What Is the Difference Between Endometriosis and Endometrial Cancer?

Endometriosis and endometrial cancer have some symptoms in common. However, they are very different conditions and develop from different biological processes. 

Endometriosis is not cancer. Instead, it is a condition where the lining of your uterus (the endometrium) starts to grow in other parts of your body. 

Endometrial cancer can develop when the uterus lining starts to grow out of control, forming a tumor. The tumor’s cancer cells can spread to other parts of your body, forming tumors there. 

While endometrial cancer is much less common than endometriosis, it’s still the most common gynecological cancer in American women. 

How Are the Symptoms of Endometriosis and Endometrial Cancer Similar?

Some women don’t have symptoms with either condition. There are some symptoms that can appear for either condition such as:

• Blood spotting or bleeding between periods - if you’re at an age prior to menopause
• Pain during or after sex
• Lower back pain and/or pelvic area pain
• Blood in urine
• Painful urination

Patients have some or all of these symptoms with endometriosis:

• Swelling caused by blood buildup in the tissue outside of the uterus. 
• Heavy periods
• Bloating
• Constipation or diarrhea
• Painful bowel movements, especially during menstruation
• Decreased fertility

Additional symptoms of endometrial cancer can include:

• Bleeding or spotting after menopause
• Weight loss that can’t be explained
• Blood in stool 
• Stomach pain and swelling in the later stages of cancer

This means that if you’re experiencing some of these symptoms, you shouldn’t assume it’s one thing or the other. Schedule an appointment with a gynecologist who can perform an exam and request some additional testing such as an ultrasound to see what’s inside of the uterus.

Do Endometriosis and Endometrial Cancer Develop in the Same Way?

Endometriosis usually starts outside your uterus, ovaries, or fallopian tubes. However, it can start anywhere in the body.

Endometrial cancer usually develops in surrounding tissue such as the lymph nodes, abdomen lining (peritoneum), or liver. It can spread to bones, blood, brain, lungs, or adrenal glands.

Who Is At The Highest Risk For Endometriosis?

Endometriosis is fairly common, affecting up to 10% of women who are in their reproductive years. It can develop as soon as a woman starts menstruating. But most patients are diagnosed in their 30s or 40s.

It typically takes years to diagnose endometriosis. Your risk of developing it increases if you have: 

• Family members who’ve had it
• Menstrual periods that last more than seven days
• Periods that started before age 12
• Spotting between periods
• Heavy periods and/or cramping
• Pain or bloating with periods

Endometrial cancer is rarely diagnosed before age 45; 62 is the average age of diagnosis. It’s more likely to develop in Black women compared to White women. Black women are typically diagnosed at a later stage of cancer, and which decreases the risk of survivorship. 

Your chances of developing very rare types of ovarian cancer (clear cell and endometrioid ovarian cancers) are higher if you had endometriosis.

How are Endometriosis and Endometrial Cancer Diagnosed?

Accurately diagnosing endometriosis requires a tissue sample for analysis in a laboratory. A small incision is made in the stomach, through which a long, thin, flexible tube with a camera is inserted. Your surgeon can see inside the uterus and pelvis area and extract a tissue sample of suspected endometrial tissue.

If you have symptoms, or an imaging test (X-ray, CT scan, ultrasound, MRI, or PET scan) indicates possible endometrial cancer, a diagnosis will also require a tissue sample to rule out cancer. Your doctor passes a thin tube through the vagina and into the uterus. The endometrium tissue can be suctioned out. Additional samples may be needed to indicate the cancer’s subtype, if it’s aggressive, and if it has spread to surrounding tissue. 

Transvaginal ultrasound is also used to diagnose endometrial cancer. By gauging the endometrium’s thickness using sound waves, your doctor can determine if bleeding is caused by a benign (noncancerous) tumor or a cancerous tumor. 

Can Endometriosis be Treated?

The goal of endometriosis treatment is to manage symptoms and try to treat any infertility that it has caused. There are several treatments that can help, including:

• Prescription or over-the-counter pain medications.
• Hormone-blocking medications can be effective because in some cases hormones cause the abnormal growth of endometrial tissue. Hormone therapy reduces the build-up of endometrial tissue that occurs with each menstrual cycle. Hormone blockers include birth control pills, progestin, and gonadotropin-releasing hormone (GnRH) agonists.
• Surgery can burn away endometrial tissue that develops outside the uterus.
• Surgery is also used to remove scar tissue blocking or displacing fallopian tubes or ovaries, often restoring fertility.

How is Endometrial Cancer Treated?

Treatment depends on the subtype of endometrial cancer you have, how many tumors there are if it’s responsive to hormone-blocking drugs, and how aggressive it is. 

• Surgery combined with other therapies is the most common treatment. Surgery removes all or most of the tumor. A total hysterectomy removes the uterus and cervix. Fallopian tubes, ovaries, and lymph nodes may also be removed with minimally invasive surgery using a laparoscope. Surgery is also used to determine the extent of the cancer, which helps your doctor determine the best treatment plan for your specific needs. 
• Radiation therapy is often used to kill any remaining cancer cells after surgery, improving your chances that the cancer won’t return.
• If hormones are increasing the growth of your tumor, you’ll be prescribed hormone-blocking medications to slow or stop tumor growth. Hormones are used to treat cancer and preserve fertility or if a hysterectomy is not possible.
• Chemotherapy kills cancer cells throughout the body and may be used If the cancer has already spread beyond the uterus.
• Immunotherapy is a newer treatment used in treating endometrial cancer. It works by increasing your immune system’s ability to fight cancer.
• Targeted drug therapies stop the growth of tumors by targeting specific features in cancer cells.

Endometriosis and endometrial cancer are different diseases with many similar symptoms. If you develop painful periods, spotting, or pain in your stomach-pelvic area or lower back, get checked by a healthcare professional. Prompt treatment can relieve the pain of endometriosis. Early diagnosis of endometrial cancer provides the best chance of a cure.

If you are diagnosed with endometrial cancer, treatments are available locally in the Atlanta area. RCOG has a team of experts conveniently located in cities throughout the Atlanta area, including Conyers, Covington, Decatur, Snellville, and Blairsville.