Uterine Cancer

Uterine cancer usually means endometrial cancer — cancer of the lining of the uterus. It is the commonest gynaecological cancer in high-income countries and is rising in urban India along with obesity and diabetes. Most cases present early with bleeding, which is why outcomes are relatively good.

Key warning sign — never ignore

Any bleeding after menopause — even a spot — always needs evaluation. Don't assume it's "normal." Pre-menopausal women with very heavy, prolonged, or between-period bleeding also need evaluation, especially if over 35 or with risk factors.

Risk factors

• Obesity (biggest modifiable factor).
• Type 2 diabetes, metabolic syndrome.
• PCOS (chronic anovulation).
• Late menopause, early periods, no children.
• Unopposed oestrogen therapy.
• Some hormonal treatments for breast cancer — usually the benefit still outweighs the small uterine risk; just monitor.
• Lynch syndrome and other inherited cancer syndromes.

Diagnosis

• Pelvic examination and transvaginal ultrasound — looking at endometrial thickness.
• Endometrial biopsy — the key test (usually as an outpatient office procedure).
• Hysteroscopy with biopsy if needed.
• Staging scans (CT/MRI) after confirmation.

Treatment

• Surgery is the main treatment — hysterectomy with removal of ovaries, tubes, and lymph nodes where needed.
• Radiation after surgery for higher-risk cases.
• Chemotherapy, hormone therapy, targeted and immune therapy — for advanced or recurrent disease.
• Fertility-sparing treatment is possible in very early, carefully selected cases — with specialist input.
• Lynch syndrome testing — routine in many centres, as it affects the patient's future risks and her family's.

Prevention

• Healthy weight is the strongest modifiable factor.
• Managing diabetes and PCOS.
• Avoiding oestrogen without progesterone in women with a uterus.
• Regular attention to abnormal bleeding.