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Baylor College of Medicine News

Postmenopausal bleeding could be sign of endometrial cancer

After a woman goes through menopause, it is not normal for her to start bleeding again, said a gynecologic oncologist at Baylor College of Medicine.

Most postmenopausal bleeding is caused by atrophy (thinning of the cervix); however, in some cases bleeding is a sign of endometrial cancer and should not be ignored, said Dr. Concepcion R. Diaz-Arrastia, director of gynecologic oncology and associate professor of obstetrics and gynecology at BCM.

When caught in the early stages, endometrial cancer can be cured, Diaz-Arrastia said. "The issue is that there are so few symptoms and no screening methods. That's why it is so important for women to be conscious of things that may be associated with the disease, like bleeding."

What is endometrial cancer?

Endometrial cancer is the most common uterine cancer. It occurs in the endometrium or the lining of the uterus. More than 40,000 women are diagnosed with endometrial cancer every year in the United States. "We really do not know what causes it yet," said Diaz-Arrastia, also a member of the NCI-designated Dan L. Duncan Cancer Center at BCM.

What are risk factors?

Women who are obese and/or have a history of irregular menstrual cycles have an increased chance of developing endometrial cancer, Diaz-Arrastia said.

How is it diagnosed?

There are two ways endometrial cancer can be diagnosed:

Biopsy – Tissue from the endometrium is removed and analyzed by a pathologist to detect cancer cells. Dilation and curettage (D&C) – The cervix is widened/opened and lining of the uterus is surgically removed, and potential contents of the uterus are scraped out. 

How is it treated?

Treatment for endometrial cancer could include surgery, radiation therapy, chemotherapy or hormonal therapy, Diaz-Arrastia said. "The treatment course depends on the stage of cancer the patient has."

"Surgery is most often done in early-stage patients where cancer has not spread beyond the uterus," said Diaz-Arrastia. "Surgery could include removal of the uterus and perhaps fallopian tubes and ovaries."

The radiation therapy, chemotherapy and hormonal therapy are recommended in more advanced cases.

"I urge all women to educate themselves and their family and friends about this issue," said Diaz-Arrastia. "If you notice postmenopausal bleeding, contact your gynecologist and set up an appointment as soon as possible."