Ladies, heed this doctor's advice. (For Spectrum Health Beat)
Ladies, heed this doctor’s advice. (For Spectrum Health Beat)

Maybe you’re through menopause but you’ve noticed a little spotting, bleeding or watery discharge. Or you’re having cramps reminiscent of your younger days, but you haven’t had a period in years.

Or maybe you have pelvic pain or pain during sex. Or your periods are heavy and frequent. Or eating fills you up quickly and makes you nauseated. Or you can’t explain why you’re losing weight.

These could all be warning signs of endometrial cancer.

And that means it’s time to schedule an appointment with your doctor.

“Ignoring these symptoms is at your own personal hazard,” said Spectrum Health gynecologic oncologist Charles Harrison, MD. “Many women ignore their symptoms … often because they’re embarrassed by having a pelvic exam.”

Think peach

Endometrial cancer is the most common cancer of the female reproductive organs, with more than 60,000 new cases diagnosed each year, according to the American Cancer Society. In the rainbow of ribbons for cancer awareness, peach is the symbol of uterine cancer.

The recent death of PBS journalist Gwen Ifill is raising awareness of the disease.

Endometrial carcinomas start in the inner lining of the uterus, and 90 percent are hormone-driven. The other 10 percent, which are not hormone-driven, are potentially more aggressive. Other malignancies of the uterus include cervical cancer and uterine sarcomas, which start in the muscle layer or connective tissue of the uterus.

There is no screening or testing recommended for the general population.

“It underscores the importance of knowing your own body as a woman and reporting abnormal symptoms,” said TJ Krasun, senior manager of the American Cancer Society Lakeshore Division. “It’s also a reminder of the importance of having a primary care doctor and having an annual visit.”

The organization is funding 11 research grants to understand endometrial cancer, find it early and treat it in new ways.

Know your risk

Typically, endometrial cancer occurs in women age 60 or older, and it’s rare in women under 45. Risk factors include:

  • Obesity. Having more fat tissue can increase your estrogen level, and makes your risk of endometrial cancer two or three times higher than women with a normal body weight.
  • Diabetes. Endometrial cancer is up to four times more common in women with diabetes.
  • Taking estrogen without progesterone. “Women who take ‘unopposed’ estrogen for hot flashes are doing themselves a disservice,” Dr. Harrison said.
  • History of cancer. Those who had breast or ovarian cancer are at higher risk. Using tamoxifen, a drug to treat and prevent breast cancer, can also increase the likelihood of developing endometrial cancer.
  • Never having children. If you’ve never been pregnant, especially if you were infertile, your risk is higher.
  • Polycystic ovarian syndrome. This syndrome causes higher estrogen levels and lower progesterone levels, which increases your risk.
  • Family history of endometrial or colorectal cancer. Be especially careful if you have Lynch Syndrome, an inherited disorder that increases your cancer risk. Women who have been diagnosed with this disorder are recommended to undergo endometrial sampling every one to two years beginning at age 30-35, and they may consider a hysterectomy after they have completed childbearing.

Things that protect against endometrial cancer include use of birth control pills, pregnancy or multiple pregnancies, using an intrauterine device, having a normal body weight and being physically active.

Act quickly

About 90 percent of women who develop endometrial cancer have abnormal vaginal bleeding or an unusual discharge, which occurs when the inner lining of the uterus grows out of control.

It’s an alarming symptom.

But it’s also hard to ignore, which is one reason this cancer is usually diagnosed early.

Thanks to early intervention, four out of five women who develop endometrial cancer survive for five years or more.

Typical treatment includes surgery to remove the uterus and possibly the fallopian tubes and ovaries along with affected lymph nodes as needed. This may be followed by radiation or chemotherapy depending on the situation.