Types of treatment for womb cancer

Surgery is the first and most important treatment for almost all women with womb cancer. Women with very early womb cancer may need no further treatment. 

Depending on the type of womb cancer you have, whether it has spread or how far your doctor may recommend radiotherapy, hormone therapy or chemotherapy. 

Your treatment is likely to be organised by a team of specialists working together. Most women see a surgeon first because surgery is the most likely treatment. You may also see a cancer specialist (oncologist). Or your doctor may take your case to a multi disciplinary team – a team of specialist doctors (including a surgeon and cancer specialist), clinical nurse specialists and other professionals who discuss cases and plan treatment together. If you have only seen a surgeon, you can ask your surgeon if your case has been considered by an oncologist before your treatment plan is finalised.

The team will plan your treatment according to

• The type of womb cancer you have
• Whether the cancer has spread (the stage)
• What the cells look like under the microscope (the grade)
• Your general health
• Your preferences

Almost all women with womb cancer will have surgery. The amount and type of surgery you have will depend on the stage, grade and type of cancer you have. Most women with cancer of the womb will be advised to have a total hysterectomy, with the womb, fallopian tubes and ovaries removed.

Some women may need to have the lymph nodes around the womb removed and checked for signs of cancer. This is done at the same time as your hysterectomy. Not only does it remove any cancer that is in the lymph nodes, but checking them helps your specialist to decide on whether you need any further treatment. You are most likely to have this type of surgery if you have a grade 2 or 3 womb cancer. If you have a grade 1 cancer you are much less likely to have lymph nodes removed. 

For cancers that are completely contained within the womb, surgery is very successful and often, and usually no further treatment is needed.

Your specialist may suggest surgery for an advanced womb cancer. There is some evidence that although surgery may not result in a cure, removing as much as possible can help to slow down the growth of the cancer. But you need to be well enough to make a good recovery from the surgery in order to benefit from it.

Some women have radiotherapy for cancer of the womb. You may have radiotherapy

• Instead of surgery, as your main treatment
• After surgery
• Before surgery

You may have radiotherapy instead of surgery because you are not fit enough for an operation. Or you may have it because you do not want to have an operation. Your doctors may also suggest radiotherapy as the main treatment if your cancer is locally advanced. Locally advanced means the cancer has grown into nearby structures so that it may be quite difficult to remove it all with surgery. This may be the case in some stage 3 and stage 4A womb cancers.

Usually, specialists suggest radiotherapy after surgery if there is a moderate to high risk that the cancer may come back. This may be because

• The cancer had grown more than half way through the muscle wall of the womb
• The cancer had grown down to the neck of the womb (cervix)
• The cancer cells were judged to be grade 3 or 4 (high grade)

You are most likely to have radiotherapy after your surgery if you didn't have your lymph nodes removed during the operation. Your specialist may also suggest it if you did have lymph nodes removed and they turned out to contain cancer cells. If your lymph nodes were removed, but were free of cancer, you generally don't need radiotherapy after surgery. This may depend on how many lymph nodes are removed.

For advanced cancers, or womb cancer that has come back after it was first treated, you may have other types of treatment. You may have hormone therapy to help slow down the growth of an advanced cancer.

Some women may have chemotherapy for womb cancer. Doctors use chemotherapy sometimes to help control advanced womb cancers. You may also have chemotherapy before or after surgery. This is to try to lower the risk of the cancer coming back later. But this type of treatment is still being investigated. It is not standard at the moment because we don't know how much help it is. There are trials looking into using both radiotherapy and chemotherapy after surgery for womb cancer where doctors think there is a high risk of the cancer coming back.

There are clinical trials going on around the world for all types of cancer. Doctors and researchers are always working to improve treatment outcomes. Comparing groups of patients who are having different treatments is the best way of doing this. There is a page in this section about womb cancer research. And we have a database of clinical trials in the UK. To look for any womb cancer trials, choose 'womb' from the dropdown menu of cancer types.