What is endometrial cancer?
The endometrium is the hormonally responsive lining of the uterus. Most endometrial cancers are endometrioid adenocarcinomas, but serous, clear cell, carcinosarcoma, and other high-risk histologies behave differently. Uterine sarcomas are separate cancers and require different management. Risk is associated with age, obesity, unopposed estrogen exposure, tamoxifen, diabetes, and inherited Lynch syndrome, while many people have no clear cause. Unlike cervical cancer, there is no routine screening test for average-risk people; evaluation of abnormal bleeding is central to early detection. Pathology provides histology and grade. Modern classification also uses mismatch-repair status, p53 findings, and POLE mutation status to define molecular groups that can refine recurrence risk and treatment. Inherited evaluation may follow mismatch-repair results or family history. Care depends on histology, grade, stage, molecular profile, fertility goals, health, and preferences. Type and stage cannot be inferred from bleeding severity. Expert gynecologic pathology review may be useful when histology is rare or mixed.
Signs and symptoms
Abnormal vaginal bleeding is the most common symptom. This includes any bleeding or spotting after menopause, bleeding between periods, periods that are unusually heavy or prolonged, or a new irregular pattern. Watery, pink, or blood-tinged discharge may occur. Some people develop pelvic pressure or pain, pain during sex, urinary or bowel changes, abdominal swelling, fatigue, or unexplained weight loss, especially with more advanced disease. Fibroids, polyps, endometrial hyperplasia, hormonal changes, medications, and other noncancer conditions can also cause bleeding or discharge. These symptoms cannot identify the cause on their own. Postmenopausal bleeding should always be evaluated, and persistent changes before menopause also deserve assessment. Heavy bleeding with dizziness or fainting, severe pain, or other acute symptoms requires urgent medical attention.
Diagnosis and staging
Evaluation commonly includes medical history, pelvic examination, and transvaginal ultrasound to measure and inspect the endometrium. Endometrial biopsy samples the lining and usually confirms diagnosis; hysteroscopy with directed sampling or dilation and curettage may be used when office biopsy is insufficient. Pathology identifies histologic type, grade, and molecular markers. Imaging such as MRI, CT, or PET-CT is selected according to tumor features and concern for spread. Surgical staging usually includes hysterectomy, removal of both tubes and ovaries, examination of the abdomen, and sentinel-node mapping or lymph-node assessment when indicated. FIGO stage describes uterine invasion, cervical involvement, regional spread, and distant metastasis. Testing for mismatch-repair proteins or microsatellite instability is important, with additional p53 and POLE testing increasingly used for molecular classification. Care depends on histology, grade, stage, biomarkers, fertility goals, health, and preferences. Fertility-preserving evaluation requires careful confirmation of low-grade disease confined to the endometrium and excludes ovarian involvement. Expert pathology review can clarify uncommon or mixed tumors.
Established treatment paths
Surgery is standard for most operable endometrial cancers and usually includes total hysterectomy with removal of both fallopian tubes and ovaries, plus appropriate nodal assessment. Minimally invasive surgery is often possible. Selected low-grade, early cancers may be treated with progestin therapy and close repeat sampling when fertility preservation is a priority or surgery is unsafe. After surgery, observation, vaginal brachytherapy, external-beam radiation, chemotherapy, or combinations are chosen according to stage, histology, grade, lymphovascular invasion, nodes, and molecular classification. Advanced or recurrent disease may be treated with chemotherapy, hormone therapy for hormone-sensitive tumors, immunotherapy, targeted therapy, radiation, or surgery in selected situations. Mismatch-repair status and other molecular features can guide immunotherapy and combination choices. Radiation can control pelvic disease or relieve bleeding and pain. Clinical trials may be appropriate. The plan should address surgical menopause, fertility, sexual health, bone and heart health, lymphedema, and treatment effects. Care depends on type, stage, biomarkers, prior therapy, health, and preferences. Recurrence confined to the vagina or pelvis may sometimes be treated with radiation or surgery, depending on previous treatment. Surveillance focuses on symptoms, examination, and selected imaging rather than a single universal blood test.
Supportive care
Supportive and palliative care can begin at diagnosis and continue during treatment, survivorship, or advanced illness. The oncology team can address pain, nausea, fatigue, sleep, appetite, emotional distress, sexual health, and practical concerns. Nutrition guidance, appropriate physical activity, rehabilitation, counseling, social work, and palliative-care consultation may help maintain function and quality of life. Supportive approaches should complement, not replace, oncology treatment, and should be adapted to symptoms, goals, and medical history.
Profiles documenting endometrial cancer care
These profiles mention a matching cancer specialty in their published materials. Browse their locations, reported services, and practical details.
Sources
Source information checked: 2026-09-29. The links below identify the public and clinic-provided materials used for this page.
- NCI: Uterine Cancer ↗Checked 2026-09-29
- NCI: Endometrial Cancer Treatment ↗Checked 2026-09-29
- NCI PDQ: Endometrial Cancer Treatment ↗Checked 2026-09-29
How Cancer Clinic Finder compiles information · Suggest a factual correction
