9 Signs Doctors Look for to See Whether Endometrial Cancer Has Returned

Even with successful treatment, endometrial cancer can sometimes come back (recur). Recurrence may be:

Local: Near the site of the original cancer, such as your vagina or the lymph nodes in your pelvis or lower abdomen.

Distant: In other parts of your body, like your lungs or bones. 

It’s most likely within the first few years after treatment, so you’ll have regular checkups to watch for signs. Here are symptoms to tell your doctor about.

Most people whose endometrial cancer returns do have symptoms, and unusual vaginal bleeding or discharge is the most common. If you had your uterus removed during treatment, or if you’re past menopause, any bleeding is considered abnormal and you should get it checked out right away. If you still have your uterus, watch for especially heavy periods or bleeding between periods.

Pain is another common sign that endometrial cancer has returned, whether it’s local or in distant areas like your bones. You may feel it in your abdomen, pelvis, back, or hips.

Take note of unusual symptoms when you use the bathroom. They can mean the cancer has spread to your bladder or digestive system. These can include:

• Trouble peeing
• Pain when you pee
• Blood in your urine
• Constipation
• Diarrhea
• Bleeding from your bottom

Another place where endometrial cancer is likely to recur is in your peritoneum. That’s the tissue that lines your abdomen and makes fluid to keep your organs from rubbing or sticking together. Cancer here can cause your peritoneum to make too much fluid. It can fill your belly and make you feel bloated. Your stomach may stick out or feel hard.

Fluid in your belly puts pressure on your stomach. That can make you lose your appetite or feel full quickly when you do eat, even if it’s just a small amount. You may also feel nauseated or throw up.

If you’ve lost weight without trying — like 10 pounds in several months — that’s another red flag to bring up with your doctor. It might be happening because a return of endometrial cancer is affecting your appetite. But cancer can also cause your body to burn more calories and to break down muscle and fat.

It’s not unusual to feel very tired during cancer treatment, and for people with endometrial cancer, fatigue can linger long after you’re finished. But it can also be a sign that the cancer has come back. This isn’t normal tiredness — it’s exhaustion that doesn’t go away even if you get rest.

It may not seem like there would be a connection between a gynecological cancer and your breathing, but if endometrial cancer comes back outside your pelvis or lower abdomen, it’s most likely to appear in your lungs. That can lead to symptoms like shortness of breath and coughing. Fluid in your belly can also make it hard to breathe.

Your lymphatic system is a network of vessels and glands called lymph nodes that carry fluid and waste products away from your organs and tissues. When endometrial cancer recurs in your lymph nodes, it can disrupt the flow. That can cause swelling, especially in your legs and belly. Your doctor will see whether your lymph nodes are enlarged during your checkups.

Besides getting regular checkups, other habits that protect your overall health may also lower the chances of recurrence.

Get to a healthy weight. Being overweight is a big risk. Body fat raises estrogen levels, which drives endometrial cancer.

Eat nutritiously. Diets high in fat and sugar are linked to higher risk.

Exercise. There’s some evidence that staying active may help keep endometrial cancer  from coming back and help you live longer.