Can Headaches Be a Symptom of Endometrial Cancer?

Headaches are not a typical presenting symptom of endometrial (uterine) cancer. The most common signs of endometrial cancer involve the uterus and pelvis especially abnormal vaginal bleeding, new or unusual vaginal discharge, and pelvic or lower abdominal pain. ^[1] During early disease, physical exams can be normal, and systemic symptoms like headaches are generally unrelated. ^[1] Public health guidance on gynecologic cancers emphasizes abnormal vaginal bleeding and pelvic symptoms rather than headaches. ^[2]

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Typical Symptoms of Endometrial Cancer

• Abnormal vaginal bleeding: Bleeding between periods, postmenopausal spotting/bleeding, excessively heavy or prolonged episodes after age 40. ^[1]
• Pelvic or lower abdominal pain/cramping: Persistent pelvic discomfort or cramps. ^[1]
• Vaginal discharge changes: New discharge after menopause. ^[3]

National cancer resources also note pressure or discomfort in the pelvis/abdomen in later stages, and organ-specific symptoms if the cancer spreads locally (e.g., urinary or rectal changes). ^[4]

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When Headaches May Be Relevant

While headaches are not a common direct symptom of endometrial cancer, there are specific contexts where headaches can occur in someone with this cancer:

1) Treatment‑related side effects

Headaches can arise as part of the side effects from chemotherapy and immunotherapy regimens used for recurrent or metastatic endometrial cancer (for example, carboplatin, paclitaxel, with immunotherapies like durvalumab or dostarlimab). ^[5] Headaches are listed among nervous system changes that can be rare but serious, sometimes accompanied by fever, confusion, stiff neck, dizziness, or drowsiness symptoms that warrant urgent medical attention. ^[6] Headaches may also appear with certain hormonal or endocrine changes during immunotherapy, such as thyroid inflammation (thyroiditis), which can present with fatigue, dizziness/fainting, or abnormal heartbeat. ^[7]

2) Rare paraneoplastic neurological syndromes

Endometrial cancer has been linked very rarely to paraneoplastic neurological disorders (immune‑mediated effects of cancer on the nervous system), such as opsoclonus‑myoclonus ataxia or vasculitic sensorimotor polyneuropathy. ^[8] These syndromes typically cause neurological symptoms (e.g., abnormal eye movements, ataxia, asymmetric sensorimotor deficits, painful paresthesias), and while headache is not the hallmark, neurological involvement can sometimes include headache depending on the specific syndrome. ^[9] Such paraneoplastic processes are uncommon and require specialist evaluation. ^[10]

3) Brain or scalp metastases (very rare)

Brain involvement from endometrial cancer is rare, but if cancer spreads to the brain or skull/scalp, progressive headaches can occur, sometimes with other neurological signs (nausea/vomiting, seizures, weakness, vision or speech changes). ^[11] In documented cases, elderly individuals presented with worsening headaches and a rapidly enlarging scalp mass, and imaging showed extension into cranial spaces. ^[12] General guidance on brain metastases lists headache (sometimes with nausea/vomiting), mental changes, seizures, weakness or numbness, and vision/speech difficulties as typical symptoms. ^[13] As metastatic lesions grow, they exert pressure on brain tissue, producing these symptoms. ^[14]

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Practical Guidance

• If you are experiencing headaches without classic uterine symptoms (like abnormal vaginal bleeding or pelvic pain), endometrial cancer is unlikely to be the cause. ^[1]
• If you have known endometrial cancer and develop new or severe headaches, especially with fever, stiff neck, confusion, or neurological changes, this could relate to treatment effects or, rarely, neurological complications prompt medical review is advisable. ^[6]
• If headaches are accompanied by neurological red flags (new seizures, weakness, vision or speech changes), doctors may consider brain imaging to rule out metastases or other causes. ^{[13] [14]}

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Summary

• Headaches are not a common symptom of endometrial cancer itself. The hallmark symptoms center on abnormal vaginal bleeding and pelvic pain. ^{[1] [2]}
• Headaches can occur in people with endometrial cancer due to therapy side effects, rare paraneoplastic syndromes, or very uncommon brain/scalp metastases particularly when accompanied by other neurological signs. ^{[6] [8] [11]}
• Any severe, persistent, or new‑pattern headache especially with neurological symptoms should be evaluated to identify treatable causes and ensure appropriate care. ^{[13] [14]}