2026/09/16 11:55
Zheng Yamin (2nd from right), president of the Taiwan Gynecological Cancer Medical Association, reminds women that if they experience abnormal bleeding, they should not just treat it as menopause or irregular menstruation, but should be more vigilant. (Photo by reporter Hou Jiayu)
[Reporter Hou Jiayu/Taipei Report] Abnormal bleeding should not be dismissed as menopausal irregular menstruation! Ms. Liu, a 67-year-old woman, suffered from repeated bleeding for a year and a half without seeking medical treatment. It was not until her legs swelled due to blood clots that she was diagnosed with stage 4 endometrial cancer. Doctors remind that abnormal bleeding, discharge, pelvic pain, anemia and fatigue are all warning signs; starting from August this year (2026), the health insurance will add immunotherapy benefits, and it is estimated that about 300 people will benefit.
Zheng Yamin, chairman of the Taiwan Gynecological Cancer Medical Association, pointed out that the incidence of endometrial cancer has approximately tripled in Taiwan in the past 20 years and continues to rise. The median age of onset is approximately 57 years old, which is 4 years earlier than international literature. The proportion of patients under the age of 50 has reached 35%, and the mortality rate has increased by 83.3% in the past 15 years.
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Zheng Yamin reminded that common clinical warning signs include abnormal vaginal bleeding, abnormal vaginal discharge, pelvic pain, anemia, fatigue, etc. The most typical one is postmenopausal bleeding. She said that even before and after menopause, if there is a sudden change in menstrual pattern or abnormal amount or frequency of bleeding, you should seek medical examination.
There are also three common myths in clinical practice, including "you only need to worry about heavy bleeding", "having a Pap smear means there is no risk of gynecological cancer", and "endometrial cancer will only occur after menopause". Zheng Yamin said that small and repeated abnormal bleeding cannot be ignored. Pap smear is mainly used to screen for cervical cancer and cannot replace endometrial cancer examination. In addition, endometrial cancer is not only possible in postmenopausal women, but also accounts for a certain proportion of patients under the age of 50.
Ms. Liu, 67, was not diagnosed until her condition worsened because she had ignored abnormal bleeding for a long time. She recalled that she had been bleeding repeatedly for about a year and a half. She thought it was just a normal phenomenon during menopause, until a blood clot caused severe swelling in her left leg and difficulty walking. She went to the doctor. Her family mentioned her past history of abnormal bleeding to the doctor, and further examination revealed that it was stage 4 endometrial cancer. At that time, the cancer index had exceeded 900. Subsequently, she underwent surgery and about half a year of chemotherapy combined with immunotherapy. Currently, her cancer index has dropped to below 25, her condition is under stable control, and she continues to be tracked.
Zheng Yamin said that the treatment of endometrial cancer has developed towards precision medicine in recent years. Doctors will choose strategies such as surgery, chemotherapy, and immunotherapy based on the molecular characteristics of the tumor and the patient's condition. Among them, molecular biomarkers such as dMMR can help with treatment decisions. She also reminded that the period before and after menopause is the most common period. If you are combined with chronic diseases such as obesity and diabetes, you should be more vigilant.
It is worth noting that starting from August this year, the National Health Insurance added temporary payment for new cancer drugs. For patients with primary advanced or recurrent endometrial cancer with dMMR/MSI-H, immunotherapy combined with chemotherapy will be included in the payment. It is estimated that about 300 new patients will be benefited, and each person can save about 1.82 million yuan in drug expenses per year. Huang Yuwen, head of the medical review and medicinal materials group of the National Health Insurance Department, said that the new system will continue to evaluate the efficacy, safety and financial impact of health insurance through 2 to 3 years of real-world data, hoping to fill the treatment gap for advanced endometrial cancer.
