Abnormal vaginal bleeding
Bleeding after menopause, between periods, or unusually heavy or prolonged periods.
PATIENT GUIDE · GYNAECOLOGIC CANCER
Uterine Cancer: Understanding the Signs and Treatment
Uterine cancer often begins in the inner lining of the uterus, called the endometrium. Abnormal bleeding—especially after menopause—is an important symptom that should be assessed rather than ignored.
Educational information only. Your diagnosis and treatment plan require individual medical assessment.
How to use this guide
Use these sections to understand the next steps, prepare questions and discuss your options with your doctor.
Your progress0 of 4 completed
This checklist is for guidance. You do not need to complete every step before seeking medical advice.
Recognise warning signs
Symptoms of uterine cancer
Abnormal bleeding is the most important symptom to recognise. Symptoms can have non-cancerous causes, but persistent or unexpected changes need assessment.
Pelvic pain or pressure
Persistent discomfort, pressure, or pain in the lower abdomen or pelvis.
Unusual fatigue
Ongoing tiredness, which may sometimes be related to prolonged blood loss or other causes.
Back or abdominal discomfort
Persistent discomfort may occur, though it is not specific to uterine cancer.
Do not wait for pain: Any vaginal bleeding after menopause should be evaluated promptly, even if it happens only once or is a small amount.
Risk factors
What can increase risk?
Risk factors do not mean that cancer will develop. They help clinicians understand personal risk and decide what assessment may be needed.
Increasing age
Uterine cancer is more common after menopause, although it can occur earlier.
Obesity
Excess body fat can affect hormone levels and is associated with increased endometrial cancer risk.
Hormonal factors
Long-term exposure to oestrogen without enough progesterone can increase risk in some circumstances.
Family or genetic history
Lynch syndrome and some family histories can increase risk and may warrant specialist assessment.
Metabolic conditions
Diabetes and related metabolic factors may be associated with higher risk.
Certain medicines or history
Tamoxifen use and some other medical or reproductive-history factors may affect risk; discuss your history with a clinician.
Diagnosis
How is uterine cancer diagnosed?
Tests are selected based on symptoms, examination findings, medical history, and the suspected cause of bleeding.
Clinical examination
Your clinician reviews bleeding patterns, medical history, and relevant examination findings.
Pelvic ultrasound
Ultrasound can assess the uterus and the thickness and appearance of the endometrium.
Endometrial biopsy
A sample of the uterine lining is commonly needed to confirm or exclude endometrial cancer.
MRI or other imaging
Additional imaging may help assess local extent and plan treatment when indicated.
Pathology report
The tissue report identifies the cancer type and features that help guide treatment.
A scan alone usually cannot confirm endometrial cancer. The clinician will explain whether tissue sampling or further tests are needed for your situation.
Treatment
Uterine cancer treatment options
Treatment depends on whether the cancer is endometrial cancer or another uterine cancer, the pathology findings, stage, tumour markers, overall health, and individual goals.
Surgery
For many endometrial cancers, hysterectomy is central to treatment and may include removal of the fallopian tubes and ovaries. Lymph-node assessment depends on the risk profile.
Radiotherapy
Radiotherapy may be recommended after surgery or as a primary treatment in selected situations, depending on the tumour type, stage, and surgical fitness.
Chemotherapy
May be recommended for higher-risk disease, advanced cancer, recurrence, or specific uterine cancer subtypes.
Hormone therapy
May be considered for selected hormone-sensitive endometrial cancers, including certain cases where fertility preservation is being evaluated by specialists.
Targeted therapy
Some patients may be eligible for targeted medicines based on tumour characteristics and biomarker testing.
Immunotherapy
May be appropriate for selected advanced or recurrent cancers depending on pathology, biomarkers, prior treatment, and current clinical guidance.
Important: These options are not interchangeable and not everyone needs more than one treatment. Uterine sarcoma and other uncommon uterine cancers may require a different plan from endometrial cancer.
Your care pathway
What happens after an abnormal result?
Your care team will explain each step and adapt the sequence to your needs.
Consultation
Review symptoms, history, examination, and prior reports.
Confirm diagnosis
Arrange biopsy or other tests needed to understand the cause.
Plan treatment
Discuss pathology, stage, treatment choices, benefits, and risks.
Recovery and follow-up
Review recovery, final pathology, additional treatment, and surveillance.
Common questions
Uterine cancer FAQs
Answers to common questions from patients and families.
Abnormal uterine bleeding is a key warning sign. Any bleeding after menopause should be assessed promptly. Heavy, prolonged, or unexpected bleeding before menopause also deserves medical review.
Take the next step
Get clarity on your diagnosis and options
Arrange a consultation or seek a second opinion to discuss your treatment plan.
This page is for education and does not substitute for examination, diagnosis or personalised medical advice. Please discuss persistent or concerning symptoms with a qualified clinician.