Uterine cancer
Uterine cancer symptoms and risks
Understand the symptoms, key risk factors, including age and family history, and the difference between the two types of uterine cancer.
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Sources and references 
What are the symptoms of uterine cancer?
The most common symptom of cancer of the uterus is unusual vaginal bleeding. This may include:
- bleeding or spotting after menopause
- heavier than usual periods or other changes in periods
- bleeding between periods
- constant bleeding (periods that continue without a break).
A less common symptom is a smelly, watery vaginal discharge. In rare cases, symptoms include abdominal (belly) pain, unexplained weight loss, difficulty urinating (weeing) or a change in bowel habit (pooing). Any of these symptoms can happen for other reasons, but it is best to see your doctor for a check-up.
What are the risk factors for uterine cancer?
The exact cause of cancer of the uterus is unknown, but factors that can increase the risk include:
- age – cancer of the uterus is most common in women aged over 50 and in women who have stopped having periods (postmenopausal)
- body weight – carrying extra body weight (overweight or obese) is a major risk factor
- medical factors – having diabetes; having previous radiation therapy for cancer in the pelvic area; having endometrial hyperplasia (see box below)
- family history – having an inherited change in a gene (mutation) linked with endometrial cancer (e.g. Lynch syndrome or Cowden syndrome), or having one or more close blood relatives diagnosed with cancer of the uterus or ovarian cancer
- reproductive history – not having children
- hormonal factors – starting periods before the age of 12; going through menopause after the age of 55; taking some types of oestrogen-only menopausal hormone therapy (MHT, previously called hormone replacement therapy or HRT); or taking tamoxifen, an anti-oestrogen drug used for breast cancer.
Many people who have risk factors don’t develop cancer of the uterus, and some people who get this cancer have no risk factors. If you are concerned about any risk factors, talk to your doctor. Maintaining a healthy body weight and being physically active are the best ways to reduce the risk of developing cancer of the uterus.
Other conditions of the uterus
Some conditions can affect the uterus and cause abnormal vaginal bleeding and pain. They may be found during tests for cancer of the uterus.
- Polyps – Small, soft growths attached to the inner wall of the uterus. Polyps are usually benign (not cancer), but some may turn into cancer. They can be removed during a hysteroscopy (see page 15) and tested for cancer.
- Fibroids – Benign tumours that begin in the muscle layer of the uterus (myometrium). Surgery may be used to reduce the size of the fibroid (myomectomy) or remove the uterus (hysterectomy).
- Endometrial hyperplasia – Thickening of the uterus lining (endometrium) caused by too much oestrogen. Usually benign, but can lead to cancer, so may be treated with hormones, minor surgery or, in some cases, hysterectomy.
- Endometriosis – When endometrial tissue grows outside the uterus (e.g. in the abdomen). Does not usually lead to cancer. May be treated with surgery or hormones.
Which health professionals will I see?
Your general practitioner (GP) will arrange the first tests to assess any symptoms. If these tests do not rule out cancer, you will be referred to a gynaecological oncologist or gynaecologist for more tests. If cancer of the uterus is diagnosed, the specialist will consider treatment options. To ensure the best outcome, it is recommended that you are treated by a specialist gynaecological cancer team.
Treatment options will often be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting. During and after treatment, you may see a range of health professionals for various aspects of your care.
gynaecological oncologist: diagnoses and performs surgery for cancers of the female reproductive system (e.g. cancer of the uterus, or cervical, ovarian, vulvar and vaginal cancers)
gynaecologist: specialises in diseases of the female reproductive system; may diagnose cancer of the uterus and then refer you to a gynaecological oncologist
radiation oncologist: treats cancer by prescribing and overseeing a course of radiation therapy
medical oncologist: treats cancer with drug therapies such as chemotherapy, hormone therapy, targeted therapy and immunotherapy (systemic treatment)
cancer genetics specialist: specialises in understanding cancers that have occurred as a result of inherited risk
cancer care coordinator: coordinates your care, liaises with other members of the MDT and supports you and your family throughout treatment; care may also be coordinated by a clinical nurse consultant (CNC) or clinical nurse specialist (CNS)
nurse: administers drugs and provides care, information and support throughout treatment
fertility specialist: diagnoses, treats and manages infertility; may be an obstetrician, gynaecologist or reproductive endocrinologist
women's health physiotherapist: assists with physical problems associated with gynaecological cancers, such as bladder and bowel issues, sexual issues and pelvic pain
lymphoedema practitioner: educates people about lymphoedema prevention and management, and provides treatment if lymphoedema occurs; often a physiotherapist or occupational therapist
psychologist, counsellor: help you manage your emotional response to diagnosis and treatment
Sources and references
This edition has been developed by Cancer Council NSW on behalf of all other state and territory Cancer Councils as part of a National Cancer Information Subcommittee initiative. All updated content has been clinically reviewed by Professor Alison Brand, Clinical Professor, The University of Sydney and Director, Department of Gynaecological Oncology, Westmead Hospital, NSW. This edition is based on the previous edition, which was reviewed by the following panel: A/Prof Orla McNally, Consultant Gynaecological Oncologist, Director Oncology/Dysplasia, Royal Women’s Hospital, Honorary Clinical Associate Professor, University of Melbourne, and Director of Gynaecology Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; A/Prof Yoland Antill, Medical Oncologist, Peninsula Health, Parkville Familial Cancer Centre, Cabrini Health and Monash University, VIC; Grace Guerzoni, Consumer; Zeina Hayes, 13 11 20 Consultant, Cancer Council Victoria; Bronwyn Jennings, Gynaecology Oncology Clinical Nurse Consultant, Mater Hospital Brisbane, QLD; A/Prof Christopher Milross, Director of Mission and Radiation Oncologist, Chris O’Brien Lifehouse, NSW; Mariad O’Gorman, Clinical Psychologist, Liverpool Cancer Therapy Centre and Bankstown Cancer Centre, NSW. We would like to thank all the health professionals, consumers and editorial teams who have worked on current and previous editions of this title.
Uterine Cancer
Cancer Council 13 11 20
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