Fertility, Fear and the Unexpected Rise of Endometrial Cancer in Young Women
Endometrial cancer is on the rise. Once considered a disease that mainly affected older, postmenopausal women, it is now the fifth most common cancer among Malaysian women, with a prevalence rate of 5.6%. Increasingly, women under 50 are receiving this diagnosis. For many, it brings not only health concerns but also difficult questions about fertility and the future.
Dr Andi Anggeriana Binti Andi Asri, based at Sunway Medical Centre in Sunway City, sees this trend first-hand. As a Consultant in Obstetrics, Gynaecology, and Gynae-Oncology, she sheds light on what's driving the increase—and how advances like robotic-assisted surgery are changing treatment.
Dr Asri highlights that endometrial cancer can be particularly insidious in its early stages. 'Abnormal uterine bleeding, whether postmenopausal or otherwise, is the most common symptom,' she explains. Other warning signs include pelvic pain, unexplained weight loss, pain or difficulty during urination or intercourse, and unusual vaginal discharge.
She has observed a noticeable increase in younger patients, some even in their early 30s, being diagnosed with this cancer. This shift is alarming not only for its impact on health but also for the potential threat to fertility—a major concern for many women in this age group.
A range of lifestyle and hormonal factors appear to be contributing to this trend. Obesity, sedentary habits, and conditions such as polycystic ovary syndrome (PCOS) are known to elevate oestrogen levels, which in turn can thicken the uterine lining and increase cancer risk.
'Many young women come in for fertility or hormonal consultations, only to be diagnosed with endometrial cancer. It's a life-altering discovery,' adds Dr Andi.
When it comes to treatment, early detection is crucial. For women diagnosed at an early stage, fertility-sparing options such as hormonal therapy may be possible, but these require careful monitoring and carry the risk of recurrence.
In some early-stage cases, fertility-sparing treatments are possible. 'Women diagnosed early may be eligible for hormonal therapy to manage the cancer while preserving the uterus,' says Dr Andi. However, she cautions that this option requires stringent medical monitoring and carries a risk of recurrence.
For women who must undergo a hysterectomy or other fertility-ending treatments, the psychological impact can be profound. 'It's heartbreaking. Many haven't started or completed their families, and the loss of fertility adds another layer to the emotional strain,' Dr Andi notes. Comprehensive emotional support is therefore a crucial part of the treatment journey.
Recent advancements such as robotic-assisted surgery offer significant benefits, including greater precision, smaller incisions, and faster recovery times.
'Robotic-assisted surgery offers greater precision, smaller incisions, and faster recovery times compared to traditional surgery, resulting in less scarring, reduced pain, and a quicker return to normal activities for women of all ages,' Dr Andi notes.
With more young women at risk, awareness and timely diagnosis are more critical than ever. Dr Andi encourages regular gynaecological check-ups, particularly for those with obesity, PCOS, or a family history of cancer.
'It's not uncommon for patients to come in for fertility assessments and leave with a cancer diagnosis,' she says. Recognising symptoms such as abnormal bleeding—even among younger women—is essential.
Endometrial cancer can no longer be seen solely as a disease of older women. The growing number of younger patients is a signal to the healthcare community and the public alike. While advancements such as robotic-assisted surgery offer hope for more effective treatment, early detection remains the most powerful tool.
Dr Andi sums it up: 'Awareness and timely intervention are our best tools in the fight against endometrial cancer. The earlier, the better, so you can live a longer and fuller life.' Related
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