Clinical reference

Cancer of the uterus (endometrial cancer)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Endometrial Cancer - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK525981/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD28.04 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents

No dose - referral pathway, no medicine given in primary care
Cancer of the uterus (endometrial cancer) - disease-level clinical article (uterine-cancer-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

Abnormal uterine bleeding is by far the most common presenting symptom [abnormal uterine bleeding]
About 10% of postmenopausal bleeding is ultimately traced to endometrial cancer [abnormal uterine bleeding]
Advanced disease can bring pelvic and abdominal pain, ascites, and spread through the lymphatics or peritoneum [abdominal pain · ascites · pelvic pain]
Vaginal discharge, pelvic pain, constipation, or diarrhea are less common presenting complaints [abdominal pain · constipation · diarrhoea · pelvic pain · vaginal discharge]

Signs — what you find (1)

The exam is often unremarkable, though an enlarged uterus may be felt in advanced disease

Tests (5)

An endometrial stripe under 4 mm on transvaginal ultrasound has a negative predictive value above 99%
A postmenopausal endometrial stripe of 4 mm or more calls for biopsy
Tissue is obtained by pipelle aspiration or by dilatation and curettage, with or without hysteroscopy
Chest, abdomen, and pelvis CT is done for high-grade histology to rule out spread before surgery
Molecular subtyping alongside histology can now shift the assigned stage up or down in early disease

If not this — what else fits (4)

Abnormal bleeding differentials are organized by the PALM-COEIN framework, spanning structural causes like polyps or fibroids to non-structural causes like clotting or ovulation disorders
An intrauterine or ectopic pregnancy, and gestational trophoblastic disease, must be ruled out in premenopausal bleeding
A hormone-secreting ovarian tumor or thyroid and adrenal disease can drive bleeding through ovulatory dysfunction
A pelvic mass may turn out to be a fibroid, ovarian cyst, hydrosalpinx, or scar tissue rather than cancer

SourceStatPearls "Endometrial Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line

Adult dose and duration

Malignant uterine (usually endometrial) tumour; postmenopausal bleeding is the cardinal warning sign and mandates urgent gynae-oncology referral for biopsy and staging rather than primary-care treatment. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - Abnormal uterine bleeding in premenopausal women aged 45 or older, or in younger premenopausal women with risk factors (obesity, PCOS, Lynch syndrome, tamoxifen use), requires endometrial assessment to exclude cancer.
RED FLAG - Pelvic pain, abnormal vaginal discharge, or uterine enlargement on examination may indicate advanced endometrial malignancy requiring evaluation.
RED FLAG - Postmenopausal bleeding, abnormal or heavy intermenstrual bleeding in an older woman, or a pelvic mass.

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