What are the symptoms of uterine cancer?

Uterine Cancer Symptoms

Approximately 90% of patients with uterine cancer present with abnormal vaginal bleeding, most commonly postmenopausal bleeding that is characteristically painless. 1, 2

Cardinal Presenting Symptom

• Abnormal vaginal bleeding is the hallmark symptom, occurring in 85-90% of cases, and is typically painless in nature 1, 2, 3, 4
• Postmenopausal bleeding specifically is the most common presentation and warrants immediate evaluation regardless of whether pain is present 1, 2, 5
• The painless nature of the bleeding often prompts patients to seek care early when disease is still localized, resulting in approximately 75-83% of patients being diagnosed with early-stage disease 1, 2

Additional Common Symptoms

Pelvic and Abdominal Manifestations:

• Palpable pelvic or lower abdominal mass (32-45% of cases) 6, 4
• Abdominal or pelvic pain (28-38% of cases) 1, 6, 4
• Abdominal discomfort, fullness, or distension 1

Other Gynecologic Symptoms:

• Abnormal vaginal discharge (27% of cases), which may be bloody, rusty, or brown in color 7, 6
• Changes in menstrual bleeding pattern in premenopausal women, including irregular menses or increased clotting 1, 7

Pressure-Related Symptoms:

• Urinary frequency or bladder pressure from mass effect 1
• Constipation or bowel habit changes from rectal compression 1
• Dyspareunia (painful intercourse) 1

Constitutional Symptoms:

• Lethargy and fatigue 1
• Weight loss 1
• Decreased appetite 7

Advanced Disease Presentations

• Abdominal distension and bloating from ascites 1
• Shortness of breath from pleural effusion in stage IV disease 1
• Enlarged inguinal, supraclavicular, or axillary lymph nodes if nodal metastases are present 1

Critical Clinical Context

The early symptom of painless postmenopausal bleeding is what enables early detection, with 5-year survival rates exceeding 95% for stage I disease and 83% overall 1, 2. This favorable prognosis is directly attributable to patients seeking medical attention promptly when bleeding occurs 2.

Important Caveats

• Even with intensive surveillance protocols, 50-70% of recurrences are detected based on symptoms rather than routine testing 1
• Symptoms such as vaginal bleeding may indicate local recurrence, which is often curable if it represents an isolated site of disease 1
• Women should be counseled that any postmenopausal bleeding, vaginal discharge (especially if bloody), or the symptoms listed above require prompt medical evaluation rather than waiting for a scheduled appointment 1