When a woman presents with suspicious symptoms (e.g. post-menopausal bleeding), doctors may perform the following investigations:

• Pelvic (gynecologic) examination — palpation and inspection of uterus, ovaries, cervix.
• Imaging studies — most commonly a transvaginal ultrasound, which can assess the thickness of the endometrium and detect abnormalities.
• Endometrial sampling / biopsy — obtaining tissue from the lining of the uterus. If imaging/biopsy is inconclusive, a dilation and curettage (D&C) may be done.

Once cancer is confirmed, additional imaging (e.g. CT scan, sometimes PET) and possibly surgical evaluation are done to determine the stage (how far the cancer has spread).

Because there is no routine population-wide screening for endometrial cancer (unlike e.g. cervical cancer), diagnosis typically depends on symptoms prompting evaluation.

Stages of Endometrial Cancer

Once diagnosed, the extent of disease is determined by staging. The widely used classification divides endometrial cancer into four stages (I–IV).

Stage I: Cancer is confined to the uterus.

IA — limited to the endometrium or invades less than half of the myometrium (uterine muscle).

IB — invades half or more of the myometrium.

Stage II: Cancer has spread into the cervix (but not beyond uterus).
Stage III: Spread outside the uterus to regional tissues — e.g. vagina, pelvic area, regional lymph nodes, peritoneum (within pelvis).

Stage IV: Spread to distant organs — such as bladder, bowel, lungs, liver, or distant lymph nodes.

Treatment decisions and prognosis depend heavily on stage and other risk factors (tumor grade, histology, lymph node involvement).

Treatment Modalities

The choice of treatment depends on factors like the stage, tumour type, general health, fertility desires, and risk profile. Main options

Surgery — the mainstay for most cases. Typical procedure: total hysterectomy with bilateral salpingo-oophorectomy (removal of uterus, cervix, both fallopian tubes and ovaries). Often lymph nodes (pelvic, para-aortic) are assessed or removed.

Radiation therapy — may be used after surgery (adjuvant), or alone if surgery not possible. Can be external beam or internal (brachytherapy).

Chemotherapy — commonly used when cancer has spread beyond uterus (advanced stages) or for high-risk cancers.

Hormonal therapy — for certain cancers that are hormone-sensitive; an option in selected (often less aggressive) cases, or for patients desiring fertility preservation (rare, and only in carefully selected, early-stage patients).

Combined / multimodal therapy — for higher stages or aggressive disease, a combination of surgery, radiation, chemo may be used.

Role of Laparoscopic (Minimally Invasive) Surgery in Endometrial Cancer

Minimally invasive surgery — using laparoscopy (or robotic-assisted laparoscopy) — is increasingly preferred when feasible, especially for early-stage disease confined to the uterus.

Advantages over traditional “open” abdominal surgery (laparotomy) include: smaller incisions, less blood loss, less pain, faster recovery, shorter hospital stay, quicker return to daily activities.
A study from India (and other developing countries) showed that laparoscopic management led to low morbidity: in one report, with 51 patients, average blood loss was ~82.5 ml, mean operative time ~115 minutes, and mean hospital stay ~3 days. No conversions to open surgery, and early postoperative outcomes were favorable.

Oncologic outcomes (i.e. long-term cancer control) appear comparable to open surgery for appropriately selected early-stage patients.

Because of these benefits, when cancer is localized and patient is suitable, laparoscopic (or robotic) total hysterectomy + bilateral salpingo-oophorectomy with necessary nodal assessment is often the recommended surgical route.

Endometrial cancer in India is relatively uncommon but appears to be increasing. Because it often shows early warning signs (especially post-menopausal bleeding), there is a real opportunity for early diagnosis and cure through surgery. Treatment typically involves removal of uterus (plus tubes/ovaries) and possibly lymph-node assessment, with adjuvant therapy as needed. For early, localized disease, laparoscopic surgery offers a minimally invasive, safe, and effective option with quicker recovery and outcomes comparable to open surgery.