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Womb cancer

Key points

  • Womb cancer is the fourth most common cancer in women in the UK.
  • Most women who get womb cancer are over 50.
  • The most common symptom of womb cancer is bleeding from your vagina.
  • If womb cancer is diagnosed early, treatment can be very effective.
     

Womb cancer (uterine cancer), is caused by an abnormal and uncontrolled growth of cells in your womb (uterus).

About womb cancer

The womb

Your womb is a pear-shaped, muscular organ in your lower abdomen (tummy). It's part of the female reproductive system and is where your baby develops if you get pregnant. The lining of the womb is called the endometrium or endometrial layer.

Illustration showing the position of the womb and surrounding structures

Womb cancer is the fourth most common cancer in women in the UK – about 7,800 women are diagnosed each year. Most women who get womb cancer are over 50.

Womb cancer can sometimes invade surrounding tissue or spread through your bloodstream or lymphatic system to other parts of your body. Your lymphatic system is the tissues and organs that produce and store cells that fight infection and disease. A cancer that has spread is known as a metastasis.

How cancer develops

Types of womb cancer

There are two main types of womb cancer.

  • Endometrial cancer is the most common type and starts in the endometrium of your womb.
  • Uterine sarcoma is less common and develops in the cells in the muscle wall of your womb.

Symptoms of womb cancer

The most common symptom of womb cancer is bleeding from your vagina, particularly if you have been through the menopause. If you haven't been through the menopause, you may find that you have unusually heavy bleeding during your period or bleeding between periods.

Other, less common, symptoms of womb cancer include:

  • discharge from your vagina
  • pain or swelling in your lower abdomen, back or pelvis
  • pain or discomfort during sex, or bleeding after sex
  • weight loss
  • passing urine more often than usual
  • changes in your bowel movements

If you have any of these symptoms, see your GP.

Some women get a lump in their pelvis. These lumps are often benign (not cancerous), but some may be cancerous. Ask your doctor for more information.

Causes of womb cancer

The exact reasons why you may develop womb cancer aren't fully understood at present. However, you may be more likely to develop it if you have too much of the hormone oestrogen in your body (in relation to progesterone).

You're also more likely to develop womb cancer if you:

  • have polycystic ovary syndrome (PCOS) – a condition in which your ovaries contain many small cysts and don’t work properly
  • are older than 50
  • are overweight or obese
  • have close family members who have had bowel cancer
  • have taken oestrogen-only hormone replacement therapy (HRT)
  • have taken tamoxifen – a medicine sometimes used to treat breast cancer
  • have diabetes or high blood pressure
  • have never had children
  • started the menopause after the age of 52

The uterine sarcoma type of womb cancer is more common in African-American women, and in women who have previously had radiotherapy to their pelvic area.

Diagnosis of womb cancer

Your GP will ask about your symptoms and examine you. He or she may also ask you about your medical history.

Your GP may check inside your vagina and do a smear test. This is a test to examine the cells in the neck of your womb (cervix).

If your GP suspects you have womb cancer, he or she will refer you to a gynaecologist (a doctor who specialises in women's reproductive health).

You may have a number of further tests (arranged by your GP or your specialist) which may include the following.

Transvaginal ultrasound scan

In this test, a radiographer (a health professional trained to perform imaging procedures) will place a small ultrasound probe into your vagina. Ultrasound uses sound waves to produce an image of the inside of your womb. This will measure the thickness of your womb lining, which can help to diagnose womb cancer.

Biopsy

A biopsy is a small sample of tissue. This will be sent to a laboratory for testing to determine the type of cells and if these are benign or cancerous. There are several different ways to take a biopsy.

  • In an endometrial biopsy, your doctor will put a thin plastic tube into your womb through your vagina. He or she will use a syringe to gently suck cells from your womb into a tube.
  • In a hysteroscopy, your doctor will guide a narrow, flexible tube through your vagina and into your cervix. This has a light and camera on the end so your doctor can examine the inside of your womb and look for signs of cancer.
  • In dilatation and curettage (D and C), your doctor will gently open your cervix and take samples from the lining of your womb.

Blood tests

CA125 is a chemical produced by cancer cells, usually in ovarian cancer, but sometimes in womb cancer. Blood tests can check if CA125 is in your bloodstream.

Staging

If you're found to have womb cancer, you may need to have other tests to find out how advanced it is. This process, known as staging, takes into account whether the cancer has spread and how big it is. Your doctor will usually advise you to have scans, such as an ultrasound, MRI or CT scan. These will check different areas of your womb, vagina and lymphatic system.

Treatment of womb cancer

If womb cancer is diagnosed early, treatment can be very effective.

Your treatment for womb cancer will depend on the type of womb cancer you have. It will also depend on how fast it's growing, how far it has spread, your age and your general health. Your doctor will discuss your treatment options with you.

Surgery

For most women with womb cancer, the first and most common treatment is surgery. Your doctor will probably suggest a hysterectomy – an operation to remove your womb.

If you have a total hysterectomy, your surgeon will usually remove your womb, fallopian tubes and both ovaries. Your surgeon may also remove or examine the lymph nodes around your womb. As well as removing any cancerous cells, checking the lymph nodes can help your doctor to decide if you need other treatment.

The aim of surgery is to remove all traces of the cancer. If your cancer hasn’t spread outside your womb, a hysterectomy is often successful at treating it.

You might be able to have keyhole surgery, which may mean you recover from the operation more quickly. Ask your surgeon for more information.

Non-surgical treatments

Non-surgical treatments include the following. You may have these with, or instead of, surgery.

  • Radiotherapy is a treatment to destroy cancer cells with radiation. You can have external or internal radiotherapy. In external radiation, a beam of radiation will be targeted on the cancerous cells, which will shrink the tumour. In internal radiotherapy (brachytherapy), a radiation source will be put inside your womb. You may have radiotherapy if your cancer has spread and surgery isn't possible. You may also be offered radiotherapy after surgery to reduce the chance of the cancer coming back.
  • Chemotherapy uses medicines to destroy cancer cells. Chemotherapy is occasionally used to treat cancer that has spread outside your womb or to reduce the chance of the cancer coming back. It can be used alongside radiotherapy.
  • Hormone therapy uses progesterone, which is a natural hormone in women that can affect the growth of cancer cells. You may have progesterone treatment to help slow the growth of womb cancer that has returned after other types of treatment. Or you may have it to treat womb cancer that has spread to other parts of your body.

After treatment for womb cancer, you will have regular check-ups with your doctor to see if the cancer has returned. If the cancer has already spread, you can get support from specialist cancer doctors and nurses as well as treatment for any symptoms. This is called palliative care.

Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, June 2014.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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