Endometrial cancer recurrence (ECR) is the return of cancer after a period of remission following initial treatment. This can happen months or even years after the original diagnosis. Understanding what symptoms may indicate a recurrence is paramount for long-term health management. The earliest possible detection of recurrent disease offers the best opportunities for successful intervention and treatment. Awareness of both localized and distant signs is a proactive part of post-treatment surveillance.
Symptoms in the Pelvic Area
Recurrence often develops locally, appearing in the vagina, pelvis, or nearby lymph nodes. The most common symptom reported is new or persistent vaginal bleeding, even after a hysterectomy. This bleeding may manifest as light spotting, a heavier flow, or bleeding that occurs specifically after sexual intercourse.
The vaginal cuff, the closed top of the vagina after the uterus is removed, is a frequent location for local recurrence. Growth here can irritate the tissue, leading to abnormal vaginal discharge. This discharge may be watery, pink-tinged, or foul-smelling, and any new, persistent, or unusual discharge warrants immediate discussion with a medical professional.
Local tumor growth can cause persistent pelvic pain, pressure, or cramping. If the recurring tumor presses on adjacent structures, it can lead to changes in bladder or bowel function. These changes include pain or a constant urge when urinating, or difficulty with bowel movements. Pain experienced during sexual intercourse is also a potential sign.
Signs of Distant Recurrence
Endometrial cancer can recur in sites outside the pelvis. Symptoms of distant recurrence are related to the specific organ system where the cancer has returned. The most frequent sites include the lungs, bone, and liver.
If the cancer has spread to the lungs, a persistent cough or a new onset of shortness of breath may be noticed. These respiratory symptoms occur as tumor deposits interfere with normal lung function. A recurrence in the skeletal system, particularly the bones of the pelvis or spine, presents as persistent pain or aches in the back or hips.
Systemic symptoms are common indicators of distant disease. Unexplained weight loss and decreased appetite are frequent signs. Persistent fatigue is another general symptom that may signal a systemic issue. Abdominal swelling or bloating, sometimes accompanied by nausea or vomiting, can indicate recurrence in the abdominal cavity or liver.
Monitoring and Reporting Symptoms
Self-reporting is the most effective tool in post-treatment monitoring, as most recurrences are first found because of symptoms reported by the patient. Following treatment, the oncology team typically schedules regular follow-up visits more frequently in the first two to three years, when recurrence is most likely. These appointments generally occur every three to six months during the initial high-risk period, gradually decreasing in frequency over time.
A dedicated symptom record can be helpful, noting when any new changes began, how often they occur, and their severity. This detailed record assists the physician in differentiating between a temporary issue and a potential recurrence. Imaging scans and blood tests are ordered if symptoms or a physical exam suggest a problem.
It is important to contact the medical team if any new or concerning symptom is noted, rather than waiting for the next scheduled appointment. While symptoms like pain or bleeding can be caused by many conditions unrelated to cancer, the oncology team must investigate and rule out recurrence. Maintaining open communication ensures that any potential return of the disease is addressed promptly.