Based on PubMed | Is unexplained weight loss a symptom of endometrial cancer?

Short Answer

Yes, unexplained weight loss can be a symptom of endometrial (uterine) cancer, but it is more commonly associated with later or advanced stages rather than early disease. ^{[1] [2]}

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What Endometrial Cancer Typically Looks Like

• Most common early sign: Abnormal vaginal bleeding especially bleeding after menopause or bleeding between periods remains the hallmark early symptom. ^[3]
• Other local symptoms: Pelvic pain, pain with urination or sex, and unusual vaginal discharge can occur and often relate to the tumor’s local effects. ^{[1] [4]}

Key point: Because early endometrial cancer often causes abnormal bleeding, it’s frequently detected sooner than many other cancers. ^[3]

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Where Unexplained Weight Loss Fits In

• Systemic sign of later disease: Unexplained weight loss tends to appear in more advanced stages when cancer effects are more widespread, rather than being an early warning sign. ^[1]
• Not specific to endometrial cancer: Weight loss without a clear reason can be caused by many conditions (other cancers, thyroid problems, chronic infections, depression, and more), so it should prompt a thorough evaluation. It is a red flag that warrants medical review, but by itself it does not confirm endometrial cancer. ^[2]

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Why Weight Loss Happens in Advanced Cancer

• Cancer-associated cachexia: In advanced gynecologic cancers, ongoing inflammation and metabolic changes can lead to reduced appetite, muscle loss, and unintentional weight loss (cachexia). This syndrome is driven by complex shifts in energy expenditure and protein/fat metabolism and contributes to fatigue and lower quality of life. ^{[5] [6]}
• Clinical impact: Cachexia is linked to poorer function and prognosis across cancers, underscoring the importance of early symptom recognition and supportive care. ^{[5] [7]}

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Practical Guidance

• Seek evaluation for abnormal bleeding: Any postmenopausal bleeding or bleeding between periods should be assessed promptly, as this is the most common early sign of endometrial cancer. Early detection often allows for curative treatment. ^[3]
• Don’t ignore unexplained weight loss: If you are losing weight without trying, especially alongside pelvic symptoms or abnormal bleeding, a timely medical assessment is advisable. This may include a pelvic exam, ultrasound, and endometrial sampling if indicated. ^[3]
• Whole-person care in advanced disease: When weight loss is present in known gynecologic cancers, multimodal supportive approaches (nutrition, appetite support, anti-inflammatory strategies, and psychosocial care) can help improve quality of life. ^{[6] [7]}

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Summary Table: Symptoms of Endometrial Cancer

Symptom	Typical Stage Association	Notes
Abnormal vaginal bleeding (postmenopausal or between periods)	Early and common	Most frequent presenting symptom; prompts early detection. [3]
Pelvic pain	Often later	Can indicate deeper or more extensive disease. [1]
Pain during intercourse	Variable	May reflect local tumor effects. [1]
Urinary difficulty or pain	Variable	Local pressure or irritation. [1]
Watery or bloody vaginal discharge	Variable	Can accompany bleeding. [2]
Unexplained weight loss	More often later	Systemic sign; not specific, warrants evaluation. [1] [2]

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Bottom Line

Unexplained weight loss can occur with endometrial cancer, but it is usually a feature of later stages rather than an early sign; abnormal vaginal bleeding remains the most common early symptom that should trigger prompt medical evaluation. ^{[1] [3]}