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 9,400 women are diagnosed with womb cancer each year. Womb cancer is rare under 40 and becomes more common after the age of 55. Womb cancer can affect anyone who has a womb. This includes women, trans men and people assigned female at birth.
Most womb cancers start in glandular cells found in the lining of the womb (the endometrium). These are called endometrial cancers. There are different types of womb cancers. Endometrial cancers are usually diagnosed early and treated successfully. This information is about endometrial cancers.
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Usually the first sign of womb cancer is unusual 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 sex.
If you have any unusual vaginal bleeding, always see your GP about it. Other conditions that affect the womb, such as fibroids, can also cause unusual vaginal bleeding.
If you have symptoms, you usually start by seeing the GP. Your GP may do an pelvic examination (internal examination) to feel for anything unusual in the pelvis. They may also arrange:
Your GP may refer you directly to a gynaecologist. This is a doctor who treats problems with the female reproductive system. You will be referred urgently (within 2 weeks) if you have:
- vaginal bleeding after the menopause
- a lump in your pelvis that your GP can feel
- ongoing vaginal bleeding between your periods.
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. They may arrange:
Waiting for test results can be a difficult time. We have more information that can help.
The stage of the womb cancer describes:
- how far the cancer has grown
- if it has spread from where it started.
Grading is about how the cancer cells look under the microscope compared with normal cells.
Staging and grading of the cancer helps you and your doctor make decisions about your treatment.
A team of specialists meet to talk about the best treatment for you. They are called a multidisciplinary team (MDT).
The MDT will look at many factors when planning your treatment options. These will include:
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. Depending on the stage and grade of the cancer, you may also be offered treatments after surgery. These can help reduce the risk of the cancer coming back.
Your doctor will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions. You may also be invited to take part in a clinical trial.
The types of treatment you may have include:
Radiotherapy uses high-energy rays to destroy cancer cells, while doing as little harm as possible to normal cells. Radiotherapy may be used to reduce the risk of cancer coming back after surgery. It may also be given as the main treatment for womb cancer or to help manage symptoms of advanced womb cancer.
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to reduce the risk of cancer coming back after surgery or radiotherapy. Or it may be used to help control cancer and relieve symptoms.
Targeted therapy and immunotherapy
Newer treatments called targeted therapy and immunotherapy may be used to treat womb cancer that has spread. These can help to control the cancer and slow down the growth. Your doctor will send a sample of the cancer cells taken during a biopsy or surgery to be tested. This helps to check which type of treatment may work best for you. Your doctor or nurse will explain if these treatments are suitable for you.
If you want to have children in the future, it is important to talk to your doctor about your fertility before you start treatment. With early-stage, low-grade cancer, it may sometimes be possible to have fertility-sparing treatment.
After treatment, you will probably want to get back to doing the things you did before your cancer diagnosis. But you may still be coping with the side effects of treatment and with some difficult emotions. Recovery takes time, so try not to be hard on yourself. It is not unusual to feel anxious and lonely at this time.
After your treatment, you will have regular check-ups. They will include an internal examination. These will be every few months at first. Eventually, you may only be seen once a year. If you have any problems or new symptoms in between appointments, it is important to contact your cancer doctor or specialist nurse as soon as possible.
Some people do not have routine appointments. Instead, they are asked to contact their cancer doctor or nurse if they have new symptoms, or are worried about anything. Important symptoms to be aware of are:
- bleeding from the vagina or back passage
- pain in the pelvic area
- any lumps or swellings
If womb cancer comes back in the same area, it can often be treated successfully.
You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.
Macmillan is also here to support you. If you would like to talk, you can:
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 firstname.lastname@example.org
Concin et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. International Journal of Clinical Oncology. 2021. Available from www.pubmed.ncbi.nlm.nih.gov/33397713/
Royal College of Radiotherapy: Clinical Oncology. Radiotherapy dose fractionation, third edition. 2019. Available from www.rcr.ac.uk/publication/radiotherapy-dose-fractionation-third-edition
Sundar et al. BGCS uterine cancer guidelines: Recommendations for practice. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017. Available from www.bgcs.org.uk/wp-content/uploads/2019/05/BGCSEndometrial-Guidelines-2017.pdf
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. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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