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Endometrial cancer, also known as uterine cancer, affects the inner lining of the uterus. 

It (endometrial cancer) is the fourth most common women’s cancer and most common female genital tract cancer in Singapore. While endometrial cancer can affect women of any age, the majority of cases (70%) occurs in women above the age of 50.

“Infertility or failure to ovulate puts a woman at greater risk of developing endometrial cancer while getting pregnant and having children has a protective effect,” shares Consultants from the KK Gynaecological Cancer Centre at KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.

Most cases of endometrial cancer present early with some form of abnormal vaginal bleeding, particularly post-menopausal bleeding.

5 Things to remember about endometrial cancer (uterine cancer)

1. Endometrial cancer is not painful in the early stages of the disease. Don’t wait for painful symptoms to occur, get any suspicious symptoms checked

2. Post-menopausal bleeding is not normal, and may be a symptom of endometrial cancer

3. Irregular heavy periods can also be a symptom of endometrial cancer, and any woman suffering from it should seek medical attention

4. Endometrial cancer is curable if it is detected at an early stage. The 5-year survival rate for endometrial cancer is about 80 per cent

5. If endometrial cancer is discovered early and is confined to the uterus, removing the womb often eliminates all of the cancer

How to prevent endometrial cancer (uterine cancer)

There are various ways a woman can reduce her risk of endometrial cancer:

1. Maintain a healthy weight and lifestyle
   Have a nutritious diet (eating foods that are low in fat and cholesterol and high in fibre, such as fruits, vegetables and wholegrain breads and cereals). Exercise regularly 

2. Go for a yearly pelvic examination

3. Consult a doctor early, if you notice any abnormal vaginal bleeding. Most bleeding is not caused by uterine cancer, but your doctor can investigate the cause of the abnormal bleed.

​Stages of endometrial cancer (uterine cancer)

If endometrial cancer (uterine cancer) is not detected early, it can spread (metastasize) from the uterus to neighbouring areas such as the cervix, and further away to the bowels. 

The different stages of the endometrial cancer are determined by how far the disease has spread.

Stage 1: Cancer is limited to the uterus

Stage 2: Cancer has spread from the uterus to the cervix

Stage 3: Cancer has spread to the wider pelvic region, including the pelvic lymph nodes

Stage 4: Cancer has spread outside the pelvic region, to the bladder, bowels, rectum

Treatments for endometrial cancer (uterine cancer)

Treatment of endometrial cancer will depend on the stage of the disease and the general health of the patient. 

Doctors usually recommend surgery as the best treatment for endometrial cancer. Surgery typically involves the removal of the uterus (hysterectomy), as well as the removal of the fallopian tubes and ovaries (salpingo-oophorectomy).

“If you are still having your periods, you'll experience menopause once your ovaries are removed," says Consultants from the KK Gynaecological Cancer Centre.

The surgeon will also remove the pelvic lymph nodes, to assess the spread of the cancer. 

If the cancer is at an advanced stage, the patient may be required to undergo further treatment after surgery. This could be in the form of radiotherapy, hormonal treatment or chemotherapy.

If the patient is not fit enough to undergo surgery, she may be treated with radiation alone.

Treatment options for endometrial cancer include:

Surgery

Treatment for uterine cancer usually involves surgical removal of the uterus (hysterectomy), fallopian tubes and ovaries (salpingo-oophorectomy). 

The surgeon may also remove lymph nodes for testing. Surgery also allows doctors to assess the extent of spread of the cancer (stage of the cancer) and decide what treatment will have the best chance for success.

The procedure can be done by minimally invasive surgery or open surgery. The surgeon will assess each patient’s condition and recommend the most suitable surgery method.

Following surgery, additional or adjuvant treatment such as chemotherapy and radiotherapy may be required depending on the stage, grade and subtype of the cancer.

Radiotherapy

Radiotherapy uses powerful energy beams, to kill cancer cells. In some instances, the doctor may recommend radiation to reduce the risk of uterine cancer recurrence after surgery.

Brachytherapy (internal radiotherapy) is usually given for early stage disease while external beam radiotherapy is given for more advanced disease.