Uterine Cancer: Symptoms, Causes & Treatment Guide

Uterine cancer (also called endometrial cancer) is a cancer that develops in the lining of the uterus. It is the most common gynecologic cancer in developed countries. The main warning sign is abnormal vaginal bleeding, especially after menopause. When detected early, uterine cancer has an excellent prognosis with over 95% of patients surviving five years or more. Treatment typically involves surgery, and most women are cured with treatment.

What Is Uterine Cancer?

Uterine cancer, also known as endometrial cancer, is a type of cancer that begins in the inner lining of the uterus (the endometrium). It is the most common gynecologic cancer in developed countries and typically affects women after menopause. The good news is that most cases are detected early when the cancer is highly treatable.

The uterus, commonly called the womb, is a hollow, pear-shaped organ where a baby grows during pregnancy. The uterus has two main parts: the cervix (the lower narrow part that connects to the vagina) and the corpus (the main body of the uterus). Uterine cancer specifically refers to cancer that develops in the corpus of the uterus, which is why it's sometimes called "uterine corpus cancer" or "cancer of the uterine body."

The endometrium is the tissue lining the inside of the uterus. This lining thickens each month during the menstrual cycle in preparation for a potential pregnancy. If pregnancy doesn't occur, the lining is shed during menstruation. Uterine cancer typically develops when cells in this endometrial lining begin to grow out of control, forming a tumor.

It's important to understand that uterine cancer is a completely different disease from cervical cancer, which develops in the cervix and is primarily caused by human papillomavirus (HPV) infection. Uterine cancer is not caused by HPV and has different risk factors, symptoms, and treatments.

How Uterine Cancer Develops

Uterine cancer develops when something goes wrong during cell division in the endometrial lining. The hormone estrogen plays a key role in this process. Estrogen stimulates the cells of the endometrium to grow and multiply. Normally, another hormone called progesterone (also known as the "corpus luteum hormone") balances the effects of estrogen by stopping the endometrial cells from growing and signaling them to mature.

When there is too much estrogen relative to progesterone—a condition called "unopposed estrogen"—the endometrial cells may continue to grow unchecked. Over time, this abnormal growth can lead to a precancerous condition called endometrial hyperplasia, which can then progress to cancer.

In the early stages, the cancer is confined to the endometrial lining. As it progresses, it can grow through the endometrium and invade the muscular wall of the uterus (called the myometrium). In more advanced stages, the cancer can spread (metastasize) to nearby structures such as the lymph nodes, ovaries, fallopian tubes, vagina, or even to distant organs like the lungs or liver.

Types of Uterine Cancer

There are two main types of uterine cancer, distinguished by their relationship to estrogen:

Type 1 (Endometrioid carcinoma): This is the most common type, accounting for about 80-85% of all uterine cancers. These cancers are typically linked to excess estrogen and tend to grow slowly. They are often detected at an early stage and have an excellent prognosis.

Type 2 (Non-endometrioid carcinomas): These include serous carcinoma, clear cell carcinoma, and other rare types. They are not as closely linked to estrogen, tend to be more aggressive, and are more likely to spread beyond the uterus. Although less common, they account for a disproportionate number of deaths from uterine cancer.

What Are the Symptoms of Uterine Cancer?

The most common and important symptom of uterine cancer is abnormal vaginal bleeding, especially any bleeding that occurs after menopause. Before menopause, symptoms may include unusually heavy periods, bleeding between periods, or significant changes in menstrual patterns. These symptoms should always be evaluated by a healthcare provider.

Uterine cancer often produces symptoms early in its development, which is one reason it has such a high cure rate—most cases are caught before the cancer has spread. The key is recognizing these symptoms and seeking medical evaluation promptly.

Postmenopausal Bleeding

Any vaginal bleeding after menopause is abnormal and should be taken seriously. While not all postmenopausal bleeding is cancer—it can also be caused by benign conditions like polyps or vaginal dryness—it is the most common warning sign of uterine cancer. Approximately 90% of women with uterine cancer experience postmenopausal bleeding as their first symptom. If you have gone through menopause and experience any vaginal bleeding or spotting, see a doctor promptly.

Note that occasional spotting in the first year after your final period can be normal as hormone levels fluctuate during the menopausal transition. However, if bleeding persists or returns after a year without periods, it should be evaluated.

Changes in Menstrual Bleeding

For women who have not yet reached menopause, uterine cancer may cause changes in the normal menstrual pattern. These changes can include:

• Heavier periods: Bleeding that is significantly heavier than your usual pattern
• Longer periods: Menstrual bleeding that lasts longer than normal
• Bleeding between periods: Spotting or bleeding that occurs outside of your regular menstrual cycle
• Irregular periods: Changes in the frequency or timing of your periods

Unusual Vaginal Discharge

Some women with uterine cancer notice changes in vaginal discharge. This may appear as watery, blood-tinged, or pinkish discharge. The discharge may also have an unusual odor. While vaginal discharge is normal and can vary throughout the menstrual cycle, any significant change or persistent discharge should be discussed with a healthcare provider.

Pelvic Pain or Discomfort

Pain is not a common early symptom of uterine cancer, but it can occur. Some women experience a sensation of pressure or discomfort in the pelvic area. Pain during urination or sexual intercourse may also occur. In some cases, particularly in women who have had previous treatments that caused narrowing of the cervix (such as treatment for cervical cell changes), the blood from the cancer may not be able to exit easily, causing painful cramping similar to menstrual cramps.

Other Possible Symptoms

In more advanced cases, uterine cancer may cause:

• Unexplained weight loss
• Fatigue and general weakness
• Loss of appetite
• Swelling in the abdomen
• Pain in the lower back or legs (if cancer has spread)

When Should You See a Doctor for Uterine Cancer?

You should see a doctor if you experience any vaginal bleeding after menopause, significant changes in your menstrual pattern, or unusual vaginal discharge. While these symptoms often have benign causes, they can also be signs of uterine cancer, which is highly curable when detected early. Don't delay—early detection saves lives.

The decision of when to seek medical attention can sometimes feel uncertain, especially when symptoms like changes in bleeding might seem minor. However, when it comes to potential uterine cancer, it's always better to err on the side of caution. The excellent survival rates for uterine cancer are largely due to early detection, and early detection depends on women recognizing symptoms and seeking prompt evaluation.

See a Doctor Soon If You Experience:

• Any bleeding after menopause: Even light spotting should be evaluated
• Persistent changes in menstrual bleeding: Periods that become much heavier, longer, or more frequent
• Bleeding between periods: Spotting that occurs outside your normal cycle
• Unusual vaginal discharge: Especially if watery, blood-tinged, or foul-smelling
• Pelvic pain or pressure: Unexplained discomfort in your lower abdomen

These symptoms warrant medical evaluation, but they don't necessarily indicate an emergency. In most cases, you can schedule a regular appointment with your primary care doctor or gynecologist. If your symptoms occur on a weekend, it's generally fine to wait until the following weekday to be seen.

How Is Uterine Cancer Diagnosed?

Uterine cancer is diagnosed through a combination of physical examination, imaging tests (particularly transvaginal ultrasound), and tissue sampling (endometrial biopsy or hysteroscopy). The tissue sample is essential for definitive diagnosis. If cancer is confirmed, additional imaging tests are performed to determine if the cancer has spread.

The diagnostic process for uterine cancer typically begins when a woman reports symptoms, most commonly abnormal vaginal bleeding. The goal of the evaluation is to determine the cause of the symptoms, confirm or rule out cancer, and if cancer is present, determine its extent (staging).

Initial Evaluation

Your doctor will start by taking a detailed medical history, including questions about your symptoms, menstrual history, pregnancies, hormone use, and family history of cancer. This is followed by a physical examination, including a pelvic exam, where the doctor examines the vagina, cervix, uterus, ovaries, and surrounding tissues for any abnormalities.

Transvaginal Ultrasound

A transvaginal ultrasound is typically one of the first tests performed. In this painless procedure, a small probe is inserted into the vagina to create detailed images of the uterus and ovaries using sound waves. This test can measure the thickness of the endometrial lining—a thickened lining in a postmenopausal woman may suggest the need for further evaluation. Ultrasound can also detect other abnormalities like polyps or fibroids.

Endometrial Biopsy

The definitive diagnosis of uterine cancer requires a tissue sample from the endometrium. The most common way to obtain this is through an endometrial biopsy, which can often be done in the doctor's office. During this procedure, a thin, flexible tube is inserted through the cervix into the uterus, and a small sample of the endometrial tissue is suctioned out. The procedure is quick, though it may cause brief cramping similar to menstrual cramps. The tissue sample is then examined under a microscope by a pathologist to look for cancer cells.

Hysteroscopy

In some cases, a hysteroscopy may be performed. This involves inserting a thin, lighted instrument with a camera (hysteroscope) through the cervix to directly visualize the inside of the uterus. If abnormal areas are seen, tissue samples can be taken during the same procedure. If polyps or other growths are found, they can often be removed during hysteroscopy. This procedure is usually done as a day procedure and may require local or general anesthesia.

Further Testing If Cancer Is Found

If the biopsy confirms uterine cancer, additional tests are needed to determine the stage of the cancer—how far it has spread. These tests may include:

• CT scan (computed tomography): Creates detailed images of the chest, abdomen, and pelvis to check if cancer has spread to lymph nodes or other organs
• MRI (magnetic resonance imaging): Provides detailed images of the pelvis and can help determine how deeply the cancer has invaded the uterine wall
• PET scan (positron emission tomography): May be used in certain cases to detect cancer spread throughout the body
• Blood tests: Including a complete blood count and tests for tumor markers like CA-125

Understanding Uterine Cancer Stages

The stage of uterine cancer describes how far the cancer has spread. Staging is typically confirmed after surgery when the removed tissue can be examined. The FIGO (International Federation of Gynecology and Obstetrics) staging system is used:

How Is Uterine Cancer Treated?

The primary treatment for uterine cancer is surgery to remove the uterus (hysterectomy), typically along with the ovaries and fallopian tubes. Depending on the stage and characteristics of the cancer, additional treatments such as radiation therapy, chemotherapy, hormone therapy, or immunotherapy may be recommended. Treatment is personalized based on each patient's specific situation.

Treatment planning for uterine cancer involves a team of specialists including gynecologic oncologists, radiation oncologists, and medical oncologists. They work together to recommend the best treatment approach based on the cancer's stage, type, grade, and the patient's overall health and preferences.

Surgery

Surgery is the cornerstone of treatment for uterine cancer and is the primary treatment for most patients. The standard surgical procedure is a total hysterectomy with bilateral salpingo-oophorectomy, which means removing the uterus, cervix, both ovaries, and both fallopian tubes. The ovaries are typically removed because they can be a site of cancer spread and because removing them eliminates a source of estrogen that could potentially fuel cancer recurrence.

During surgery, the surgeon also removes and examines the sentinel lymph nodes (the lymph nodes nearest to the tumor) to check for cancer spread. This is called sentinel lymph node mapping. If cancer is found in the sentinel nodes, more extensive lymph node removal may be recommended, along with additional treatment after surgery.

Most uterine cancer surgeries can be performed using minimally invasive techniques—either laparoscopically (through small incisions using specialized instruments) or robotically assisted. The organs are removed through the vagina, avoiding large abdominal incisions. This approach typically results in less pain, shorter hospital stays, and faster recovery compared to traditional open surgery. However, some patients may need open surgery through an abdominal incision depending on individual factors.

Surgery is performed under general anesthesia. Most patients can go home within one to three days after minimally invasive surgery and return to normal activities within a few weeks. Recovery from open surgery typically takes longer.

Fertility-Sparing Treatment

For young women with early-stage, low-grade uterine cancer who wish to preserve their ability to have children, fertility-sparing treatment may be an option. This involves hormone therapy with progestin (a form of progesterone) to shrink or eliminate the cancer, rather than immediate surgery. This approach requires very careful patient selection and close monitoring with regular biopsies, as there is a risk the cancer could progress or recur. After completing childbearing, hysterectomy is typically recommended. This option should be discussed thoroughly with a gynecologic oncologist who can help weigh the risks and benefits.

Additional Treatments After Surgery

Depending on what is found during surgery and when examining the removed tissue, additional (adjuvant) treatment may be recommended to reduce the risk of the cancer coming back. The decision about whether to recommend additional treatment depends on the stage, grade, and specific characteristics of the cancer.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It may be recommended after surgery to reduce the risk of cancer recurrence, particularly if the cancer has spread beyond the uterus or has features suggesting a higher risk of coming back. There are two main types:

• External beam radiation: Radiation is delivered from a machine outside the body, targeting the pelvis. Treatment is typically given five days a week for several weeks, with each session lasting only a few minutes.
• Vaginal brachytherapy (internal radiation): A radioactive source is placed directly in the vagina to deliver radiation to the area where the uterus was. This targets the area at highest risk for local recurrence while sparing more healthy tissue. Treatment involves several sessions over one to two weeks.

Chemotherapy

Chemotherapy uses drugs that kill rapidly dividing cells, including cancer cells. It may be recommended for:

• Higher-stage cancers that have spread beyond the uterus
• High-grade or aggressive cancer types
• Cancers with features suggesting higher risk of spread
• Recurrent cancer

Chemotherapy for uterine cancer is typically given intravenously in cycles, with periods of treatment followed by rest periods to allow the body to recover. Treatment is usually given as an outpatient, meaning you can go home the same day. Common regimens involve combinations of drugs given every three to four weeks for several cycles.

Immunotherapy

Immunotherapy helps the body's immune system recognize and attack cancer cells. It may be used in combination with chemotherapy for advanced or recurrent uterine cancer, particularly in cancers that have certain genetic characteristics (such as mismatch repair deficiency or high microsatellite instability). Immunotherapy drugs are given intravenously, typically every few weeks.

Hormone Therapy

Because many uterine cancers are fueled by estrogen, hormone therapy can be used to slow or stop cancer growth. Progestin therapy (a form of progesterone) can shrink some uterine cancers. This treatment is typically used for:

• Low-grade cancers in women who cannot have surgery due to other health problems
• Young women who wish to preserve fertility (as discussed above)
• Recurrent cancer, to slow progression and relieve symptoms

Progestin can be given as tablets or through an intrauterine device (IUD).

Targeted Therapy

Targeted therapies are drugs that target specific features of cancer cells. Some targeted drugs are used for uterine cancer, often in combination with other treatments for advanced or recurrent disease. These may target specific genetic mutations or pathways that help the cancer grow.

What Happens After Treatment?

After treatment for uterine cancer, regular follow-up appointments are essential to monitor for any signs of recurrence and to manage any side effects from treatment. Follow-up typically continues for five years, with more frequent visits in the first few years when the risk of recurrence is highest. Most women who complete treatment for early-stage uterine cancer will not experience a recurrence.

The goal of follow-up care is to detect any cancer recurrence as early as possible, when it is most treatable, and to help manage any ongoing effects of cancer treatment. Your follow-up schedule will be tailored to your specific situation based on the stage and type of cancer you had and the treatments you received.

Typical Follow-Up Schedule

Most follow-up schedules include:

• First two years: Check-ups every three to four months
• Years three to five: Check-ups every six months
• After five years: Annual check-ups, or less frequent as determined by your doctor

At each follow-up visit, your doctor will ask about any new symptoms, perform a physical examination including a pelvic exam, and may order tests if there are any concerns. Routine imaging tests (like CT scans) are not typically done at every visit unless there are symptoms or other reasons for concern.

Signs of Recurrence to Watch For

Between appointments, contact your doctor if you experience:

• Vaginal bleeding or unusual discharge
• Pelvic pain or pressure
• Unexplained weight loss
• Persistent fatigue
• New lumps or masses
• Any symptoms that concern you

What If Uterine Cancer Comes Back?

If uterine cancer returns (recurs), treatment is still possible and depends on where and how the cancer has recurred. Options may include additional surgery, radiation therapy, chemotherapy, immunotherapy, hormone therapy, or targeted therapy. Many women with recurrent uterine cancer can be treated successfully, especially if the recurrence is detected early.

Recurrence means the cancer has come back after treatment. It can recur locally (in the pelvis near where the uterus was), regionally (in nearby lymph nodes), or distantly (in organs far from the original site, such as the lungs or liver). The treatment approach depends on where the cancer has recurred, previous treatments received, and the patient's overall health.

If recurrence is localized and can be completely removed, surgery may be an option. Radiation therapy may be used if the area was not previously irradiated. For more widespread recurrence, systemic treatments like chemotherapy, immunotherapy, hormone therapy, or targeted therapy may be recommended. These treatments can often control the cancer and relieve symptoms, sometimes for extended periods.

What If Uterine Cancer Cannot Be Cured?

When uterine cancer is advanced and cannot be cured, treatment focuses on controlling the disease and maintaining quality of life for as long as possible. Many women with advanced uterine cancer live well for months to years with appropriate treatment. Palliative care can help manage symptoms and provide support throughout the journey.

In some cases, despite treatment, uterine cancer may not be curable. This is more common with advanced-stage disease or aggressive cancer types. However, this does not mean treatment stops—rather, the goals shift from cure to controlling the cancer, relieving symptoms, and maintaining the best possible quality of life.

Treatments for advanced cancer may include chemotherapy, immunotherapy, hormone therapy, or targeted therapy. These can often shrink tumors or slow their growth, relieving symptoms and extending life. Radiation therapy can be used to treat specific areas causing pain or other symptoms. Many women live well with advanced uterine cancer for a significant time.

Palliative care is specialized medical care focused on relieving symptoms and improving quality of life. It can be provided alongside cancer treatment and is not the same as hospice care (which is for the final stages of life). Palliative care specialists can help manage pain, fatigue, nausea, and other symptoms, as well as provide emotional and practical support for patients and families.

How Does Uterine Cancer Affect Your Life?

A uterine cancer diagnosis and its treatment can affect many aspects of life, including physical health, emotional well-being, sexuality, and fertility. The extent of these effects varies based on the stage of cancer and treatments received. Most women adapt well over time, and support is available to help manage these challenges.

The impact of uterine cancer on your life depends on many factors, including the stage of your cancer, the treatments you receive, your overall health, and your personal circumstances. While a cancer diagnosis is life-changing, many women successfully complete treatment and return to their normal activities. Here are some common areas that may be affected:

Fertility and Pregnancy

Standard treatment for uterine cancer involves removing the uterus, which means pregnancy is no longer possible afterward. If you are young and wish to have children, it's important to discuss this with your doctor before treatment begins. In some cases, fertility-sparing treatment with hormones may be an option for early-stage, low-grade cancers, allowing the possibility of pregnancy before eventually having a hysterectomy. If you have eggs or embryos you wish to preserve before treatment, discuss this with your medical team as well.

Menopause and Hormonal Effects

If your ovaries are removed during surgery and you have not yet gone through menopause, you will experience surgical menopause. This causes an immediate drop in estrogen levels, which can lead to symptoms like hot flashes, night sweats, vaginal dryness, and mood changes. These symptoms may be more intense than natural menopause because they occur suddenly rather than gradually.

There are treatments available to help manage menopausal symptoms, including medications for hot flashes and vaginal moisturizers or lubricants for vaginal dryness. Estrogen replacement therapy is generally not recommended for women who have had uterine cancer because it could potentially stimulate any remaining cancer cells. However, local vaginal estrogen (low-dose creams or suppositories) may be safe in some cases—discuss this with your doctor.

Fatigue

Feeling extremely tired is one of the most common effects of cancer and cancer treatment. Fatigue can persist for weeks to months after treatment ends. While rest is important, research shows that gentle physical activity often helps more than prolonged rest. Pace yourself, take short breaks rather than long periods of inactivity, and gradually increase your activity level as you recover. Talk to your doctor if fatigue is severe or persistent—other treatable causes may be contributing.

Bowel and Bladder Changes

Surgery and radiation therapy can sometimes affect bladder and bowel function. Some women experience urinary incontinence (leaking urine), urgency, or frequent urination. Bowel changes may include diarrhea, constipation, or increased gas. Most of these effects improve over time. Pelvic floor exercises (Kegel exercises) can help strengthen the muscles that control urination. Various treatments and strategies can help manage these symptoms if they persist.

Lymphedema

If lymph nodes are removed during surgery or damaged by radiation, lymph fluid may not drain properly, causing swelling called lymphedema. This most commonly affects the legs but can also occur in the pelvis or vulva. Lymphedema can develop soon after treatment or years later. Symptoms include swelling, a feeling of heaviness or tightness, and reduced flexibility. If you notice these symptoms, report them to your doctor. Specialized physical therapy, compression garments, and other treatments can help manage lymphedema.

Sexuality and Intimacy

Cancer treatment can affect sexuality in various ways. Physical changes like vaginal dryness, shortening of the vagina (from radiation), or menopausal symptoms can make intercourse uncomfortable. Emotional factors like changes in body image, fatigue, anxiety, and relationship stress can also affect sexual desire and function. It's important to know that these effects are common and that help is available.

If you've had radiation therapy, using a vaginal dilator (a tube-shaped device you insert into the vagina) regularly can help prevent the vagina from narrowing and becoming less elastic. Your healthcare team can provide guidance on this. Vaginal moisturizers and lubricants can help with dryness. Open communication with your partner and, if needed, counseling with a specialist in sexual health can help address emotional and relationship aspects.

Emotional Well-Being

It's normal to experience a range of emotions after a cancer diagnosis and treatment—including fear, anxiety, sadness, anger, and relief. Some women feel particularly vulnerable in the period after treatment ends, when regular contact with the medical team decreases. If you're struggling emotionally, know that support is available through counseling, support groups, and sometimes medication for anxiety or depression. Don't hesitate to reach out for help.

Work and Daily Life

Many women are able to return to work and normal activities after recovering from treatment. The timeframe depends on the type of treatment you received and how you're feeling. If you need time off work for treatment and recovery, you may be entitled to medical leave. If you experience ongoing effects that make your previous work difficult, workplace accommodations may be available.

What Causes Uterine Cancer?

The exact cause of uterine cancer is not known, but the main factor is prolonged exposure to estrogen without adequate progesterone to balance it. The biggest modifiable risk factor is obesity, which increases estrogen production. Other risk factors include age over 50, late menopause, never having been pregnant, and certain genetic conditions like Lynch syndrome.

Uterine cancer develops when cells in the endometrium undergo genetic changes that cause them to grow uncontrollably. While the exact trigger for these changes is not fully understood, we know that hormonal factors—particularly estrogen—play a major role in most cases. Understanding risk factors can help identify women who may benefit from closer monitoring.

The Role of Estrogen and Progesterone

Estrogen stimulates the growth of the endometrial lining, while progesterone signals the cells to stop growing and mature. Normally, these hormones are in balance. When estrogen levels are high relative to progesterone (called "unopposed estrogen"), the endometrial cells continue to grow and multiply, which can eventually lead to cancer. This is why risk factors for uterine cancer generally relate to conditions that cause higher or longer exposure to estrogen.

Obesity - The Major Modifiable Risk Factor

Obesity is the most significant modifiable risk factor for uterine cancer. Fat tissue produces estrogen, so women who are overweight or obese have higher estrogen levels. The risk increases with the degree of obesity—women who are severely obese have up to five times the risk of developing uterine cancer compared to women of normal weight. Maintaining a healthy weight through diet and exercise is one of the most important steps you can take to reduce your risk.

Age

Uterine cancer is rare before age 40 and becomes more common with increasing age. The average age at diagnosis is around 60. This is partly because cumulative estrogen exposure increases over time and partly because the cancer-causing genetic changes accumulate with age.

Menstrual and Reproductive History

Factors that increase lifetime estrogen exposure raise uterine cancer risk:

• Early menstruation: Starting periods before age 12 means more years of estrogen exposure
• Late menopause: Going through menopause after age 55 extends estrogen exposure
• Never being pregnant: Pregnancy temporarily interrupts estrogen production, so women who have never been pregnant have more continuous exposure
• Polycystic ovary syndrome (PCOS): This condition causes irregular ovulation and menstruation, leading to less progesterone production and more unopposed estrogen

Hormone Therapy

Estrogen-only hormone therapy (without progesterone) for menopausal symptoms significantly increases uterine cancer risk. This is why women who still have a uterus and take hormone therapy are prescribed combined estrogen-progesterone therapy—the progesterone protects against the cancer-promoting effects of estrogen. Tamoxifen, a medication used to treat and prevent breast cancer, acts like estrogen in the uterus and also increases uterine cancer risk.

Lynch Syndrome and Genetic Factors

Lynch syndrome is an inherited genetic condition that significantly increases the risk of uterine cancer (as well as colon cancer and several other cancers). Women with Lynch syndrome have up to a 60% lifetime risk of developing uterine cancer. Lynch syndrome is caused by mutations in genes that repair DNA errors (called mismatch repair genes). If you have a family history of Lynch syndrome or multiple family members with colon or uterine cancer, genetic counseling and testing may be recommended. Women found to have Lynch syndrome may be offered preventive surgery (removing the uterus while it's still healthy) or more intensive monitoring.

Other Risk Factors

• Type 2 diabetes: Associated with increased risk, partly due to its link with obesity
• Previous breast or ovarian cancer: Shared risk factors may increase risk
• Previous radiation to the pelvis: Slightly increased risk years after treatment
• Endometrial hyperplasia: A precancerous thickening of the endometrium that can progress to cancer

Coping With a Cancer Diagnosis

Receiving a cancer diagnosis can be overwhelming. It's normal to experience a range of emotions including shock, fear, anger, and sadness. Give yourself time to process the news, seek support from loved ones and healthcare providers, and take an active role in understanding your diagnosis and treatment options.

Being told you have cancer is one of life's most difficult experiences. There is no "right" way to react—some people feel shocked and numb, others feel scared or angry, and some feel a strange sense of calm or even relief that there's finally an explanation for their symptoms. All of these reactions are normal.

It can help to bring a family member or friend to medical appointments to help listen, take notes, and remember what was discussed. Don't hesitate to ask questions—write them down beforehand so you don't forget. If you don't understand something, ask for clarification. Understanding your diagnosis and treatment options can help you feel more in control.

Many cancer centers have specialist nurses (sometimes called nurse navigators or contact nurses) who can provide support, answer questions, and help coordinate your care. Social workers and counselors are also available to help with emotional and practical concerns. Patient support groups, whether in person or online, can provide valuable peer support from others who understand what you're going through.

If you have children, they need age-appropriate information and reassurance. Children often sense when something is wrong, and honest communication can be less frightening than imagining the worst. Resources are available to help you talk to children about cancer.

Many people find that once treatment begins and they have a plan, they feel better—the waiting and uncertainty are often the hardest part. Take things one step at a time, and remember that most women with uterine cancer are cured or live well for many years with treatment.