What are the symptoms that led to diagnosis

I will jump in here because I am an RN.  There are some things that make you more likely to get endometrial cancer.  Obesity, beginning periods early, late menopause, unopposed estrogen use, and not giving birth, and family history of endometrial cancer.  Do you have any of those characteristics?  No one can answer your question.  It is something we learn here.  There are no cut and dried answers.  Your doctor is being cautious.  He or she is offering the oppoturnity to be pretty sure you don't have cancer.  But it is your choice, and your risk.  The risk is pretty great if you have any pre exisitng conditions as above.  But it is your decision.   I was older and had one incidence of bleeding and pursured it.  I was diagnosed with a very early cancer and elected to have no treatment.  IF i had waited, I might have had to have chemo and radiation, and might have died.  I am the aggressive type cell.  So, it is something you have to decide.  But our stories here might help you understand the situration you are in. 

Forherself makes excellent points. I will also point you to this: https://www.nccn.org/patients/guidelines/content/PDF/uterine-patient.pdf  

The thing that stood out to me, compared to others, is that you are not actually in menopause?  A risk factor post menopause is bleeding. I had two teeny tiny spots, light pink, so small that the first time I dismissed it, the second time a few weeks later I went for a pap, vaginal ultrasound. Prior to menopause age 52, 15 years before my dx of UPSC I had the same symptoms as you, heavy bleeding, clots, a mess. No cancer. I would urge you to read the guidelines, and use that to formulate questions if you have any. Those guidleines pertain mostly to the diagnosis of endometriod cancer, the most common type, which is estrogen dependent. My UPSC, serous, is not. Uterine sarcoma also is not estrogen dependent, which means that obesity, too much estrogen etc. is not a risk factor for the rarer uterine cancers. 

That being said, endometrial biopsies are not always accurate in finding cancer because they may only sample areas that do not have tumor tissue. In my case, I had polyps that were also cancerous, only after hysterectomy they were able to determine that I also had cancer penetrating the uterine wall because they were able to examine the entire uterus. You might want to discuss this with your doctor. I had a procedure called hysteroscopy instead of a biopsy which allowed them a lighted view into the uterus. Many of our contributors were not able to tolerate the biopsy procedure due to pain or other issues. 

So you have a big decision to make. The vast majority of women with your symptoms do not end up with cancer, or it is the very treatable endometriod type. Educating yourself will give you the tools and knowledge to make informed decisions with your doctor. The fact that your doctor is proactive is important, so many of us had to fight with our docs to get tests, treatment. To give your some perspective, so many of us would give anything to go back and push for an early diagnosis as diagnostic tests that eliminate cancer are like gold compared to having to deal with treatment. I understand your hesitancy, I was the same at first, sadly having a doctor who was incompetent at best. So I would read the guidelines, read the threads about biopsies. Good luck to you and let us know how you are doing.

Denise 

Hey Denise, I couldn't agree more with the statement, "The fact that your doctor is proactive is important".  Sadly, my gyn is retiring and I just saw her for the last time.  We talked about me not having any of the normal, contributing factors, and I had both the "typical garden variety type" and UPSC.  She saved my life and I will never forget this woman!  I told her I have read where other women have not been as lucky as me and push to get answers and how incredibly sad it is.

Sky, It sounds like you are aware of your body, and that is a good thing. 

I had some intermittent spotting and thought it was due to the onset of menopause, since my periods had become irregular and I was 51.  When I saw my gynecologist, she said she thought I was likely going through menopause.  Her plan was to do the endometrial biopsy, and once it came back normal, she would start me on a low-dose hormone.  However, the biopsy was positive and she referred me to a gynecologic oncologist.  I also had an ultrasound and my myometrium was not abnormally thickened.

Light spotting on toilet paper started in late April of this year. I am 68 and knew this could not be good.  My internist sent me to have a urine analysis that came back negative for UTI, etc so off to OBGYN.  Exan and pap were good but subsequent vagibnal ultarsound showed something. Referred to gynecologist oncologist as I had early stage breast cancer almost 6 years ago (NED) for D&C and other tests that came back cancer.  Had no other symptoms.  I wish I had known more about EC and that I was at higher risk of developing another cancer and I would have asked for ultrasounds proactively.  Get the testing done and all the best. 

Hope you have been well.

Once again, your thoughtful and informative insights are spot on (no pun intended, lol).

Denise