Kanser rahim (womb cancer, also called endometrial or uterine cancer) starts in the womb and is most common in women who have been through the menopause; its main warning sign is bleeding or spotting from the vagina after the menopause. Other signs include unusually heavy periods, bleeding between periods and a change in discharge. In Malaysia, it is the fourth most common cancer in women and has been rising. A high level of oestrogen, for example from being overweight, is one of the main risk factors. Womb cancer is usually treatable when found early, so see a doctor without waiting if you have any of these symptoms.
What is kanser rahim (womb cancer)?
The womb (uterus, or rahim) is where a baby grows during pregnancy. Womb cancer usually starts in its lining and is often called endometrial cancer; doctors and cancer registries may also call it uterine or corpus uteri cancer.
According to the NHS, womb cancer is most common in women who have been through the menopause, but it can affect anyone with a womb. You cannot get womb cancer if you have had your womb removed (a hysterectomy). It is usually treatable when it is found early.
Kanser rahim vs kanser pangkal rahim (serviks)
In Malay, people sometimes use kanser rahim loosely. It helps to know the difference:
| Kanser rahim (womb cancer) | Kanser pangkal rahim (cervical cancer) | |
|---|---|---|
| Where it starts | The body of the womb (usually its lining) | The cervix, the lower part of the womb that opens into the vagina |
| Main cause or risk | High oestrogen levels, such as from being overweight; more common after menopause | Long-lasting infection with high-risk HPV |
| What to do | See a doctor if you have symptoms, such as bleeding after the menopause | Have regular cervical screening (Pap smear or HPV test), which can find changes early |
| Our guide | This article | Kanser serviks |
Womb cancer in Malaysia
According to the Malaysia National Cancer Registry Report 2017-2021 (Ministry of Health):
- 5,087 cases of corpus uteri (womb) cancer were registered from 2017 to 2021;
- it was the fourth most common cancer among women in Malaysia, after breast, colorectal and lung cancer;
- incidence has been rising, and among women aged 25 to 59 it overtook cervical cancer in this period;
- the lifetime risk was about 1 in 125, highest among Indian women (1 in 91), followed by Chinese (1 in 125), Malay (1 in 143) and Other Bumiputera women (1 in 200);
- incidence was highest among women aged 65 to 69;
- among cases with staging information, 39.1% were found at a late stage (stage III or IV).
Finding it earlier matters, which is why symptoms such as bleeding after the menopause should never be ignored.
Tanda kanser rahim: symptoms
According to the NHS, the main symptoms of womb cancer can include:
- bleeding or spotting from the vagina after the menopause;
- heavy periods that are unusual for you;
- vaginal bleeding between your periods;
- a change to your vaginal discharge (see our guide to keputihan).
Other symptoms can include:
- a lump or swelling in your tummy or between your hip bones (pelvis);
- pain in your lower back or pelvis;
- pain during sex;
- changes in how often you pee or poo.
The NHS stresses that these symptoms are common and can be caused by many conditions, such as fibroids. Having them does not mean you have cancer, but they should be checked.
When to see a doctor
According to the NHS, see a doctor (at a klinik kesihatan or a GP) if you have any symptoms of womb cancer, and do not wait, because if they are caused by cancer, finding it early can make it easier to treat. Try not to be embarrassed; doctors are used to talking about these symptoms.
The doctor will ask about your health, symptoms and family history. Tell them if you or your family have a history of cancer or Lynch syndrome, a genetic condition that increases cancer risk. They may examine your tummy and do an internal examination; you can ask for a female doctor or nurse.
Punca kanser rahim: who is at higher risk?
According to the NHS, having a high level of the hormone oestrogen is one of the main things that can increase your chance of womb cancer. You may have higher oestrogen if you:
- are overweight;
- take some types of hormone replacement therapy (HRT) (see our guide to menopaus);
- have never given birth;
- have polycystic ovaries (see our guide to PCOS), now also called polyendocrine metabolic ovarian syndrome (PMOS);
- went through the menopause after the age of 55.
You might also be more likely to get womb cancer if you have:
- diabetes;
- a family history of bowel, ovarian or womb cancer, or inherited Lynch syndrome;
- taken medicines such as tamoxifen, used to treat breast cancer;
- had radiotherapy to your pelvis.
Tests and diagnosis
According to the NHS, if a doctor refers you to a specialist, tests may include:
- a transvaginal ultrasound scan of the womb;
- blood tests;
- a hysteroscopy, where a thin tube with a camera looks inside the womb;
- a biopsy, where cells from the lining of the womb are taken and tested.
The tests should not be painful, though some can be uncomfortable. If cancer is found, scans such as CT, MRI or PET and sometimes genetic tests help find out its size and whether it has spread (the stage).
How is womb cancer treated?
According to the NHS, womb cancer is usually treatable when it is found early. Treatment depends on the size of the cancer, where it is, whether it has spread, and your general health:
| Treatment | How it is used (NHS) |
|---|---|
| Surgery | Often the main treatment, especially when found early; usually removing the womb and cervix (hysterectomy), and sometimes the ovaries, fallopian tubes and nearby lymph nodes |
| Radiotherapy | The main treatment if you cannot have surgery, if the cancer is large or has spread, or after surgery to help stop it coming back |
| Chemotherapy | On its own or with radiotherapy if you cannot have surgery; after surgery to help stop the cancer coming back; or to slow the cancer and ease symptoms if it has spread |
| Hormone therapy, immunotherapy and targeted medicines | Options for some people, for example if the cancer has spread or is advanced |
Your care team will explain the benefits and side effects and talk to you about the effect of treatment on fertility. You will have regular check-ups during and after treatment.
Can you lower your risk?
You cannot always prevent womb cancer, but according to the NHS you can lower your chance of getting it if you:
- keep to a healthy weight (see our weight loss guide);
- stay active and exercise regularly;
- eat a healthy, balanced diet;
- talk to a doctor about which HRT is best for you if you are thinking about taking it.
If you have Lynch syndrome, your care team will talk to you about ways to reduce your cancer risk.
Frequently asked questions (FAQ)
What is kanser rahim (womb cancer)?
Kanser rahim usually means womb (uterus) cancer, also called endometrial cancer or uterine cancer, which starts in the womb. It is different from kanser pangkal rahim or kanser serviks, which is cancer of the cervix, the lower part of the womb. Womb cancer is most common in women who have been through the menopause and is usually treatable when found early.
What are the early signs of womb cancer (tanda kanser rahim)?
According to the NHS, the main symptoms are bleeding or spotting from the vagina after the menopause, unusually heavy periods, bleeding between periods, and a change in vaginal discharge. Other symptoms include a lump or swelling in the tummy or pelvis, pain in the lower back or pelvis, pain during sex, and changes in how often you pee or poo.
Is bleeding after menopause always cancer?
No. These symptoms are common and can be caused by many conditions. But bleeding or spotting after the menopause is a main symptom of womb cancer, so the NHS advises seeing a doctor without waiting, because finding cancer early can make it easier to treat.
How common is womb cancer in Malaysia?
According to the Malaysia National Cancer Registry Report 2017-2021, 5,087 cases of corpus uteri (womb) cancer were registered in 2017 to 2021, making it the fourth most common cancer in Malaysian women. Its incidence has been rising, and the lifetime risk was about 1 in 125. Among women aged 25 to 59, it overtook cervical cancer in this period.
What causes womb cancer (punca kanser rahim)?
Having a high level of the hormone oestrogen is one of the main risk factors. According to the NHS, your risk may be higher if you are overweight, take some types of HRT, have never given birth, have polycystic ovaries, went through the menopause after 55, have diabetes, have a family history of bowel, ovarian or womb cancer or Lynch syndrome, have taken tamoxifen, or have had radiotherapy to the pelvis.
Can womb cancer be cured?
Womb cancer is usually treatable when it is found early. Treatment depends on the size and spread of the cancer and your general health. Surgery to remove the womb and cervix (hysterectomy) is often the main treatment, sometimes with radiotherapy, chemotherapy or targeted medicines.
Can I lower my risk of womb cancer?
You cannot always prevent it, but the NHS suggests keeping to a healthy weight, staying active, eating a healthy balanced diet, and talking to a doctor about which type of HRT is best if you are thinking of taking it. People with Lynch syndrome should discuss risk reduction with their care team.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Symptoms such as unusual bleeding are common and usually caused by other conditions, but they should always be checked. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
