Endometrial cancer, also known as womb cancer, begins in the lining of the uterus (the endometrium). It is the most common gynaecological cancer in the UK and is often detected early due to recognizable symptoms such as abnormal bleeding.

When diagnosed promptly, treatment is highly effective. Surgical intervention frequently provides excellent outcomes, and advances in minimally invasive techniques mean faster recovery with less discomfort.

Endometrial cancer often presents with noticeable symptoms. Common warning signs include:

• Vaginal bleeding after menopause
• Bleeding between periods or unusually heavy periods
• Unexplained pelvic pain or discomfort
• Unusual vaginal discharge that may be blood-tinged or watery
• Pain during intercourse

If you experience any of these symptoms, seek medical assessment promptly. While these symptoms can be caused by benign conditions such as fibroids or polyps, they should always be evaluated by a gynaecologist. Early detection significantly improves treatment outcomes.

Diagnosis begins with a detailed consultation and pelvic examination. Further investigations may include:

• Transvaginal ultrasound to assess the thickness and appearance of the uterine lining
• Hysteroscopy (examination using a small camera inside the uterus) to visualize and biopsy the endometrium
• Endometrial biopsy to obtain tissue samples for laboratory analysis
• MRI or CT imaging if cancer is confirmed, to determine the stage and guide treatment planning
• Blood tests to assess overall health

All assessments are conducted by experienced specialists, with results communicated clearly and compassionately to help you understand your diagnosis and options.

Treatment depends on the cancer stage, grade, tumour characteristics, and your individual circumstances. Most patients undergo surgical treatment, which typically involves:

Surgical Treatment:

• Total hysterectomy (removal of the uterus)
• Bilateral salpingo-oophorectomy (removal of fallopian tubes and ovaries)
• Lymph node assessment or removal when indicated
• Robotic surgery or minimally invasive techniques for smaller incisions, quicker recovery, and fewer complications

In selected early cases where preservation of the uterus is medically appropriate and desired, conservative surgical approaches may be considered after thorough discussion of risks and benefits.

Additional Treatments:

Depending on the final pathology and stage, your multidisciplinary oncology team may recommend:

• Radiation therapy to target any remaining cancer cells
• Systemic treatments coordinated through specialist oncology teams
• Hormonal therapies for specific cancer types
• Clinical surveillance and monitoring

Treatment is personalized to balance effective cancer control with quality of life and recovery.

While the exact cause of endometrial cancer isn't fully understood, certain factors may increase risk:

• Hormonal imbalance – prolonged oestrogen exposure without progesterone (as seen in obesity or certain hormone therapies)
• Older age – most cases occur after menopause
• Obesity – excess body fat can alter hormone levels
• Early menstruation or late menopause – extended lifetime exposure to oestrogen
• Never having been pregnant
• Inherited conditions such as Lynch syndrome
• Certain medications such as long-term tamoxifen for breast cancer (benefits generally outweigh risks)

Understanding your risk factors can help guide screening and prevention strategies.

While not all cases can be prevented, you can reduce your risk by:

• Maintaining a healthy weight through balanced diet and regular physical activity
• Discussing hormone replacement therapy (HRT) options carefully – combined oestrogen and progesterone therapy is safer than oestrogen alone if you still have your uterus
• Discussing genetic testing if there is a family history of Lynch syndrome or early cancers
• Attending regular gynaecological check-ups, especially if you have risk factors

Dr Mohamed Otify is a Consultant Gynaecological Oncologist and Gynaecological Surgeon specializing in advanced robotic and minimally invasive surgery for endometrial cancer. He works within multidisciplinary cancer teams to provide evidence-based, personalized care.

His approach prioritizes:

• Expert surgical treatment using the latest robotic and minimally invasive techniques
• Comprehensive staging and risk assessment
• Multidisciplinary team collaboration for optimal treatment planning
• Personalized care balancing effective treatment with quality of life
• Clear communication and compassionate support throughout your journey

If you are experiencing abnormal bleeding, post-menopausal bleeding, or have concerns about endometrial cancer, book a consultation for expert assessment, diagnosis, and personalized treatment planning.