Uterine Cancer: A Patient Guide to Understanding and Care

Overview

Uterine cancer is a growth of abnormal cells in the uterus, the pear-shaped organ in the pelvis where a baby grows during pregnancy. The most common form is endometrial cancer, which starts in the inner lining (endometrium). A rarer type is uterine sarcoma, which starts in the muscle wall or other supportive tissues. Most cases are found in people after menopause, and many are caught early when treatment can be highly effective.

This guide uses plain language to explain what to expect. Your individual situation is unique—always discuss questions and next steps with your doctor or gynecologic oncology team.

Signs & Symptoms

The most important early sign is abnormal vaginal bleeding or spotting. In people who still have periods, this can mean bleeding between periods, heavier or longer periods, or bleeding after sex. After menopause, any vaginal bleeding or pink/brown discharge needs prompt medical attention.

• Unusual vaginal bleeding or discharge (most common symptom)
• Pelvic pain or pressure that does not go away
• Pain during sex
• Unexplained weight loss
• Feeling a mass or fullness in the lower abdomen (less common and often later)

Causes & Risk Factors

Uterine cancer develops when cells in the uterus grow out of control. Exact causes are not fully known, but higher and longer exposure to the hormone estrogen without enough progesterone raises risk. Most people with risk factors never develop the disease, and some people with no known risks still do.

• Age (most common after age 50–60)
• Obesity (fat tissue can increase estrogen)
• Never having been pregnant or late menopause
• Certain hormone therapies or tamoxifen use
• Family history of uterine, ovarian, or colon cancer (including Lynch syndrome)
• History of endometrial hyperplasia (thickened lining)
• Diabetes or polycystic ovary syndrome (PCOS)

Diagnosis

If symptoms suggest uterine cancer, your clinician will start with a detailed history and pelvic exam. The key test is an endometrial biopsy—removing a small sample of the uterine lining in the office for lab analysis. Transvaginal ultrasound measures lining thickness. If needed, a dilation and curettage (D&C) under anesthesia or hysteroscopy (looking inside the uterus with a thin camera) may be done. Imaging such as CT, MRI, or PET scans helps determine if cancer has spread (staging).

Treatment & Management

Treatment depends on the type, stage, grade of the cancer, your overall health, and whether you want to preserve fertility (possible only in carefully selected early cases). A multidisciplinary team—often including a gynecologic oncologist—plans care.

Many people with early-stage endometrial cancer are cured with surgery alone. Your team will also address side effects, fertility concerns, menopause symptoms, and sexual health.

Living With It

After treatment, regular follow-up visits check for recurrence and manage long-term effects such as surgical menopause, fatigue, or changes in body image. Emotional support, nutrition, physical activity as able, and open communication with your care team help quality of life. Survivorship care plans outline recommended check-ups, tests, and healthy habits.