Symptoms of endometrial cancer recurrence: Watch out for unusual weight loss, bleeding, pain, nausea

Symptoms of endometrial cancer: It primarily affects postmenopausal women, and symptoms like unusual bleeding, pain, swelling, nausea, or weight loss often signal a recurrence (Image: Pexels)

Endometrial cancer can sometimes return even after treatment, but spotting it early can save lives. According to the National Cancer Institute (NCI), it's the cancer that forms in the tissue lining the uterus (the small, hollow, pear‑shaped organ in a woman’s pelvis in which a fetus develops). Most endometrial cancers are adenocarcinomas. It is the most common gynecologic malignancy in developed countries and primarily affects postmenopausal women. Symptoms like unusual bleeding, pain, swelling, nausea, or weight loss often signal a recurrence.

Even after beating endometrial cancer, it can come back, leaving women and their families worried and anxious. Dr Jeyhan B. Dhabhar, medical oncologist and hemato-oncologist at Jaslok Hospital & Research Centre, Mumbai, tells Moneycontrol, “It can be scary, but spotting the first signs early helps doctors choose the right treatment and improve results. Around 70 percent of recurrences come with noticeable symptoms. Historically, options were limited, mostly chemotherapy, and survival rates were low. But advances in personalised medicine now allow doctors to tailor treatment to each patient’s tumour, giving new hope when recurrence is detected early.”

Dr Dhabhar lists the symptoms to watch for:

• Unusual vaginal bleeding or discharge
• Pain in the tummy or pelvis
• Swelling in legs or other areas
• Feeling sick, vomiting, or losing appetite
• Losing weight without trying
• Feeling dizzy or fainting
• Persistent cough or shortness of breath
• A new lump or mass
• Unexplained skin changes

“Sometimes recurrence doesn’t show any symptoms. That’s why regular follow-ups are important to catch it early,” adds Dr Dhabhar. Modern treatments look at the unique genes and proteins in each tumour. “This means doctors can choose the most effective treatment with fewer side effects,” the expert adds.

According to the American Cancer Society, if endometrial cancer returns, it usually happens within the first few years after treatment. That’s why a structured follow-up schedule is important.

Typically, your oncologist may recommend:

• Physical exams: every 3 to 6 months for the first 2-3 years, then every 6 to 12 months for up to 5 years, and yearly after that.
• Imaging tests: only if physical exams or symptoms, suggest a problem

During follow-ups, the doctor will:

• Perform a pelvic exam and check for enlarged lymph nodes
• Ask about symptoms as most recurrences are detected this way
• Pap-test might be done. However, these are generally no longer recommended for routine follow-up

If recurrence is suspected, additional tests such as CT scans, ultrasounds, blood tests (CA 125), or biopsies may be done. Routine imaging and blood tests are usually unnecessary if you have no symptoms or exam changes. Early diagnosis combined with personalised therapy is helping more women survive and feel hopeful after a recurrence.

Early symptoms include unusual vaginal bleeding or discharge, pain in the tummy or pelvis, and swelling in the legs or other areas.

Yes, around 70 percent of recurrences present with noticeable symptoms like unusual bleeding, weight loss, nausea, or pain.

Regular follow-ups help detect any recurrence early, which is crucial for effective treatment and better outcomes.

Doctors typically perform pelvic exams and check for enlarged lymph nodes. Imaging tests may be recommended if symptoms suggest a problem.

Routine imaging and blood tests are usually unnecessary unless there are symptoms or changes during physical exams.