Endometrial Cancer: Introduction
What is cancer?
Cancer is when cells in the body change and grow out of control. To help you understand what happens when you have cancer, let’s look at how your body works normally. Your body is made up of tiny building blocks called cells. Normal cells grow when your body needs them, and they die when your body does not need them any longer.
Cancer is made up of abnormal cells that grow even though your body doesn’t need them. In most cancers, the abnormal cells grow to form a lump or mass called a tumor. If cancer cells are in the body long enough, they can grow into (invade) nearby areas. They can also break off and spread to other parts of the body (metastasis).
What is endometrial cancer?
Endometrial cancer starts in the cells that form the inner lining of the uterus (which is called the endometrium).
You may hear endometrial cancer called uterine cancer. It’s actually 1 of 2 main types of uterine cancer. The other is called uterine sarcoma. It starts in the muscle layer of the uterus, not the lining.
Endometrial cancer is the most common type of cancer in the uterus. It usually takes years to develop. It most often occurs in women who have already gone through menopause. It is highly curable when found early.
Understanding the uterus
The uterus is an organ. It’s part of the female reproductive system. You may know it as the womb. The uterus is usually pear-shaped and about the size of a fist. It is located in the lower belly (pelvic area) between your bladder and your rectum. Your uterus is connected to your fallopian tubes. These tubes help carry eggs from your ovaries into the uterus. The small opening that connects the uterus to your vagina is the cervix.
The uterus is made up of 3 layers:
Endometrium. This is the inner lining.
Myometrium. This is the middle muscle layer.
Serosa. This is the outer smooth layer.
The uterus protects a growing baby during pregnancy. During labor, the myometrium muscle tissue helps push the baby out through the cervix. The smooth serosa makes it easy for the uterus to move in the pelvis as needed.
Understanding the endometrium
In women who still have their periods, one of the ovaries releases an egg into a fallopian tube each month. During this time, the endometrium becomes thicker as it gets ready to receive a fertilized egg. If the egg connects with a male sperm cell, this fertilized egg attaches to the endometrium. If the egg is not fertilized, it travels out of the uterus along with the endometrial lining as a woman’s period (menstrual flow).
How endometrial cancer spreads
If endometrial cancer spreads, it tends to grow into the muscle layer of the uterus, the myometrium, and then may go to places near the uterus. This may be the fallopian tubes, ovaries, cervix, vagina, or lymph nodes. It can also spread to the bladder or rectum. Advanced stages of endometrial cancer can spread as far as the bones and lungs. Most cases of endometrial cancer are found in the early stages before they have spread outside the uterus.
Cancer that spreads to other parts of the body is called metastatic cancer. The process is called metastasis. Metastasis is a complex process. The cancer cells of the tumor grow into other tissues, blood vessels, and the lymph system. They then travel through the bloodstream or lymph system to reach other parts of the body where they grow into new tumors.
Talk with your healthcare provider
If you have questions about endometrial cancer, talk with your healthcare provider. Your healthcare provider can help you understand more about this cancer.
Endometrial Cancer: Risk Factors
What is a risk factor?
A risk factor is anything that may increase your chance of having a disease. Risk factors for a certain type of cancer might include smoking, diet, family history, or many other things. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer.
Things you should know about risk factors for cancer:
Risk factors can increase a person’s risk, but they don’t necessarily cause the disease.
Some people with 1 or more risk factors never get cancer. Other people can get cancer and have no risk factors.
Some risk factors are very well known. But there is ongoing research about risk factors for many types of cancer.
Some risk factors, such as family history, may not be in your control. But others may be things you can change. Knowing the risk factors can help you make choices that might lower your risk. For example, if an unhealthy diet is a risk factor, you may choose to eat healthy foods. If excess weight is a risk factor, your healthcare provider may check your weight or help you lose weight.
Who is at risk for endometrial cancer?
Risk factors for endometrial cancer include:
Diet high in animal fats
Not being physically active
Family history of endometrial cancer
Family history of colon cancer (hereditary nonpolyposis colon cancer or Lynch syndrome)
Personal history of breast cancer
Personal history of ovarian cancer
Past radiation therapy to the pelvis
Personal history of atypical endometrial hyperplasia
Most of the risk factors linked to endometrial cancer come from too much exposure to the hormone estrogen. Estrogen and progesterone are the two main types of female hormones. The balance between these two hormones change every month during your menstrual cycle. The hormones need to be in the right balance for your uterus to be healthy. Risk factors that can affect this hormone balance and can increase your risk for endometrial cancer include:
Starting monthly periods before age 12
Inability to get pregnant (infertility)
Not giving birth to any children
Taking tamoxifen to prevent or treat breast cancer
Use of estrogen replacement therapy (ERT) to treat menopause symptoms
Personal history of polycystic ovary syndrome (PCOS)
Personal history of a type of ovarian tumor that produces estrogen, such as granulosa cell tumor
What are your risk factors?
Talk with your healthcare provider about your risk factors for endometrial cancer and what you can do about them. For instance, you may be able to lower your risk in areas you can control, such as diet and exercise. In fact, you can make some general lifestyle changes to reduce your endometrial cancer risk:
Eat a healthy diet and stay at a healthy weight. Limit the fat in your diet. Eat a moderate amount of a variety of foods. Get regular physical activity. If you have diabetes, work with your healthcare team to manage your condition. Your plan may include diet, exercise, and medicine. These steps will all help keep your weight within a healthy range.
Monitor and treat endometrial hyperplasia. If you have precancerous changes of the endometrium, talk to your doctor. You may need screening tests to check on the changes. Or you may need treatment.
Review your hormone therapy strategy. If you’ve gone through menopause and use estrogen therapy to help deal with the changes in your body, use the lowest dose possible for the shortest amount of time. Talk with your doctor about taking progesterone along with estrogen. This is called combination therapy. Using just estrogen without progesterone can lead to endometrial cancer if you still have your uterus. If your symptoms of menopause have gone away or gotten better, you may be able to reduce or stop hormone therapy.