Uterine Cancer
(Womb Cancer)

Uterine cancer is the fifth most common cancer in the UK, but is often discovered early and can be treated successfully.
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Overview

What is Uterine Cancer?

Uterine cancer, also known as cancer of the womb, primarily affects women aged 60 to 70 and ranks as the fifth most prevalent cancer in the UK. Typically, it is detected early and effectively treated. Cancer refers to the unregulated growth of cells, resulting in the formation of tumours. If these tumours possess the ability to spread to other tissues or organs, they are classified as cancerous or malignant. If they lack the ability to spread, they are deemed benign. The uterus, commonly referred to as the womb, constitutes a vital component of the female reproductive system. The most frequently observed form of uterine cancer occurs when cells in the lining of the womb (endometrium) begin to grow uncontrollably, referred to as endometrial cancer.

Common symptoms of Uterine cancer

  • Bleeding after menopause
  • Excessive or unusually heavy bleeding
  • Bleeding between periods
  • Vaginal discharge that is pink, watery, or white
  • Pelvic pain
  • Pain during intercourse
  • Weight loss
Around 90% of womb cancer cases are identified due to bleeding after menopause. It's crucial to note that abnormal bleeding can also be a symptom of other more common conditions such as endometriosis or fibroids. If you experience any of these symptoms, it is important to promptly consult your doctor or a gynaecologist. While it is unlikely to be cancer, if it is, early treatment offers better outcomes.
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What causes Uterine Cancer?

The precise cause of womb cancer remains unknown; however, it is believed that the balance between the female sex hormones estrogen and progesterone plays a significant role in its development. Several risk factors can indicate an increased likelihood of developing womb cancer:
  • Family history: There is a genetic link to womb cancer, and cases of ovarian cancer in close family members may increase the risk of developing the disease.
  • Age: Womb cancer commonly occurs after menopause, with 93% of cases observed in women between the ages of 50 and 70 in the UK.
  • Weight: Being overweight increases the risk of womb cancer, with overweight women being twice as likely and obese women being three times as likely to develop the disease compared to women of normal weight.
  • Menstrual history: Women who started menstruating early or reached menopause later have a higher likelihood of developing womb cancer. Irregular or infrequent periods may also be contributing factors.
  • Fertility and pregnancy: Womb cancer is more prevalent in women who have not had children or have experienced fertility issues. The risk decreases with the number of children a woman has had.
  • Contraception: Taking oral contraceptive pills appears to reduce the risk of developing womb cancer.
  • Polycystic Ovary Syndrome (PCOS): Women who have had PCOS may face an increased risk of womb cancer. For more information on PCOS, please refer to our separate fact sheet on the condition.
  • Hormone replacement therapy (HRT): Undergoing HRT, particularly the estrogen-only type, can elevate the risk of womb cancer. Your doctor will discuss the risks and benefits of HRT if you are considering it.
  • Tamoxifen treatment: Taking tamoxifen for breast cancer treatment increases the risk of womb cancer. However, the benefits of the drug outweigh the heightened risk. It is important to have regular pelvic check-ups and promptly report any unusual bleeding.
  • Race: White women are more likely to develop womb cancer, while black women who do develop the disease may experience a more aggressive form of cancer.
It is essential to consult with your healthcare provider if you have any concerns or fall into any of the above-mentioned risk categories.
Jason Yap - Consultant Gynaecologist
Consultant Gynaecologist, Gynaecological Oncologist & Lead Clinician for Vulval Disease
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Diagnosis

How can Uterine Cancer be diagnosed?

Once your symptoms have been discussed, your consultant gynecologist may need to conduct a pelvic examination to assess your condition. This examination might involve applying gentle pressure to your lower abdomen and palpating the pelvic region internally by inserting a gloved finger into the vagina while simultaneously pressing on the abdomen. Additionally, a speculum, a device enabling visualization of the cervix or neck of the womb, may be used.

Further diagnostic tests that may be recommended include:
  • Endometrial biopsy: A small sample of tissue is extracted from the inner lining of your womb to be analyzed in a laboratory.
  • Dilatation and curettage (D&C): This procedure is performed under general anesthesia and involves the scraping of tissue from the inner lining of the womb for microscopic examination.
If cancer is detected, additional tests will be necessary to determine the stage and extent of its spread (referred to as staging). These tests may encompass:
  • Pelvic or transvaginal ultrasound scan: A probe is passed over the lower abdomen or inserted into the vagina, and sound waves are used to generate images of the womb, ovaries, and surrounding pelvic area.
  • MRI scan: This imaging technique provides detailed two or three-dimensional pictures of organs and structures within the body without employing x-rays or radiation. It aids in assessing tumor size and location. However, MRI scans may not be suitable for all individuals.
  • CT or CAT scan: Similar to an MRI scan, this procedure employs a series of x-rays to construct an image of soft tissues.
These diagnostic examinations and tests are conducted to gather comprehensive information about the condition, aiding in the determination of appropriate treatment options. Your healthcare team will guide you through the process and explain the implications of the results.
Treatments

What treatments are there for Uterine Cancer?

The effectiveness and available treatment options for womb cancer rely on the stage of the cancer and its extent of spread. Fortunately, the majority of womb cancer cases are detected early, leading to successful treatment outcomes. The primary goal of all treatments is to eliminate or eradicate the abnormal cells.

Surgery

The most frequently employed treatment for womb cancer is surgical removal of the womb, known as a hysterectomy. In many cases, the procedure also involves the removal of the fallopian tubes and ovaries, referred to as hysterectomy with bilateral salpingo-oophorectomy. Following the hysterectomy, additional treatment may not be necessary. For further details on this surgical procedure, please refer to our dedicated fact sheet on hysterectomy.

Further treatment

If the womb cancer has spread or if it is an aggressive form of the disease, additional treatment may be necessary to target any remaining cancer cells after surgery. However, if the cancer was detected early, these supplementary treatments may not be required.The following treatment options may be considered:
  • Chemotherapy: This involves a course of drugs designed to kill any remaining cancer cells and inhibit the growth of new ones. The drugs can be administered orally as tablets, more commonly through intravenous injection, and sometimes directly into the abdomen.
  • Radiotherapy: While less frequently used than chemotherapy, radiotherapy employs high-energy X-rays to destroy any remaining cancer cells. It is highly targeted to minimize damage to surrounding healthy cells.
  • Hormone Therapy: The hormone progesterone may be utilized to prevent the growth of cancer in other areas of the body.
It is important to note that cancer treatments can result in unpleasant side effects such as nausea, vomiting, fatigue, and hair loss. It is crucial to discuss these potential side effects with your consultant prior to making a decision about treatment. Coping with cancer can be challenging both physically and emotionally, and the support of your family and friends will be invaluable. There are numerous organizations that provide support and can connect you with other women who have experienced similar circumstances. A list of these organizations is provided at the end of this fact sheet.

Fertility considerations

Womb cancer typically affects women after menopause. However, in rare cases, women may require treatment while still of childbearing age. If a hysterectomy is performed, it will result in infertility. If you desire to have children, hormone therapy might be an option to control the growth of the cancer without resorting to a hysterectomy. However, it is important to be aware that there is a possibility of cancer recurrence. It is essential to discuss your individual situation and fertility desires with your consultant to make informed decisions.
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Clinic locations

Healthcare clinics across Birmingham and the West Midlands