6 cancer symptoms women shouldn't ignore
Endometrial Cancer Screening Exams
Endometrial cancer is cancer of the lining of the uterus, or womb. Endometrial cancer screening is only recommended for women at increased risk.
Being at increased risk doesn’t mean you will definitely get endometrial cancer. But it does mean you should start regular screening exams to detect cancer if it develops. When found early, the chances for successfully treating the disease are greatest.
If you’ve been diagnosed with or have a family history of Lynch syndrome, also known as hereditary non-polyposis colorectal cancer, you should be screened for endometrial cancer. The following screening exams are recommended:
- Transvaginal ultrasound every year
- Endometrial biopsy every year
If you are unsure about your risk, print and share MD Anderson’s endometrial cancer screening chart with your doctor.
See your doctor if you have symptoms of endometrial cancer
Be aware of your body and be on the lookout for changes that might be symptoms of endometrial cancer. These symptoms do not always mean you have endometrial cancer, but it's a good idea to discuss them with your health care provider if they are new, last more than a few weeks or happen more than 12 times a month.
Reduce your risk for endometrial cancer
Endometrial cancer has several risk factors that won’t necessarily trigger screening but increase your chances of getting the disease. Some are in your control and some are not. There are steps you can take to reduce your risk of endometrial cancer:
- Maintain a healthy weight. Experts believe that 6 out of every 10 cases of endometrial cancer are caused by being overweight or obese.
- Know your family history. Talk to family members about their history of breast, endometrial, colorectal and other cancers. Having this knowledge can help you know if you should seek genetic counseling to get a better picture of your risk.
- Think twice about hormone replacement therapy. If your doctor recommends HRT, make sure you ask how it will affect your cancer risk. Consider alternative treatments for menopausal symptoms.
Exams for women who’ve had endometrial cancer
If you’ve had endometrial cancer, you need a different plan to check for recurrence. Print and share MD Anderson’s endometrial cancer survivorship chart with your doctor. Your doctor can use this chart to develop a more tailored plan for you.
The screening plans on this page apply to women expected to live for at least 10 years. They’re not for women who have a health condition that may make it hard to diagnose or treat endometrial cancer. Your doctor can help you decide if you should continue screening after age 75.
What to expect from an endometrial biopsy
If you’ve been told you need an endometrial biopsy, you probably have some questions. Why has it been ordered? What will it involve? And, most importantly, what will the results show your doctors?
We sat down with gynecologic oncologist Larissa Meyer, M.D., to learn more.
What is an endometrial biopsy?
It’s a very simple, in-office procedure that allows doctors to obtain a sample of the cells that form the lining of the uterus, also known as the endometrium.
Doctors use these samples to look for evidence of abnormalities that could indicate precancerous changes in the cells or the presence of actual cancer in the endometrium.
Why are endometrial biopsies usually performed?
Your doctor could order an endometrial biopsy for several reasons:
- Abnormal bleeding from the vagina: In post-menopausal women, this would mean any bleeding at all. In pre-menopausal women, this would mean unusual patterns of bleeding.
- Hereditary cancer syndromes: We don’t normally screen for endometrial cancer in women at average risk. But for certain patients in high-risk groups, such as those with Lynch syndrome or other hereditary cancer syndromes, screening may be recommended.
- Abnormal scan results: An endometrial biopsy may be needed if an ultrasound reveals a thick endometrial “stripe,” for example, or a radiologist sees something unusual that they don’t think should be there.
- Treatment monitoring: Sometimes, a hysterectomy is recommended for someone with endometrial hyperplasia (a type of abnormal cell growth that can lead to cancer), early-stage endometrial cancer, or a uterine tumor that is not otherwise removable. Patients who wish to preserve their fertility may wish to be treated with hormone therapy instead. In those situations, doctors would likely perform an endometrial biopsy every three months to monitor their progress.
What happens during an endometrial biopsy?
The doctor inserts a speculum into the vagina so that they can see the cervix. A speculum is the same instrument used to hold open the vagina during a Pap test.
Then, the doctor passes a tiny, soft, flexible straw called a pipelle through the cervix until it touches the fundus, or uppermost part, of the uterus. They gently move it around while drawing back the plunger to suck in some tissue. Then, they remove the pipelle, which is only about the diameter of a piece of linguine.
That’s really all there is to it. Other than the speculum, which is usually made out of stainless steel, there’s no metal involved. There’s also no blade and no cutting.
What happens if the pipelle can’t pass easily through the cervix?
If the uterus is moving around too much, we have an instrument called a tenaculum that we can place on the cervix to help stabilize the uterus and hold it steady.
If the cervical canal is too narrow, we have a series of very small rounded instruments to gently dilate it in the clinic.
If all else fails, we can perform the biopsy under general anesthesia. But that scenario is very rare.
What do the results of my endometrial biopsy mean?
Here are some words and phrases you might see on your biopsy results:
- Proliferative endometrium
- Atrophic endometrium
- Hyperplasia
- Carcinoma
If you see either of the first two phrases, your results are normal.
If you see either of the other two phrases, your results indicate that some abnormal/precancerous or cancerous cells were found. Ask your doctor what that means for next steps, as you will likely need some form of treatment.
What is the recovery process like for an endometrial biopsy?
The cervix doesn’t like to be opened, so many patients compare the experience to having bad menstrual cramps. Unfortunately, topical anesthesia hasn’t been shown to be effective in reducing this sensation. But it’s often helpful to take ibuprofen before the procedure. Talk to your doctor to see if that might be appropriate for you, and if so, what dosage they’d recommend.
Any lingering discomfort from the biopsy usually goes away within 10 to 20 minutes. After that, most people are fine, and can go right back to doing whatever they were doing before the procedure.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.