• Abnormal uterine bleeding, abnormal menstrual periods
  • Bleeding between normal periods before menopause
  • Vaginal bleeding or spotting after menopause
• Extremely long, heavy, or frequent episodes of vaginal bleeding after age 40
• Lower abdominal pain or pelvic cramping
• Thin white or clear vaginal discharge after menopause

A pelvic examination is frequently normal, especially in the early stages of disease. Changes in the size, shape, or feel of the uterus or surrounding structures may be seen when the disease is more advanced.

Tests that may be done include:

• Endometrial aspiration or biopsy
• Dilation and curettage (D and C)
• Pap smear (may raise a suspicion for endometrial cancer, but does not diagnose it)

If cancer is found, other tests may be done to determine how widespread the cancer is and whether it has spread to other parts of the body. This is called staging.

Stages of endometrial cancer:

1. The cancer is only in the uterus.
2. The cancer is in the uterus and cervix.
3. The cancer has spread outside of the uterus but not beyond the true pelvis area. Cancer may involve the lymph nodes in the pelvis or near the aorta (the major artery in the abdomen).
4. The cancer has spread to the inner surface of the bowel, bladder, abdomen, or other organs.

Cancer is also described as Grade 1, 2, or 3. Grade 1 is the least aggressive, and grade 3 is the most aggressive.