Gynecologic Oncology Program

Endometrial Cancer

Symptoms and Diagnosis

Most cancers of the endometrium grow slowly. Often (although not always) the first noticeable symptom is abnormal bleeding.

A woman should see a doctor if she experiences:

bleeding or discharge not related to periods (menstruation)
difficult or painful urination
pain during intercourse
pain in the pelvic area

These symptoms are common to infections and other conditions and do not necessarily indicate that a woman has cancer. However, about 90 percent of patients with endometrial cancer report irregular vaginal bleeding or discharge.

If a woman has symptoms that suggest endometrial cancer, her doctor will do several tests, usually beginning with an internal (pelvic) examination. During the examination, the doctor will feel for any lumps or changes in the shape of the uterus. The doctor will then do a Pap test, using cotton, a brush, and a small plastic stick to gently scrape the outside of the cervix and vagina to pick up cells. Because cancer of the endometrium begins inside the uterus, it does not usually show up on the Pap test. However, the Pap test will show whether the cervical and vaginal cells are normal.

To look for cancerous or precancerous cells in the endometrium, the doctor will need to take a sample of endometrial tissue through either an endometrial biopsy or a dilation and curettage (D&C) procedure:

Endometrial biopsy: A very thin plastic tube is inserted into the uterus through the cervix, and a small sample of the endometrium is removed through suctioning. This is an office procedure that takes about a minute.
Dilation and curettage (D&C): After dilating the cervix, the doctor uses a special instrument to gently scrape tissue from inside the uterus. The procedure can be done as outpatient surgery, and it takes about an hour.

The sample of tissue taken from the uterus will be examined under a microscope. If it contains cancer cells, the cancer will be graded and staged and a prognosis determined.

The chance of recovery (prognosis) and choice of treatment for endometrial cancer depend on the stage of the cancer (whether it is just in the endometrium or has spread to other parts of the uterus or other parts of the body) and the patient's general health. The chance of recovery may also depend on how the cells look under a microscope. In early-stage cancer, the prognosis may also depend on whether female hormones (progesterone) affect the growth of the cancer.

This page was last updated on: March 3, 2008.