Endometrial (uterine) cancer

Endometrial cancer develops from the inner lining of the uterus (the endometrium) and is most common after the menopause. Because its main warning sign is abnormal vaginal bleeding, it is often detected at an early stage.

Symptoms

  • Any bleeding or spotting after the menopause
  • Before the menopause: bleeding between periods, or unusually heavy or prolonged periods
  • Blood-stained or watery, foul-smelling discharge
  • In advanced cases: pelvic pain, abdominal bloating and weight loss

Bleeding after the menopause, however slight, should always be assessed by a gynaecologist. The cause is usually benign, but it may also be the only warning sign.

Risk factors

Most endometrial cancers are linked to long-term exposure of the uterine lining to oestrogen. The main factors that increase the risk are:

  • Excess weight, diabetes and high blood pressure
  • Starting periods at a young age or a late menopause
  • Never having given birth; polycystic ovary syndrome
  • Oestrogen therapy without progesterone, or tamoxifen use
  • Inherited conditions in the family such as Lynch syndrome

Having one of these risk factors does not mean you will develop the disease, but symptoms should be assessed more carefully.

How is it diagnosed?

Assessment begins with a gynaecological examination and a transvaginal ultrasound, which measures the thickness of the uterine lining. A definitive diagnosis requires a tissue sample from inside the uterus. This is usually taken in hospital by curettage or under hysteroscopy.

If the pathology result confirms cancer, imaging such as MRI or CT is used to assess whether the disease has spread.

Treatment options

Surgery is the main treatment for endometrial cancer. The extent of the operation is planned according to the type and stage of the disease.

Surgery

Removal of the uterus, fallopian tubes and usually the ovaries; assessment of the lymph nodes when needed.

Laparoscopic (keyhole) surgery

In suitable patients the operation is performed through small incisions with a camera, usually with a shorter hospital stay and faster recovery.

Sentinel lymph node mapping

In suitable patients, instead of removing all lymph nodes, the nodes to which the disease would spread first are identified and examined.

Additional treatment

Depending on the pathology result after surgery, radiotherapy, chemotherapy or targeted therapy; this decision is made by a multidisciplinary tumour board.

In selected young women who wish to have children and have very early-stage disease of a particular type, hormone treatment that preserves the uterus, with close follow-up, may be considered.

Follow-up after treatment

Check-ups are more frequent in the first years after treatment and less frequent afterwards. They include an examination and imaging when needed. If you notice new bleeding, pain or other symptoms, seek advice without waiting for your next appointment.

Frequently asked questions

Does a smear test detect endometrial cancer?

No. The smear test screens for diseases of the cervix and does not reliably detect cancer of the uterine lining. Abnormal bleeding needs separate assessment even if your smear is normal.

My ultrasound showed a thick uterine lining – does this mean cancer?

Usually not. Thickening can also be caused by a polyp, hyperplasia or hormonal factors. A tissue sample is usually needed for a definitive assessment.

Can the operation be done by keyhole surgery?

In many suitable patients, yes. The decision depends on the stage of the disease, the size of the uterus and your general health.

Will I go through the menopause if my ovaries are removed?

If you have not yet reached the menopause, removing the ovaries will bring it on. How to manage any resulting symptoms is discussed when your treatment is planned.

Book a consultation

Prof. Dr. Derya Sivri Aydın sees patients at Medical Park Bahçelievler Hospital, Istanbul. International patients are supported by the hospital's International Patient Services Center.

The information on this page is for general guidance only; the right diagnosis and treatment for you are decided after a consultation. Last updated: November 2026.