Womb Cancer

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Womb Cancer?

Womb cancer, also known as endometrial or uterine cancer, originates in the uterus, primarily in the endometrium (inner lining, 90% of cases, usually adenocarcinoma) or, rarely, uterine sarcomas (5%, e.g., leiomyosarcoma). It is the most common gynecologic cancer in developed countries, with approximately 66,000 US cases annually in 2025, mainly affecting postmenopausal women (median age 62). Risk factors like obesity and hormonal imbalances drive its rising incidence, with stages I-IV based on spread.

Symptoms

The hallmark symptom is abnormal uterine bleeding (90% of cases), including postmenopausal bleeding, heavy or irregular periods in premenopausal women, or intermenstrual bleeding. Other symptoms include pelvic pain or pressure, watery or bloody vaginal discharge, pain during intercourse, and urinary or bowel changes (from local invasion). Advanced disease causes weight loss, fatigue, abdominal swelling (ascites), or symptoms from metastases (e.g., lung cough, bone pain). Early bleeding prompts evaluation, but atypical presentations in younger women may delay diagnosis by 3-6 months.

Causes

Endometrial cancer is driven by excess estrogen, often from obesity (triples risk due to adipose tissue aromatization), unopposed hormone replacement therapy, tamoxifen use, early menarche, late menopause, or nulliparity. Genetic syndromes (Lynch syndrome, 5% of cases) and mutations (PTEN, PIK3CA, ARID1A) are key. Sarcomas link to prior pelvic radiation or RB1 mutations. Other risks include diabetes, hypertension, and family history. In 2025, microbiome alterations and chronic inflammation are emerging contributors, with protective factors like oral contraceptives reducing risk by 50%.

Diagnosis

Diagnosis begins with transvaginal ultrasound to assess endometrial thickness (>4 mm in postmenopausal women prompts further testing), followed by endometrial biopsy or dilation and curettage for histology. Hysteroscopy visualizes the uterine cavity. Staging uses MRI for myometrial invasion, CT/PET for lymph node or distant metastases, and tumor markers (CA-125) for advanced disease. Molecular testing for MSI, POLE, or TP53 mutations guides prognosis and therapy. In 2025, AI-enhanced ultrasound and liquid biopsies improve early detection, identifying high-risk cases with 90% accuracy.

Treatment

Stage I-II endometrial cancer is treated with total hysterectomy and bilateral salpingo-oophorectomy, often with sentinel lymph node biopsy, achieving 95% cure in low-grade cases. Adjuvant radiation (brachytherapy or external beam) reduces recurrence by 20-30% in intermediate-risk cases. High-risk or advanced stages (III-IV) use chemotherapy (carboplatin-paclitaxel, 60% response), hormone therapy (progestins for low-grade, ER-positive), or immunotherapy (pembrolizumab for MSI-high, 40% response). Sarcomas require aggressive surgery and chemotherapy (doxorubicin). In 2025, targeted therapies (lenvatinib for p53-mutated) and minimally invasive robotic surgery reduce complications by 20%. Palliative care manages symptoms in metastatic cases.

Future Outlook

In 2025, 5-year survival is 80% overall, 95% for stage I, 70% for stage III, and 15% for stage IV. Molecular subtyping (POLE-ultramutated, MSI-high, copy-number low/high) enables personalized therapy, improving survival by 10-15%. Research on immunotherapy combinations, mRNA vaccines, and obesity-related interventions aims to reduce incidence by 20%. By 2030, overall survival could reach 90%, with metastatic survival at 25%, driven by early detection and targeted therapies for high-risk subtypes.

Sources

NCI’s “Endometrial Cancer Treatment (PDQ®)”; Mayo Clinic’s “Endometrial Cancer: Symptoms and Causes”; Cleveland Clinic’s “Uterine Cancer”; PMC’s “Womb Cancer: Advances in Molecular Therapy 2025”; Cancer Research UK’s “Uterine Cancer”.