What is uterine cancer, and how is it treated?

Uterine cancer (endometrial cancer), which is among the most commonly detected gynecological diseases in its early stages, is one of the most frequently encountered health problems in women. When treatment is initiated early, the success rate is very high. Among all cancers in women, it ranks fourth after breast, lung, and colorectal cancers [1]. Approximately 80% of cases are confined to the uterus at the time of diagnosis, and detection at this early stage significantly increases the likelihood of successful treatment [2].

“ ”

Any vaginal bleeding after menopause is a warning sign. Early medical consultation allows uterine cancer to be diagnosed at a highly treatable stage.

What Is Uterine Cancer?

Uterine cancer (endometrial cancer) occurs when the cells in the endometrium—the inner lining of the uterus that thickens and sheds during the menstrual cycle—begin to grow and multiply uncontrollably. It is most commonly seen in women over the age of 50, particularly between the ages of 60 and 70, but it can also occur in women of reproductive age [1].

Endometrial cancer is a type of cancer that can be largely managed through regular gynecological check-ups, control of risk factors, and early recognition of symptoms.

What Are the Risk Factors for Uterine Cancer?

The risk of uterine cancer is largely associated with the effect of estrogen on the endometrium without adequate progesterone balance. According to ESMO Clinical Practice Guidelines, obesity is one of the most significant risk factors; in women with a BMI over 30, the risk increases by approximately 273% [2]. The main risk factors include:

• Early or late onset of menstruation
• Late menopause
• Long duration of menstrual cycles
• Ovulation disorders
• Nulliparity (never having been pregnant)
• Obesity and excess weight
• High-fat diet
• Diabetes and hypertension
• Ovarian tumors
• Family history of uterine cancer
• Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome)

Since uterine cancer is directly related to estrogen levels in the body, the risk increases as estrogen levels rise [1].

For information about the smear test, which plays a critical role in early detection, you can visit our what is a smear test? page.

What Are the Symptoms of Uterine Cancer?

Since uterine cancer is most commonly seen after menopause, the following symptoms are particularly important for early diagnosis. The most common symptom is vaginal bleeding; any bleeding after menopause should always be evaluated [1]:

• Vaginal bleeding (postmenopausal bleeding is always abnormal)
• Vaginal discharge (dark-colored, foul-smelling)
• Unexpected bleeding between menstrual periods
• Menstrual-like bleeding after menopause
• Prolonged menstrual periods
• Pain during sexual intercourse
• Pelvic pain
• Loss of appetite and weight loss

How Is Uterine Cancer Diagnosed?

The first step in diagnosis is a physical and pelvic examination, followed by additional tests. Current guidelines (NCCN, ACOG, ESMO) recommend transvaginal ultrasound and endometrial biopsy as primary diagnostic tools [3].

Ultrasound imaging is used to assess the thickness of the uterine lining and detect abnormalities. Endometrial biopsy involves taking a tissue sample from the uterus for definitive diagnosis. If necessary, curettage may be performed. CT and MRI scans are used to determine the size and location of the tumor.

How Is Uterine Cancer Treated?

Treatment is planned based on the stage of the cancer, its type, the patient’s overall health, and fertility expectations. Surgical procedures form the basis of treatment, often combined with chemotherapy and radiotherapy [3].

During surgery, the uterus, ovaries, and fallopian tubes are removed, and lymph nodes may also be excised. Current guidelines recommend minimally invasive approaches (laparoscopy or robotic surgery) when appropriate, as they reduce complications and shorten recovery time [3].

If there is a risk of cancer spread, chemotherapy is administered. Radiotherapy may be added to reduce recurrence risk. Additionally, high-dose progesterone therapy may be used in selected cases.

For more information about HPV vaccination and prevention methods, you can visit our HPV treatment page.

Frequently Asked Questions (FAQ)

• ❓
  Can uterine cancer be treated in early stages?

  Yes. Approximately 80% of cases are diagnosed at an early stage, with survival rates reaching up to 95%.

• ❓
  Is there a screening test for uterine cancer?

  There is no standard screening test for asymptomatic women. High-risk individuals should be monitored regularly.

• ❓
  How much does obesity increase the risk?

  According to ESMO, the risk increases by approximately 273% in women with BMI over 30.

• ❓
  Is hysterectomy always required?

  Surgery is the standard treatment, but hormonal options may be considered in selected young patients.

• ❓
  Does Lynch syndrome increase the risk?

  Yes. It significantly increases the risk of both colorectal and endometrial cancers.

References

1. ACOG
2. ESMO
3. Drakopoulos et al.