrogen such as an elevated Body Mass Index (BMI), as oestrogen is stored in the body’s fat cells. Obesity can increase your risk of womb cancer by ten times. It’s not always possible to prevent womb cancer, but some things are thought to reduce your risk, for example maintaining a healthy weight.

A very small percentage of womb cancers are linked to a genetic (hereditary) condition called Lynch Syndrome.

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 symptoms because they have recently had a clear cervical screening test. However, the condition cannot be picked up by a cervical screening appointment, so it is important to still get any abnormal symptoms checked out.

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 symptoms, when they happen, and how often. It can be really helpful to keep track of your bleeding so that you can give your doctor a full and accurate picture, when you bleed, how heavily, for how long, and any other noticeable symptoms such as pain levels.

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

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 who have not had penetrative sex or have any vaginal or vulval health conditions such as vaginismus, but it 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, sometimesunder general anaesthetic, where some tissue from the womb lining is biopsied.

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). If you report your symptoms soon enough treatment can be curative. 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 can sometimes 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.