Abnormal Vaginal Bleeding is a Sign of Uterine Cancer

Abnormal vaginal bleeding, especially after menopause, is the primary sign of uterine cancer. Bleeding may be so light that it’s only a pink discharge or drainage from the vagina. Whether you are a young woman with irregular periods or you are an older woman who is either approaching menopause or well past it, you should not hesitate to immediately bring any abnormal bleeding episode to the attention of your health care professional. Early diagnosis is critical to the successful treatment of uterine cancer.

If cancer is suspected, a tissue sample must be taken from inside your uterus. This procedure is called an endometrial biopsy and can usually be done in the health care professional's office with minimal discomfort. A narrow instrument is used to take the sample. You may have cramps or pain for a short time after the procedure.

The American Cancer Society released a 2001 update of their guidelines on testing for early uterine cancer detection. According to the guidelines, there is no indication that screening for uterine cancer is warranted for women who have no identified risk factors (identified risk factors include using unopposed estrogen therapy, never having been pregnant or never having given birth, infertility or failure to ovulate, obesity, diabetes or hypertension). It is recommended, however, that at the time of menopause, women at average risk should be informed about risks and symptoms of uterine cancer, and strongly be encouraged to report any unexpected bleeding or spotting to their physicians.

According to the guidelines there is no indication that screening for uterine cancer should be recommended for women at increased risk for uterine cancer because, as in the case with average-risk women, individuals at increased risk who develop uterine cancer tend to present with symptoms at an early, favorable stage. As with average-risk women, at the time of menopause, those at increased risk should be informed about the risks and symptoms of uterine cancer, and strongly encouraged to report any unexpected bleeding or spotting to their physicians. Women at increased risk, but with no symptoms, should also be informed about the potential benefits, risks and limitations of testing for early uterine cancer detection, to ensure informed decisions about testing may be made.

The guidelines recommend that annual screening for uterine cancer with endometrial biopsy should be offered by age 35 for women with or at risk for hereditary nonpolyposis colorectal cancer. Women in this high-risk group should be informed about the risks and symptoms of uterine cancer, and should be informed about potential benefits, risks and limitations of testing for early uterine cancer detection.

If your endometrial biopsy is not conclusive (such as if not enough tissue was retrieved), your health care professional may also recommend having a dilation and curettage (D&C) to remove pieces of the lining of the uterus. During a D & C, the opening of the cervix is dilated and the walls of the uterus are scraped gently to remove any growths. This tissue is then checked for cancer cells.

In addition, you may also need to have routine blood tests, a urine test and a chest X-ray. If the biopsy or D&C are positive, staging surgery is required to properly measure the extent of disease.

Copyright 2003

National Women's Health Resource Center Inc. (NWHRC).