What is womb cancer?
The womb (uterus) is a pear-shaped organ where a baby is carried during pregnancy. It is low in the pelvis (the area between the hips) and is supported by the pelvic floor muscles.
In the UK, about 9,700 people are diagnosed with womb cancer each year. Womb cancer is rare in people aged under 45 and becomes more common after the age of 55.
Womb cancer can affect anyone who has a womb. This includes women, trans (transgender) men and people assigned female at birth. Womb cancer does not affect trans women or people assigned male at birth.
Most womb cancers start in glandular cells found in the lining of the womb (the endometrium). These are called endometrial cancers. They are usually diagnosed early and treated successfully. This information is about endometrial cancers.
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Booklets and resources
Types of womb cancer
There are different types of endometrial cancer. Some doctors describe endometrial cancers as type 1 or type 2.
Type 1 endometrial womb cancers
Type 1 cancers are usually slow growing (low grade) and are diagnosed at an early stage. Sub-types include endometrioid cancers if they are grade 1 or grade 2.
About 3 out of 4 womb cancers (75%) are grade 1 or grade 2 endometrioid cancers. They are usually diagnosed at an early stage.
Type 2 endometrial womb cancers
These cancers are always high grade (grade 3) and usually grow quickly. They include:
- serous endometrial carcinoma (also called uterine serous carcinoma)
- carcinosarcoma (these cancers are not sarcomas, despite their name)
- clear cell carcinoma
- grade 3 endometrioid cancers
- mixed cell endometrial cancers.
They also include these very rare types:
- gastro-intestinal type mucinous carcinoma
- mesonephric-like carcinomas
- undifferentiated carcinoma.
Other types of womb cancer
Some cancers start in the supporting tissues of the womb, or in the muscle layer of the womb (the myometrium). These are called soft tissue sarcomas. The most common type of sarcoma of the womb is leiomyosarcoma.
We have more information about soft tissue sarcomas.
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Symptoms of womb cancer
The first sign of womb cancer is usually abnormal vaginal bleeding. For example, this could be:
- bleeding after the menopause – this is the most common symptom
- bleeding between periods
- heavier periods than usual, if you have not been through the menopause
- a bloody or pink and watery vaginal discharge.
Less common symptoms are pain or discomfort in the pelvic area, or pain during vaginal sex.
If womb cancer is more advanced, symptoms can include:
- swelling in the tummy (abdominal) area
- shortness of breath
- a change in toilet habits (peeing and pooing).
Womb cancer is sometimes found during screening for cervical cancer or by other tests or scans.
Other womb conditions, such as fibroids, can also cause abnormal vaginal bleeding.
Always tell your GP if you have any abnormal vaginal bleeding. It is important to be checked.
If you are transgender (trans)
If you are a trans man and have not had surgery to remove the womb, you are still at risk of womb cancer.
Talk to your GP if you are worried about womb cancer, have any of the symptoms, or have a family history of cancer.
The LGBT Foundation can give you confidential advice and support. You can also talk to one of our cancer support specialists.
Causes of womb cancer
Doctors do not know the exact causes of womb cancer. But there are risk factors that can increase your chance of developing it. Womb cancer risk is often linked to hormone levels changing over time. But this is not always the case. Sometimes the cause is not clear.
Having a risk factor does not mean you will get womb cancer. And not having a risk factor does not mean that you will not get womb cancer.
We have more information about the causes and risk factors of womb cancer.
Diagnosis of womb cancer
If you have symptoms, you will usually begin by seeing your GP, who will examine you. Your GP may do an internal examination to check the pelvic area. They may also arrange:
- a blood test
- a urine sample
- a transvaginal ultrasound.
If they think that your symptoms could be caused by cancer, they will refer you to a specialist doctor called a gynaecologist.
You will be referred urgently for a specialist appointment if you have vaginal bleeding after the menopause. An urgent referral means you will be seen by a specialist as soon as possible.
You may also be referred urgently if you have:
- a lump in your pelvis that your GP can feel during your examination
- ongoing vaginal bleeding between your periods.
If you take hormone replacement therapy (HRT), tell your doctor about any changes or missed doses. These factors can sometimes cause vaginal bleeding.
The gynaecologist will explain any other tests you need to have. This may include:
- a cervical screening test, if you have not had one recently
- a biopsy.
They will also ask whether you have any close relatives with womb or bowel cancer.
Further tests for womb cancer
If you are diagnosed with womb cancer, you may have further tests. These show the position of the cancer and whether it has spread from where it started. This is called staging. The results of these tests help you and your doctor make decisions about your treatment. Your doctor or specialist nurse can talk to you about these further tests. They may arrange:
- an MRI scan
- a CT scan
- a PET or PET-CT scan
- a chest x-ray.
Waiting for test results can be a difficult time. We have more information that can help.
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Staging and grading of womb cancer
The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
A doctor decides the grade of the cancer by how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.
Knowing the stage and grade helps your doctors plan the best treatment for you.
The stage and grade of the cancer can usually be confirmed after surgery.
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Treatment for womb cancer
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
Your treatment will depend on:
- the stage of the cancer
- your general health
- your preferences.
Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions before you agree (consent) to have treatment. You may have some treatments as part of a clinical trial.
Your cancer team may also give you advice about preparing for your treatment. This is sometimes called prehabilitation. It helps to improve your fitness and diet and to get you ready mentally before treatment.
Treatments for womb cancer include:
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Surgery
The main treatment for womb cancer is an operation to remove the womb, cervix, fallopian tubes and ovaries. This is sometimes the only treatment needed to cure the cancer. If you cannot have a general anaesthetic for health reasons, you may be offered another type of treatment.
If the cancer has spread, but is still in the pelvic area, you may still be offered an operation to remove as much of it as possible. This can make any treatment you have after surgery more effective.
If the cancer has spread to other parts of the body and it is only one place, and it is small, it may be possible to have surgery to remove it.
After surgery, your doctor may advise you to have other treatments to reduce the risk of the cancer coming back. This is called adjuvant treatment. Your cancer doctor will look at the type, stage, grade, genetic changes and risk group of your cancer to decide if adjuvant treatment might be suitable for you.
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Radiotherapy
Radiotherapy uses high-energy rays called radiation to treat cancer. It destroys cancer cells in the area where the radiotherapy is given.
You may have radiotherapy for womb cancer after surgery, to reduce the risk of the cancer coming back (adjuvant radiotherapy) or instead of surgery, if a general anaesthetic or surgery is not suitable.
Radiotherapy can be given to try to cure womb cancer that has come back after surgery (recurrent cancer) or to treat womb cancer that was not completely removed with surgery.
It may also be given to help control symptoms or when womb cancer has spread to other parts of the body. This is called palliative radiotherapy.
If the cancer has spread to only one place, and it is small, it may be possible to have a type of targeted radiotherapy called stereotactic radiotherapy. This is only suitable for a small number of people. Your doctor will explain more about this if it is suitable for you.
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Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is used for womb cancer to reduce the risk of cancer coming back after surgery or radiotherapy. This is called adjuvant chemotherapy.
Sometimes chemotherapy is used before surgery to reduce the size of the cancer. This is called neo-adjuvant chemotherapy.
Chemotherapy can also be given to help control symptoms of womb cancer that has not been completely removed by surgery or has spread to other parts of the body. This is called palliative chemotherapy. -
Targeted therapy and immunotherapy
Targeted therapy and immunotherapy may be used to treat womb cancer that has come back (recurrent cancer) or spread to other parts of the body (metastatic cancer).
Targeted therapy can help control the cancer and slow down the growth.
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Hormonal therapy
Cancer doctors may suggest hormonal therapy for womb cancer when it is advanced (stage 4) or if it has come back after treatment (recurrent womb cancer).
Hormonal therapy is also used when surgery or radiotherapy is not suitable because of other health problems.
The aim of hormonal therapy is to help shrink the cancer and control symptoms.
Related pages
Treatment for womb cancer and fertility
If you have not been through menopause and want to get pregnant in the future, it is important to talk to your doctor before you start treatment for womb cancer.
For early stage and low grade endometrioid cancers, it is sometimes possible to have treatment that does not affect your fertility (fertility-sparing treatment). This usually means having hormonal therapy instead of surgery.
It is not standard treatment, so it is important to discuss the risks and benefits with your cancer team before making any treatment decisions.
If fertility sparing treatment is not possible, your team can refer you to a fertility specialist before your surgery. They can discuss possible fertility options with you.
After womb cancer treatment
Follow-up after treatment for womb cancer
After your treatment, you will usually have regular follow-up appointments. How often you have these can depend on the risk of your cancer coming back, or whether treatment was to control the cancer and treat symptoms.
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Low risk
If the cancer was low risk, you may have follow-up appointments every 6 months for 2 years. After this, they will be yearly for another 3 years. Sometimes this will be at the hospital so the doctor can do a physical check-up and an internal examination. Sometimes they might be over the telephone with your doctor or specialist nurse.
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Higher risk
If the cancer was in a higher-risk group, you may have follow-up appointments every 3 months for 3 years. After this, they will be every 6 months for another 2 years. These will be at the hospital so the doctor can do a physical check-up and an internal examination. It may involve CT or PET-CT scans.
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Advanced
If your cancer is advanced, your doctor or specialist nurse can tell you how often you will have follow-up appointments and what these might involve.
Your doctor or specialist nurse can talk to you about your follow-up plan. But it is important to contact your cancer doctor or specialist nurse as soon as possible if you have any problems or new symptoms in between appointments. They can talk to you about symptoms to be aware of. This may include:
- any new vaginal bleeding
- bleeding after sex
- persistent pain in the abdomen (tummy area) or pelvis (lower tummy area)
- feeling bloated
- losing weight.
You can also speak to your specialist nurse if you have questions or need advice on the phone number given to you.
Some people have a different kind of follow-up where they are asked to contact their cancer team if they have any concerns. This is sometimes called Patient Initiated Follow up (PIFU). If you are having this type of follow up, your doctor or specialist nurse will explain what to be aware of.
We have more information about follow-up care after treatment.
Menopausal symptoms
If you have not been through menopause, a hysterectomy that involves removing the ovaries will cause the menopause straight away. This will also happen if you have radiotherapy without any surgery.
This is because radiotherapy stops the ovaries working. We have more information about coping with menopausal symptoms.
Hormone replacement therapy (HRT) is not usually advised after womb cancer, because it contains oestrogen. Some cancer specialists may prescribe HRT if your cancer was early stage and you are having menopausal symptoms. They may consider HRT if other things have not helped.
Some organisations give support to people going through the menopause. This includes the Daisy Network and the Women’s Health Concern.
Sex after womb cancer treatment
Womb cancer and its treatments can affect your sexual wellbeing. If you have had surgery or radiotherapy to the pelvic area, you need time to heal properly before having sex. Your healthcare team can advise you about these physical changes. But you may not feel ready for sex after this.
You can talk to your healthcare team about sex. It is important to get the right information when you need it. It can feel embarrassing or uncomfortable to talk about something so personal. But they are used to talking about sex. They would prefer you to ask so they can best help and support you. You can use words that you usually say. Do not feel you need to use medical language.
If you feel uncomfortable talking to your doctor or nurse, you can call us free on 0808 808 00 00. You may find it helpful to talk to a sex therapist. You can contact a therapist through the College of Sexual and Relationship Therapists.
Wellbeing and recovery
Taking good care of yourself can help speed up your recovery after womb cancer treatment. Even small lifestyle changes may improve your wellbeing and long term health.
Even if you already have a healthy lifestyle, you may choose to make some positive changes after treatment. We have more information on leading a healthy lifestyle after treatment.
More information and advice
We know cancer can affect you physically, emotionally and financially. We have information and advice about different ways cancer might impact you, such as help with:
Support after womb cancer
People often have many different feelings during and after womb cancer treatment. If you have finished treatment, you may feel relieved it has ended but worried about what might happen in the future.
It is important to know where to get support or information if you need it. People often need support even some time after womb cancer treatment. But sometimes it is difficult to know who to ask for help.
To find support:
- ask your GP or someone from your cancer team for advice about support in your area
- find cancer support services near you
- call the Macmillan Support Line free on 0808 808 00 00
- chat to our cancer information specialists online
- visit our Online Community womb cancer forum to talk to people who have been affected by womb cancer, share your experience, and ask questions.
The HOPE programme is a free 6 week self-management course designed to help you develop techniques and strategies when living with or after cancer. Topics include goal setting, fatigue management, and wellbeing. You can sign up for the online HOPE programme. Or to find out more about face to face programmes in your area, email ServiceOpsSupport@macmillan.org.uk
Other organisations who offer information and support
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The Eve Appeal
Tel 020 7605 0100
Email office@eveappeal.org.uk
UK national charity raising awareness and funding research into the five gynaecological cancers – ovarian, womb, cervical, vaginal and vulval.
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Womb Cancer Support UK
Email wcsuk@hotmail.co.uk
www.wombcancersupportuk.weebly.com/
Provides support, advice and information to women who have been diagnosed with womb cancer.
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Peaches Womb Cancer Trust
Email admin@peachestrust.org
Provides support for those with, or at risk of developing, womb cancer. Also aims to raise awareness and promote womb cancer research.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our womb cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Oaknin, A. et al. Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology, Volume 33, Issue 9, 860 - 877
https://www.esmo.org/guidelines/guidelines-by-topic/esmo-clinical-practice-guidelines-gynaecological-cancers/endometrial-cancer (accessed January 2024).Berek JS, Matias-Guiu X, Creutzberg C, et al. FIGO staging of endometrial cancer: 2023. Int J Gynecol Obstet. 2023; 162: 383-394. doi:10.1002/ijgo.14923 (accessed January 2024).
Suspected cancer: recognition and referral. NICE guideline [NG12] Published: 23 June 2015 Last updated: 02 October 2023 Overview | Suspected cancer: recognition and referral | Guidance | NICE (accessed January 2024).
Miss Eva Myriokefalitaki
Reviewer
Consultant Gynaecological Oncology Surgeon
Date reviewed
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We want our information to be as clear as possible. To do this, we try to:
- use plain English
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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.