A Third of Women Can't Identify This Common Symptom of Endometrial Cancer
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Fact checked by Nick BlackmerFact checked by Nick Blackmer
Key TakeawaysA recent survey revealed a large number of women are unaware that postmenopausal bleeding is the most common sign of endometrial cancer.There is no routine screening test for endometrial cancer, so individuals with a uterus need to be aware of the symptoms and report them to their physician promptly.Any bleeding that occurs after menopause should be addressed by your doctor.
A recent survey showed that more than one-third of women could not identify the most common red flag for endometrial cancer: postmenopausal bleeding. Because this symptom occurs in 90% of patients with endometrial cancer, the finding underscores a crucial need for increased awareness and education about this disease.To learn about endometrial cancer awareness—or lack thereof—researchers from the University of Minnesota recruited 648 participants at the Minnesota State Fair who were assigned female at birth to take a survey. The results showed the majority of participants were not well-versed in symptoms:Only 63% correctly identified postmenopausal bleeding as the most common sign of endometrial cancer.Women who were born in the United States, had a college education, or had private health insurance were more likely to have correctly identified postmenopausal bleeding as a sign of endometrial cancer.Out of the 145 participants who reported being postmenopausal, less than half said their healthcare provider had discussed postmenopausal bleeding with them.Women's health advocates are concerned that a lack of awareness regarding the signs and symptoms of endometrial cancer could lead to fewer women discussing their concerns with their providers.
A Note on Gender and Sex TerminologyVerywell Health acknowledges that sex and gender are related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
What Is Endometrial Cancer?Endometrial cancer occurs in the uterine lining, also called the endometrium, which is shed monthly during menstruation. While several types of cancer can affect the uterus, endometrial cancer is the most prevalent cancer of the female reproductive system."Endometrial cancer is likely to become the third most common cancer among women in the next decade or two. It's likely to overtake ovarian cancer in deaths," Casey Cosgrove, MD, a gynecologic oncologist at the Ohio State University Comprehensive Cancer Center, told Verywell. He added that while most cancer rates are decreasing, endometrial cancer is one of the few cancers that is increasing in incidence and mortality."We are seeing worsening survival across all ethnicities, but especially among women who are Black," Cosgrove said. "Understanding the growing disparities so that we can evaluate the right treatment approaches for all women is becoming increasingly important."
Related: Why Is Cancer Rising In Young Adults?
What Are the Signs and Symptoms of Endometrial Cancer?Postmenopausal bleeding occurs in 90% of patients with endometrial cancer and may often be the only symptom of the condition. Warning signs may also include:New onset of pelvic painUnexplained weight gainUrinary frequencyChanges to bowel functionOther signs of endometrial cancer can include bleeding with intercourse or new symptomatic vaginal discharge, Joshua Cohen, MD, Medical Director of the Gynecologic Cancer Program at City of Hope in Orange County, California, told Verywell."Some patients have normal vaginal discharge around the time of their period, but bleeding at other times, especially if it is odorous, is abnormal," he said.While 85% of endometrial cancers occur in postmenopausal people between the ages of 65 and 75, endometrial cancer can still develop before menopause. Therefore, anyone who experiences abnormal menstrual bleeding or any other concerning symptoms of endometrial cancer, even prior to menopause, should alert their physicians."Before menopause, the most likely cause is not cancer, but we still want them to be evaluated," Cohen said.Can You Lower Your Risk of Developing Endometrial Cancer?According to Cosgrove, obesity is the biggest modifiable risk factor for endometrial cancer."Excess adipose tissue makes estrogen, which feeds the uterus lining," he said.A healthy lifestyle can decrease your risk of endometrial cancer, among other things. Cohen suggests avoiding tobacco, exercising regularly, and following a diet that is moderate in red meat and alcohol (such as the Mediterranean diet). Such lifestyle modifications can also control conditions like high blood pressure and diabetes, which increase the risk of endometrial cancer.Other conditions that increase a person's risk of developing endometrial cancer are polycystic ovarian syndrome (PCOS) and a history of abnormal uterine bleeding. For this reason, people with conditions that cause heavy or abnormal menstrual bleeding may benefit from birth control pills or hormonal intrauterine devices, which regulate periods and prevent the build-up of uterine tissue.Women who've had breast cancer and take the estrogen-blocking drug tamoxifen as part of their treatment have a two to three times greater risk of developing endometrial cancer. However, Cohen said, "the risk is still very low compared to the benefit."Family History Matters, TooAbout 3-5% of endometrial cancers are hereditary, so people with a family history of gynecological cancers should talk to their primary care provider or gynecologist about genetic testing. Lynch syndrome, a genetic condition that predisposes a person to have several different kinds of cancer, increases a person's risk of colon and endometrial cancer.Cosgrove said anyone else who receives a diagnosis of endometrial cancer, regardless of their family history, should have genetic testing to determine if they are at risk for Lynch syndrome. If further testing confirms the diagnosis, genetic relatives will need testing and surveillance to screen for Lynch syndrome and its complications.If a person has a strong family history of colon or uterine cancer, they should have preemptive genetic testing for Lynch syndrome. If they test positive for the condition, they can decide whether they want to use hormonal therapies to reduce their risk of developing endometrial cancer or have a hysterectomy to prevent the disease altogether.Talk to Your Doctor Sooner, Not LaterThere is no screening test for endometrial cancer, and the symptoms can be vague, so early detection is vital. Stage 1 endometrial cancer has a 95% survival rate. However, individuals whose cancer has metastasized (spread beyond the uterus) have an average life expectancy of only 15 months with treatment.
TakeawayA pap smear samples cells of the cervix to screen for cervical cancer. It will not detect endometrial cancer.
If your doctor suspects endometrial cancer, they will confirm the diagnosis with an endometrial biopsy, an outpatient procedure that removes a small sample of the endometrium for evaluation. They may also order other medical imaging to determine if your cancer has spread.Cosgrove said that newer treatment approaches, such as immunotherapy, have been game changers in endometrial cancer, especially for patients with Lynch syndrome."We now have FDA-approved treatments for many patients that have Lynch syndrome," he said. "We're seeing responses that we've never seen before in endometrial cancer."Antibody-drug conjugate (ADC) drugs, such as Enhertu, are another cutting-edge treatment option for some forms of endometrial cancer. These drugs deliver chemotherapy directly to the affected receptor sites of cancer cells. "We're seeing extraordinary responses to ADC drugs," Cosgrove said.Postmenopausal individuals do not need to see a gynecologist yearly. However, it is a good idea to maintain a relationship with your gynecologist, should you need them."We can't brush symptoms under the table. If something is bothersome or is getting worse, it needs to be addressed by a care provider who is familiar with female anatomy and comfortable discussing postmenopausal symptoms such as vaginal bleeding," Cosgrove said.
What This Means For YouKnow your family history. Tell your primary care provider or gynecologist if you have a family history of cancers, especially reproductive cancers or Lynch syndrome. Your doctor should address any bleeding that occurs after menopause, even once. Early detection is critical, and your vigilance can make a difference.
Read the original article on Verywell Health.
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