Staging and grading womb cancer

Staging Back to top

Knowing the extent of the cancer helps the doctors to decide on the most appropriate treatment.| Generally, womb cancer is divided into four stages that range from small and localised, to cancer that has spread to other parts of the body. If the cancer has spread, this is known as secondary or metastatic cancer. If the cancer comes back after initial treatment it’s known as recurrent cancer.

Stage 1 womb cancer is contained within the womb.

This stage is divided into two:

• Stage 1A The cancer is contained within the lining of the womb or has begun to grow into the muscle wall of the womb, but no more than half way through it.
• Stage 1B The cancer has grown more than half way into the muscle wall.

Stage 2 womb cancer has spread to the cervix.

Stage 3 womb cancer is more advanced, but is contained within the pelvis. This stage is divided into three:

• Stage 3A The cancer is affecting the outer covering of the womb (serosa) and/or the ovaries and fallopian tubes.
• Stage 3B The cancer has spread down into the vagina and/or into the tissue between the womb and the bladder (parametrium).
• Stage 3C The cancer has spread into nearby lymph nodes. This stage is further divided depending on which lymph nodes are affected:
  Stage 3Ci the cancer is affecting the pelvic lymph nodes.
  Stage 3Cii the cancer has spread to the para-aortic lymph nodes that are found in the abdomen (tummy).

Stage 4 womb cancer means the cancer has spread beyond the womb into surrounding organs. This stage is divided into two depending on where the cancer has spread:

• Stage 4A The cancer has spread to the bowel and/or the bladder.
• Stage 4B The cancer has spread to other parts of the body, such as the lungs, bone or the brain.

Grading Back to top

There are three grades: grade 1 (low-grade), grade 2 (moderate- or intermediate-grade) and grade 3 (high-grade).

Low-grade means that the cancer cells look very like the normal endometrial cells (the cells are sometimes described as being well differentiated). They are usually slow growing and are less likely to spread.

In high-grade cancers the cells look very abnormal (the cells are poorly differentiated). They are likely to grow more quickly and are more likely to spread.

Moderate-grade cancers fall between these two grades and have a level of activity somewhere in between. They are sometimes described as being moderately differentiated.