The rates for most cancers continue to go down and that’s a really good thing. But the rates for endometrial cancer have gone up in recent years — here in the U.S. and around the world. There is something you can do to lower your risk for endometrial cancer: Lose weight.
What Is Endometrial Cancer?
Endometrial cancer is a cancer of the lining of the uterus, or the endometrium. It’s the most common cancer of the female reproductive organs. While we aren’t sure exactly what causes endometrial cancer, we do know this: Hormones play a big role. Specifically, the hormone estrogen.
Obesity Drives Endometrial Cancer Rate
Concerned About Endometrial Cancer?
Our UVA Health gynecologic oncologists specialize in endometrial cancer treatment, including minimally invasive procedures that help you recover faster.
Why the increased rates for endometrial cancer? Obesity.
Fat tissue produces extra estrogen. High levels of estrogen cause the uterine lining to thicken. This thickening can lead to tumors.
“Endometrial cancer is primarily a cancer of obese women,” says Linda Duska, MD, a gynecologic oncologist at UVA Health. In fact, the National Cancer Institute says overweight or obese women are 2 to 4 times more likely to develop endometrial cancer.
As rates of obesity increase, so do rates of endometrial cancer.
Other Endometrial Cancer Risk Factors
People are living longer. Since the disease develops mainly after menopause, that means more time for the cancer to form, says Duska.
More periods in your lifetime means more estrogen in your body. Extra estrogen increases your risk. Your risk could be higher if you:
- Start your first period early
- Begin menopause late
- Delay childbirth
- Don't have children
Endometrial Cancer & Black Women
While rates of endometrial cancer are going up overall, death rates are not. That’s because we have effective treatments. We’re catching the disease early. But that’s not the case for Black women, who are more likely to die from endometrial cancer.
Black women are twice as likely to die from endometrial cancer than white women. “The reasons are not fully understood,” says Duska. “Black women are more likely to get a more serious form of endometrial cancer. They’re also more likely to get diagnosed after the cancer has become more advanced.” Both of these factors probably contribute to the higher death rate.
“There can also be issues of lack of access to care or other social determinants of health that cause Black women to present later in disease,” Duska says. “It’s definitely complicated.”
And she says it’s up to healthcare providers to find ways to improve the outlook for Black women. “We need to make sure we are including diverse populations in clinical trials and make sure everyone has appropriate access to care and is being biopsied when they’re symptomatic,” she says.
Diagnosing & Treating Endometrial Cancer
The good news is endometrial cancer is very treatable if it’s caught early. Catching it early is easier than with most cancers. That’s because there are obvious symptoms that show up before the cancer gets to an advanced stage. Any bleeding at all after menopause is a major sign. You should see your gynecologist right away. Before menopause, be on the lookout for bleeding between periods or pelvic pain.
Most of the time, the treatment for endometrial cancer is a hysterectomy (removal of the uterus). “When the cancer is caught early enough, a hysterectomy can be a cure,” says Duska.
Preserving Your Fertility While Fighting Cancer
A small number of women get endometrial cancer before menopause. What if you’re one of them and you still want to get pregnant? There are ways to treat the cancer without a hysterectomy.
“Under special circumstances, we can use progesterone to reverse the cancer,” says Duska. “We also like to treat with an IUD because it puts the progesterone right next to the cancer.” You can also take progesterone by mouth or injection.
At UVA Health, there are ongoing studies looking at the effectiveness of adding a biologic drug to progesterone treatment. Biologics use your body’s immune system to kill cancer cells.
Managing Weight to Lower Your Risk
Since we know that obesity is a major endometrial cancer risk factor, it helps to manage your weight. A BMI of less than 30 is ideal.
Managing your weight is easier said than done. It gets harder for women to maintain a healthy weight starting in your late 20s and early 30s. That’s because your metabolism slows down and you start losing muscle mass. Duska recommends:
- Aerobic exercise
- Weight-bearing exercise to strengthen muscles
- Healthy foods and smaller portions
If you can maintain that muscle mass by staying active and eating healthy, it’s easier to keep weight off — or lose it. And there are benefits beyond eliminating an endometrial cancer risk factor. Obesity contributes to heart disease, diabetes, and other cancers.
If you’re struggling with maintaining a healthy weight, talk to your primary care provider. You may benefit from nutrition counseling, exercise consultation, medication, or other weight loss aids.