Staging and grading

When womb cancer is diagnosed, it is important to know the stage and grade of the cancer. This helps with decisions about treatment.

The stage of the cancer describes the size of the tumour and whether it has spread. Your doctor won’t know the stage of the cancer until after your operation to remove the cancer and once your test results are ready.

Womb cancer is divided into four main stages using a numbered system. It shows how far the cancer has spread on a scale of 1-4. Some of the stages are sub-divided.

Doctors will also want to know the grade of the cancer. This gives them an idea of how quickly the cancer may grow. They examine a sample of the cancer cells under a microscope. They grade the cells depending on how they look compared to normal cells and how quickly they grow. The grade helps your doctor to decide if you need further treatment after surgery.

Staging

The stage of womb cancer describes how far the cancer has grown and if it has spread from where it started. Knowing the stage of the cancer is important because it affects the decisions you and your doctor will make about treatment. Your doctor won’t know the exact stage of the cancer until after your operation to remove the cancer and when the results of all your tests are ready. Womb cancer is divided into four main stages. Some of these stages are sub-divided.

Stage 1

The cancer is contained in the womb. There are two stages:

  • Stage 1A – The cancer is only in the lining of the womb or has grown no more than halfway into the muscle.
  • Stage 1B – The cancer has grown more than halfway into the muscle wall.

Stage 2

The cancer has spread to the cervix.

Stage 3

The cancer has spread but is confined to the pelvis. There are three stages:

  • Stage 3A – The cancer is affecting the outer covering of the womb and/or involves the ovaries and fallopian tubes.
  • Stage 3B – The cancer has spread into the vagina and/or into the tissue between the womb and the side wall of the pelvis (parametrium).
  • Stage 3C – The cancer has spread to the pelvic lymph nodes and/or to the lymph nodes at the back of the tummy.

Stage 4

The cancer has spread to other organs in the body:

  • Stage 4A – The cancer has spread to the bowel and/or the bladder.
  • Stage 4B – The cancer has spread to the lungs, bones or the brain (called secondary cancers or metastases).

Other terms used

Some other terms your doctor or nurse may use to describe the cancer are:

  • Early-stage womb cancer – This usually refers to stages 1 and 2.
  • Locally advanced womb cancer – This usually refers to stage 3 and stage 4A womb cancers.
  • Advanced or secondary womb cancer – This is usually stage 4B womb cancer.
  • Recurrent cancer – This refers to a cancer that has come back after it was first treated.


Grading

Grading is about how the cancer cells look under the microscope compared with normal cells. The grade helps your doctor to decide if you need further treatment after surgery.

  • Grade 1 or low-grade or well differentiated - The cancer cells look similar to normal cells and usually grow slowly and are less likely to spread.
  • Grade 2 or moderate-or intermediate-grade - The cancer cells look more abnormal and are slightly faster growing.
  • Grade 3 or high-grade or poorly differentiated - The cancer cells look very different from normal cells and may grow more quickly.

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