Endometrial Cancer – Symptoms & Causes

Endometrium is the inner lining of the uterus (or womb) inside a woman’s body. The layer grows during every menstrual cycle and then drops off when the egg (released during the ovulation time in that cycle) does not get fertilized by a sperm. If fertilized, the endometrial layer is where the fetal development occurs.

Endometrial cancer refers to the growth of cancer cells in the endometrial layer. Endometrial cancer is sometimes referred to as Uterine Cancer or uterus cancer. There are other types of cancers that can form in the uterus (such as uterine sarcoma) but they are less common compared to endometrial cancer.

Symptoms of endometrial cancer

Symptoms of endometrial cancer include:

1. Vaginal bleeding after menopause
2. Spotting or bleeding between periods
3. Pain in pelvis or lower abdominal region.

“When you see spotting or bleeding in the middle of your menstrual cycle or during unusual days, you must see a good gynecologist near you immediately” says Dr. Deepa Ganesh, one most sought after OB-GYN (Obstetrician-gynecologist) in Chennai.

What causes endometrial cancer?

The exact cause of endometrial cancer is not known. However, the general observation is, normal body cells multiply at a fixed rate and expire after a fixed time, thereby maintaining their balance. On the other hand, cancer cells have altered DNA and they multiply faster and don’t have an expiry date set.  This results in rapid growth of cancer cells forming a tumor. As the stage of cancer progresses, the cancer cells start spreading to the nearby tissues, organs and finally start moving to other parts of the body. Such a spreading of cancer cells to different parts of the body from the origin is called ‘metastasizing’.

Doctors and medical experts have identified certain risk factors that can put a woman at risk of developing endometrial cancer:

1. Imbalance of hormones. Ovaries in a woman produce mainly two different hormones, estrogen and progesterone. A healthy body regulates these hormones in different levels at different times of the month which will result in formation of the endometrial layer, release of egg and then shedding of the endometrial layer when the egg is not fertilized. When the balance of these two hormones is disturbed (due to any condition) and if the estrogen levels go up with no relation to the levels of progesterone, that can increase the risk of endometrial cancer in the woman.

2. Commencement of menstruation at an early stage. Some girls start menstruating at an early stage. Typical age when a girl has her first period is around 12 or 13. If the first period starts earlier, say at 10 or 11 years, the risk of endometrial cancer increases.
3. Those who were never pregnant. Women who never bore a child are at higher risk of endometrial cancer than those who have become mothers at least once.
4. The risk of endometrial cancer increases with age. This is even higher in women who take estrogen alone without progesterone (when they have uterus) to control the symptoms of perimenopause or menopause condition.
5. Being overweight or obese. Being overweight or obese can alter the production of hormones in the body and reproductive hormones are no exception.

Hormone therapy for other medical conditions. If your gynecologist has put you on to hormone therapy to treat other medical condition, such as breast cancer and if that causes an imbalance in estrogen and progesterone levels, you are at an increased risk of endometrial cancer.

How can you prevent endometrial cancer?

1. When you present yourself with problems related to uterus (PCOS or anything) and if your doctor has put you on to hormone therapy, the first question you must ask is, if that would increase the risk of endometrial cancer. Ask for an alternative treatment option if that is the case.
2. Birth control pills. One time birth control pills or every day birth control pills, most of them work by changing the production of reproductive hormones. This certainly imbalances the hormones putting you at risk of endometrial cancer.
3. Being overweight or obese. Excess body weight is the primary reason for hundreds of medical conditions. Workout regularly and keep your body in the range of healthy BMI to save yourself from the risk of endometrial cancer.

When you see spotting or bleeding in between your periods, I strongly urge you to see your doctor. The reason need not be endometrial cancer but that surely is a symptom of some underlying problem. A stitch in time saves nice. Get an appointment with your trusted gynecologist and get tested as early as you can so that you can nip the problem in the bud stage.