The womb and the lymphatic system

The womb (uterus) is a pear-shaped organ where a baby is carried during pregnancy. The lymphatic system helps protect us from infection and disease. Sometimes womb cancer may spread through the lymphatic system.

The womb

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.

The womb is made up of 3 layers:

an outer, protective layer, called the serosa
a middle, muscular layer, called the myometrium
an inner layer, called the lining of the womb or endometrium.

The ovaries are on either side of the womb. They make eggs and the hormone oestrogen. The fallopian tubes connect the ovaries to the womb.

The lower part of the womb connects to the top of the vagina. This is called the cervix or the neck of the womb. Cancers that start in the cervix behave differently and are treated differently from womb cancer. We have more information about cervical cancer.

The womb and reproductive organs

An image of the female pelvis from the front, showing the vagina, cervix, womb and the ovaries. — Image: The image shows the lower abdomen, female pelvis and the top of the legs from the front. A narrow opening is shown between the legs. This leads into a narrow space shown inside the pelvis. This space is called the vagina. Above the vagina the space narrows until both sides almost touch. Then it opens again to form a hollow pear-shaped organ called the womb. The surfaces of the two sides are highlighted where they narrow between the vagina and the womb. The highlighted area is the cervix. At either side of the upper end of the womb are two small solid oval shapes. These are the ovaries. They are connected to either side of the womb by narrow tubes called the fallopian tubes.

What is the lymphatic system?

The lymphatic system helps protect us from infection and disease. It is made up of fine tubes called lymphatic vessels. These vessels connect to groups of small lymph nodes throughout the body. The lymphatic system drains lymph fluid from the tissues of the body before returning it to the blood.

What are lymph nodes?

Lymph nodes are sometimes called lymph glands. They filter bacteria (germs) and disease from the lymph fluid. When you have an infection, some lymph nodes may swell as they fight the infection.

Womb cancer and lymph nodes

Sometimes cancer can spread through the lymphatic system to other parts of the body. If the cancer cells spread outside the womb, they are most likely to go to lymph nodes in the pelvis (the area between your hips). They may sometimes go to the lymph nodes in the tummy (abdomen).

Lymph nodes in the abdomen and pelvis

The diagram shows the female abdomen and pelvis from the front. It shows a network of fine tubes and small oval shapes. These are the pelvic lymph nodes. — Image: The image shows a female’s lower abdomen, pelvis and the top of the legs from the front. A narrow opening is shown between the legs. This leads into a narrow space shown inside the pelvis. This space is called the vagina. Above the vagina the space narrows until both sides almost touch. Then it opens again to form a hollow, pear-shaped organ called the womb. The surfaces of the two sides are highlighted where they narrow between the vagina and the womb. The highlighted area is the cervix. At either side of the upper end of the womb are two small, solid oval shapes. These are the ovaries. They are connected to either side of the womb by narrow tubes called the fallopian tubes. A network of fine lines connecting small, oval shapes is shown. This is the lymphatic system and lymph nodes. This network enters the image just above the tummy button. The lymph nodes at this level are the para-aortic lymph nodes. The network then splits in to two main streams. These streams are shown sitting over each ovary, down each side of the womb and into the area each side of the vagina at the top of the legs. These are the pelvic lymph nodes.

Womb cancer

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).

Cancer Information Development team

Author

Miss Eva Myriokefalitaki

Reviewer

Consultant Gynaecological Oncology Surgeon

The Christie Hospital, Manchester

Dr Alexandra Taylor

Reviewer

Consultant Clinical Oncologist

Royal Marsden Hospital, London

Date reviewed

Reviewed: 01 March 2025

Next review: 01 March 2028

The language we use

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use plain English
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