7 Symptoms of Uterine Cancer You Shouldn't Ignore

Uterine cancer is one of the most common forms of cancer, most often affecting cisgender women who are middle-aged or older.

In 2022, there were about 67,000 new cases diagnosed, making up about three percent of all cancer diagnoses for the year. These statistics make uterine cancer the ninth most common type of cancer in 2022 (breast cancer is the most common).

Types of Uterine Cancer

Uterine cancer—technically cancer originating in the uterus—can be separated into two distinct types: the more common endometrial cancer and the less common uterine sarcoma.

Endometrial Cancer

Endometrial cancer forms in the endometrium, or the cells that line the uterus (that's what sheds each month during menstruation). This cancer is most common in people who have gone through menopause, with 60 being the average age of diagnosis.

Risk factors for endometrial cancer include:

• Exposure to estrogen through things such as early menstruation, estrogen-only hormone therapy, late menopause, and never being pregnant
  
• Endometrial hyperplasia, which is an abnormal thickening of the endometrium
• Using tamoxifen, a selective estrogen receptor modulator used to treat breast cancer, for more than two years
• Obesity, weight gain, and diabetes
• Genetic factors like inheriting Lynch syndrome, a condition that increases the risk of developing certain cancers

One study published in the Journal of the National Cancer Institute in 2022 also found a link between uterine cancer and the use of chemical hair straighteners.

On the flip side, things such as breastfeeding, exercising, and taking birth control pills that combine estrogen and progestin can decrease the risk of endometrial cancer. Oddly, smoking cigarettes can also protect against uterine cancer, but the harms of smoking outweigh this benefit.

Uterine Sarcoma

Uterine sarcoma is much rarer, primarily affecting the uterus's muscles or supporting tissues. Risk factors for uterine sarcoma include past use of radiation therapy to the pelvis and taking tamoxifen.

Uterine Cancer Symptoms

Both types of uterine cancer can display similar symptoms, but before we dive in, there's something important to remember: These symptoms can be a sign of endometrial cancer or uterine sarcoma, but they may also be a sign of a number of other far less dangerous conditions, Ursula Matulonis, MD, chief of the division of gynecologic oncology at Dana-Farber Cancer Institute in Boston, told Health. That means that having any of these symptoms doesn't automatically mean you have uterine cancer; it just suggests that it's time to make an appointment with your ob-gyn.

Uterine cancer differs from some other cancers in that you can have symptoms at very early stages of the disease, making it especially critical to be seen by a healthcare provider when you notice symptoms.

Here, gynecologic oncologists explain seven of the most common symptoms associated with uterine cancer and why it's essential to get them checked out by a medical provider ASAP.

Irregular Vaginal Bleeding or Discharge

Irregular vaginal bleeding is the most common symptom of early-stage uterine cancer or uterine cancer that hasn't yet spread to other areas of the body, Pamela Soliman, MD, professor, and center medical director in the Department of Gynecologic Oncology and Reproductive Medicine at MD Anderson Cancer Center in Texas, told Health. About 90% of women with endometrial cancer report this symptom.

This bleeding occurs when cancer grows on the uterine lining, causing it to thicken. That thickening triggers the cells at the top of the uterine lining to slough off irregularly, Dr. Soliman explained.

Unusual bleeding might occur:

• In between periods
• During your period
• After you've already gone through menopause

Depending on when you experience it, the irregular bleeding may look like spotting, or it might be heavier. It might look red or appear like a brownish discharge, Dr. Matulonis said. In a small number of endometrial cancer and uterine sarcoma diagnoses, there may be no visible blood in the discharge.

Irregular vaginal bleeding is much more likely to be a sign of cancer after menopause than before it, according to Dr. Soliman. "In a postmenopausal woman, that's definitely a red flag," said Dr. Soliman. Still, anyone with irregular bleeding or discharge should raise the issue with a healthcare provider.

Pelvic Pain

Uterine cancer can cause pelvic pain in certain circumstances, like when cancer gets big enough that it compresses nearby structures and nerves that surround the uterus, according to Alison Schram, MD, attending physician in the early drug development and gynecologic medical oncology services at Memorial Sloan Kettering Cancer Center in New York, told Health. Pain can also occur when cancer spreads beyond the uterus and into the pelvis or abdomen. In some cases, this spread can lead to fluid build-up in the pelvis or abdomen, which can, in turn, trigger discomfort, Dr. Schram said.

In some cases, the body recognizes a tumor in the uterus as abnormal and starts to cramp up in an effort to dispel it, Dr. Soliman explained.

Pain from uterine cancer can be continuous, or it can come and go. It may even come on during vaginal sex if there's external pressure put on a mass in the uterus due to intercourse. The severity of this pelvic pain, however, isn't uniform: Some patients may feel more discomfort than actual pain, said Dr. Matulonis; others might feel a sharper kind of pain.

Bloating

Bloating is a much more common symptom for ovarian cancer than uterine cancer, but it can occur in either cancer type, said Dr. Schram. It most often occurs in people whose cancer has spread from the uterus to the abdomen. This causes fluid to build up in the abdomen, called ascites. People with ascites may also have hard, swollen bellies.

Sometimes when the cancer mass is large enough, its presence alone can cause subjective bloating, Dr. Schram added.

Gastrointestinal Issues

Tummy issues most often occur in more advanced stages of uterine cancer, like when it spreads beyond the uterus and into the abdomen and pelvis. This can sometimes block off parts of the bowel and prevent stool from moving through the intestines like normal, triggering gastrointestinal issues that include:

• Diarrhea
• Constipation
• Abdominal pain
• Getting full fast

People who have had abdominal surgery or radiation to the abdomen are at a higher risk of having a bowel obstruction with cancer.

Unintentional Weight Loss

People with more advanced uterine cancer may shed pounds unintentionally. This can happen when the cancer spreads from the uterus to the abdomen, causing a tumor to push against the stomach and make you feel full even when you haven't eaten much.

Weight loss can also occur in later-stage uterine cancer because any advanced cancer can trigger inflammation in the body, which may disrupt normal metabolic processes and influence the behavior of cytokines, which are small proteins that affect the immune system. These processes can cause muscle and fat to break down too quickly.

This inflammation can eventually decrease your appetite, said Dr. Schram.

Increased Urge To Pee

If the cancer mass in your uterus gets big enough, it can push against your bladder. As a result, the bladder isn't able to fill as much as usual, and you may feel compelled to empty it more often, explained Dr. Matulonis. Although you may feel the urge to urinate more frequently, you might have a light stream.

You Might Not Experience Any Symptoms

While the vast majority of people diagnosed with uterine cancer will experience abnormal vaginal bleeding, some people have no symptoms at all. Other people might feel just generally unwell without anything specific to point to, said Dr. Schram.

People with uterine cancer might not have any noticeable symptoms because the uterus is made to be able to expand—say, to fit a tumor, in the case of cancer—without significant consequence to the nearby structures, explained Dr. Schram.

When To Contact a Healthcare Provider

The Centers for Disease Control and Prevention recommends contacting a healthcare provider if you have vaginal bleeding or discharge that's abnormal for you, especially if you've post-menopausal. You may also want to seek medical care if you've experienced any other uterine cancer symptoms for at least two weeks.

There are no regular screenings to determine if you have uterine cancer. This makes it especially important to pay attention to possible symptoms.

Once you visit a healthcare provider, they can do a proper physical exam and possibly perform an ultrasound to look at the inside of your uterus. The results from those exams will determine whether a biopsy or further testing is needed for a more accurate diagnosis.