Endometrial cancer - Why Jamaican women must pay attention to silent warning signs
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Endometrial cancer, a disease affecting the lining of the womb, is emerging as a major health concern for women in Jamaica and across the Caribbean. Alarmingly, Jamaica now has one of the highest rates of the disease in the world, making awareness, early detection, and prevention more important than ever.
According to consultant gynaecologist Dr Michael Taylor, many women are unfamiliar with the condition and often dismiss early warning signs that could save their lives.
“The womb is like a jar. It consists of three main parts — the body or walls of the jar, called the myometrium; the lining, called the endometrium; and the neck, called the cervix. Endometrial cancer arises from the endometrium, which is the lining of the womb,” he said (DEL/ EXPLAINED.).
Unlike cervical cancer or ovarian cancer, endometrial cancer specifically develops in the tissue that thickens monthly during a woman’s reproductive years in preparation for pregnancy.
Statistics from the World Cancer Research Fund and GLOBOCAN 2022 reveal a troubling reality. Jamaica recorded 494 new cases of endometrial cancer in 2022, giving the country the second-highest age-standardised incidence rate globally at 25.4 per 100,000 women. Barbados ranked third worldwide.
“These figures show that endometrial cancer is a major problem in Jamaica and the Caribbean,” Dr Taylor said.
Globally, the disease primarily affects post-menopausal women between the ages of 55 and 75. However, doctors warn that lifestyle factors are contributing to rising risks among younger women as well.
Dr Taylor identified obesity as the single biggest risk factor associated with endometrial cancer. “Obesity increases the incidence by five to seven times,” he said.
The reason lies in the body’s hormonal balance. Fat cells in obese individuals produce excess estrogen, specifically a form called oestrone, which continuously stimulates the lining of the womb.
“Usually, estrogen is balanced by another hormone called progesterone, which prevents unchecked growth. But unopposed estrogen, estrogen without progesterone, can cause uncontrolled growth that may eventually become cancerous,” he said.
In addition to hormonal imbalance, obesity is also linked to insulin resistance and elevated insulin levels, which researchers believe can contribute to the formation of cancer cells.
Other risk factors include polycystic ovarian syndrome (PCOS), a family history of the disease, early onset of menstruation, late menopause, and genetic conditions such as Lynch syndrome. Lynch Syndrome is an inherited disorder linked not only to endometrial cancer, but also certain forms of colon cancer.
One symptom stands above all others when it comes to endometrial cancer is abnormal bleeding. “The most common warning sign is abnormal vaginal bleeding,” Dr Taylor said.
For women who have already gone through menopause, any vaginal bleeding should immediately be investigated. Women approaching menopause should also seek medical attention for bleeding outside of their regular menstrual cycle.
Other symptoms may include unusual vaginal discharge, pelvic pain, and persistent discomfort in the lower abdomen. “Cancer cells in the endometrium shed and bleed, which is why abnormal bleeding is such an important symptom,” Dr Taylor noted.
Unfortunately, many women dismiss these signs as normal hormonal changes, delaying diagnosis and treatment.
Despite the seriousness of the disease, Dr Taylor emphasised that endometrial cancer is highly treatable when detected early. “If picked up at an early stage, 95 per cent of endometrial cancers are curable,” he said.
Diagnosis usually begins with a pelvic ultrasound to assess the thickness of the womb lining. Doctors may then perform a biopsy, where a small sample of tissue is taken from the endometrium and tested for cancer cells.
Treatment in Jamaica primarily involves surgery to remove the womb, fallopian tubes, and ovaries. Doctors may also assess nearby lymph nodes to determine whether the cancer has spread.
Depending on the stage of the disease, additional treatment may include chemotherapy, radiotherapy, or immunotherapy. Dr Taylor believes greater public education is critical in reducing late-stage diagnoses.
Support services are also critical for women navigating a cancer diagnosis. The Jamaica Cancer Society plays an important role in assisting patients through education, counselling, screening programmes, and guidance on accessing treatment and support services. The organisation also works to raise awareness about early detection and the importance of regular medical check-ups, while offering emotional support to patients and their families during treatment and recovery.
“Women need to understand that abnormal vaginal bleeding must be checked,” he said. He encourages women to schedule yearly gynaecological examinations and seek medical advice promptly if they experience unusual symptoms.
Maintaining a healthy weight, exercising regularly, and managing chronic conditions such as diabetes can also significantly reduce risk. Importantly, Dr Taylor wants women to move away from the belief that a cancer diagnosis automatically means death.
“A lot of patients perceive cancer as a death sentence. Endometrial cancer can be cured,” he said.
Dr Taylor’s message is simple but urgent. “Don’t ignore abnormal bleeding, abnormal discharges, or pelvic pain. Get it checked.” Women seeking information, screening, or support can consult their family doctor, gynaecologist, or local health centre.