Uterine cancer (womb cancer) – causes, risks, symptoms, and diagnosis
Womb cancer is the fourth most common cancer among women in Singapore. More than 90% of cases arise from the endometrium – the lining of the female uterus. Uterine cancer typically occurs between the ages of 50 and 70, but women under 40 years may be affected too.
The exact cause of womb cancer remains unclear, but it has been largely found to result from high levels of oestrogen stimulation or hormonal imbalances in the female body. An early onset of menses (before 12 years) or late onset of menopause (50 years average) could be an indicative factor. The use of certain prescription drugs, and underlying medical conditions such as Polycystic Ovary Syndrome (PCOS), obesity, diabetes mellitus, and hypertension are associated with an increased likelihood of developing womb cancer. Women with hereditary Lynch syndrome, a personal or family history of breast, ovarian, and/or colorectal cancer may also carry genetic risks for the disease.
Symptoms of womb cancer
The main symptom of womb cancer is abnormal vaginal bleeding. This includes:
- Postmenopausal bleeding
- Heavy menses
- Vaginal bleeding between regular periods
Women of reproductive age undergo regular menstruation for the uterine lining to shed and stay healthy. Infrequent, absent, or prolonged periods could suggest trouble in the uterus. Any amount of vaginal bleeding after menopause is a worrying sign. Contrary to popular assumption, women who have completed menopause do not experience a ‘revisit’ or ‘return’ to menstrual bleeding. Rarely, pelvic pain, urinary retention, or constipation may present due to abdominal pressure from an enlarged uterus. Persisting symptoms should be checked out by your physician.
Detecting womb cancer
A gynaecologist will be able to address potential concerns by physical examination, and an ultrasound scan of the pelvis may be conducted to identify any thickening or abnormalities of the endometrium. Where necessary, a diagnostic procedure called hysteroscopy may be performed, during which a narrow probe is inserted through the vagina to allow for closer inspection of the uterine cavity. A small sample of tissue may also be taken from the any suspicious areas at the same time for further evaluation at the laboratory. This is a safe and simple procedure and is usually done as a minor day-surgery to determine the possibility of cancer.
Common Gynaecological Cancers – Uterine Cancer FAQ by Dr Chay Wen Yee [Endometrial cancer]
If cancer is detected, further imaging such as a CT scan may follow so that your doctor can assess the extent of any spread of cancerous cells and recommend a suitable treatment plan.
This article has been fact-checked by Dr Timothy Lim, specialist in obstetrics and gynaecology at Timothy Lim Clinic for Women & Cancer Surgery, Mount Alvernia Hospital.