Is Uterine Cancer the Same as Endometrial Cancer?
Hearing the words “uterine cancer” or “endometrial cancer” can feel overwhelming, and it doesn’t help that the two terms are often used interchangeably. But they’re not the same. Endometrial cancer begins in the lining of the uterus and is the most common type, while rarer cancers like uterine sarcomas develop in the muscle or connective tissue.
Understanding the difference isn’t just a medical detail. It can shape the symptoms you notice, the diagnosis you receive, and the treatment options available to you. That’s why we’re here: as a community of women who have walked this journey and clinical experts who study and treat it every day, we want to make this information clear, accessible, and supportive.
In this blog, we’ll break down what sets uterine and endometrial cancer apart, how common they are, the warning signs to pay attention to, and the treatments that may help. Whether you’re navigating this yourself, supporting a loved one, or simply wanting to stay informed, our goal is to empower you with knowledge and remind you that you’re not alone.
What Is the Difference Between Uterine and Endometrial Cancer?
When it comes to talking about uterine cancer, one of the first questions that often comes up is: What exactly is the difference between uterine cancer and endometrial cancer? It’s an important distinction, because while these terms are sometimes used as if they mean the same thing, they don’t, and understanding the difference can guide everything from how symptoms present to the treatment options that follow. (Cancer.org)
Uterine cancer: Any cancer that starts in the uterus.
Endometrial cancer: The most common type (90% of uterine cancers), starting in the uterine lining.
Uterine sarcomas: Rare cancers (3–7%) that develop in uterine muscle or connective tissue, often more aggressive and treated differently.
In short, all endometrial cancers are uterine cancers, but not all uterine cancers are endometrial.
How Common Is Uterine Cancer?
Uterine cancer makes up 50% of all gynecologic cancers, and yet most people haven’t even heard of its many names, depending on where you live. Uterine and endometrial cancer are almost interchangeable in the USA, and in the UK, it’s referred to as womb cancer.
About 66,000 new uterine cancer cases were diagnosed in the U.S. in 2023 (ACS).
Endometrial cancer is the most common gynecologic cancer.
The average age at diagnosis is 60 years, but it does affect younger women as well.
Risk is rising, partly due to obesity and metabolic risk factors.
What are the Symptoms of Uterine and Endometrial Cancer?
Early signs are often overlooked, misdiagnosed, or mistaken for menopause or other conditions. You know your body better than anyone, so if you feel something is off, don’t ignore it and keep advocating for yourself. This may mean telling your doctor to put a note in your chart that you asked for additional testing and were denied, getting a second opinion from another PCP, or asking for a transvaginal ultrasound to check the possible thickening of the endometrial lining, if bleeding is a symptom. (Cancer.org)
Key symptoms include:
Vaginal bleeding after menopause (the most common warning sign)
Irregular or heavy menstrual bleeding
Bleeding between periods
Pelvic pain or pressure
Pain during intercourse
Unusual discharge
Unexplained fatigue or weight loss
Recognizing early endometrial cancer signs, such as abnormal vaginal bleeding or pelvic discomfort, is critical for timely diagnosis and effective treatment.
If you experience any of these symptoms, especially postmenopausal bleeding, consult a gynecologist or a gynecologic oncologist for evaluation.
How Are Uterine and Endometrial Cancers Diagnosed?
There is no routine screening test for endometrial or uterine sarcoma cancers, so diagnosis relies heavily on symptom awareness and medical evaluation. (Cancer.org)
Imaging Tools
Transvaginal Ultrasound (TVUS): Usually the first imaging test done, TVUS uses sound waves to assess the thickness of the endometrial lining and detect any abnormalities or masses inside the uterus. A thickened endometrium in a postmenopausal woman often warrants further investigation.
Pelvic MRI: Provides detailed images of the uterus and surrounding tissues, helping to evaluate tumor size, depth of invasion, and involvement of adjacent structures.
CT Scan: Used mainly for staging to check if cancer has spread to lymph nodes or other organs.
PET Scan: Sometimes used in advanced cases to detect metastases or recurrence by highlighting areas of high metabolic activity typical of cancer cells.
Tissue Sampling (Biopsy)
Endometrial Biopsy: A minimally invasive procedure often performed in a doctor’s office. A small sample of the uterine lining is removed through the cervix for microscopic examination.
Dilation and Curettage (D&C): A more thorough sampling performed under anesthesia where the cervix is dilated, and tissue is scraped from the uterine lining. Used if biopsy results are inconclusive or symptoms persist.
Hysteroscopy with Biopsy: Allows direct visualization of the uterine cavity with a small camera and targeted biopsies of suspicious areas.
Accurate tissue diagnosis is crucial for determining the cancer type and grade, and guiding treatment decisions.
Treatment Options for Uterine and Endometrial Cancer
Receiving a uterine or endometrial cancer diagnosis can feel overwhelming, but understanding the treatment options can help you feel more empowered. We encourage you to work closely with your oncologist team to navigate your treatment options and arm yourself with the knowledge to make informed decisions that are best for you. There are several standard treatment options: surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, and immunotherapy, often used alone or in combination depending on the stage, grade, and type of cancer. (cancer.org)
Treatment depends on the type, stage, grade, and the patient's health.
Early-stage, lower-grade cancers are most often treated with surgery (typically a hysterectomy with removal of fallopian tubes and ovaries). In some cases, this may be enough on its own, or it may be followed by radiation therapy to lower the risk of recurrence. (mayoclinic.org)
Later-stage or high-grade cancers usually require multi-modal treatment. Surgery may still be performed if possible, but it is often combined with chemotherapy and/or radiation therapy to address cancer that has spread beyond the uterus. (cancer.org)
Radiation therapy can be delivered in two main forms:
External Beam Radiation Therapy (EBRT): This is the most common type of radiation used for uterine and endometrial cancers. EBRT directs high-energy X-rays at the pelvis from outside the body. Treatments are typically given five days a week over several weeks. EBRT helps destroy remaining cancer cells after surgery or can be used when surgery isn’t an option.
Internal Radiation (Brachytherapy): In this type, a small device containing radioactive material is placed directly inside the vagina or uterus for a short time. Because the radiation is delivered close to the tumor site, brachytherapy can be very effective in preventing local recurrence while limiting radiation exposure to surrounding tissues. It is often used in early-stage cases after surgery or in combination with EBRT for more advanced cancers.
Stereotactic Body Radiation Therapy (SBRT): Stereotactic Body Radiation Therapy (SBRT), also known as stereotactic ablative radiotherapy, is an advanced form of external beam radiation that delivers high doses of radiation with extreme precision to small, well-defined targets. This is sometimes used in recurrent uterine/endometrial cancer. Because of its conformality and tight margins, SBRT can spare surrounding healthy tissues more effectively than conventional radiation.
Chemotherapy plays a larger role in advanced or aggressive cancers, particularly when cancer cells have moved to lymph nodes or distant organs.
Hormone therapy may be an option for certain patients with advanced but slower-growing cancers, or for those who cannot undergo surgery.
Targeted therapy and immunotherapy are important in recurrent or high-grade cases with specific genetic features, such as mismatch repair deficiency or microsatellite instability. These precision treatments are expanding options for patients who previously had few choices. (cancer.org)
No two treatment plans look the same, which is why it’s essential to work closely with your oncologist and care team. Having open conversations with your oncology team can help you understand the benefits and side effects of each option and decide on the path that aligns best with your health needs and personal goals. Knowledge is power, and learning about these treatments and side effects gives you a stronger voice in your care decisions.
Why Awareness Matters
At ECRF, we are committed to advancing translational research that expands these treatment possibilities, especially for people with high-grade or later-stage disease. Translational research means turning discoveries in the lab into real treatments for patients. In endometrial cancer, this process has already led to breakthroughs, for example, finding that some tumors with DNA repair problems respond well to immunotherapy. Each new study builds on past research, helping doctors better predict which treatments will work and giving patients more options for the future. At ECRF, supporting translational research means speeding up progress so tomorrow’s care is smarter, more effective, and available to everyone.
Too often, clinical trials do not reflect the diversity of those most affected by uterine and endometrial cancers. By driving more inclusive research, we are helping ensure that every patient, no matter their diagnosis stage, has access to the most effective, evidence-based care.
Uterine cancer is common but often overlooked in research funding and awareness
Black women are more likely to be diagnosed at advanced stages and have poorer outcomes
Supporting education, research, and advocacy is critical to closing these gaps
Taking Action
If you or someone you love experiences symptoms or receives a diagnosis, connect with a gynecologic oncologist. If you feel like you are not being taken seriously or are being dismissed, we encourage you to get a second opinion, or even a third. Not all doctors are treated equally!
At the Endometrial Cancer Research Foundation (ECRF), we are breaking barriers to advance endometrial cancer research, awareness, detection, treatment, and education. Our vision is a future where endometrial and uterine cancers are eliminated through targeted research, empowered advocacy, and equitable access to prevention, treatment, and care for all individuals affected by these diseases.
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