Stage 2 womb cancer
The stage of a cancer tells you how big the tumour is and how far it has spread. It helps your doctor decide which treatment you need.
Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system for womb cancer. There are four stages, numbered 1 to 4.
Although a 2023 version of the FIGO system is available, doctors in the UK generally use the 2021 version.
Stage 2 womb cancer means the cancer has grown into the cervix but has not spread outside the womb.
Treatment
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
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the type of womb cancer you have
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how the cancer is likely to behave (the grade)
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the risk of your cancer coming back after surgery (low, intermediate, high-intermediate, high)
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whether your cancer has any gene changes (mutations)
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your general health
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your preferences
Surgery
Surgery is the main treatment for stage 2 womb cancer.
Your surgeon removes your womb and cervix. This is a simple or total hysterectomy. They usually also remove your fallopian tubes and ovaries.
They may need to remove:
- the top of your vagina and some of the surrounding tissue
- lymph nodes in your pelvis to check for cancer cells
This is called a radical hysterectomy.
The surgeon who does the surgery is usually a specialist surgeon called a gynaecological oncologist.
If you're not fit enough for surgery
If you are not fit enough for surgery, you might be able to have other treatments. The type of treatment will depend on your situation. You might have one of the following treatments:
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vaginal hysterectomy for a low grade cancer
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external and internal radiotherapy (brachytherapy) for a high grade cancer
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hormone therapy for a low grade cancer to postpone surgery or if you can't have surgery or radiotherapy
Treatment after surgery
Treatment after surgery is called adjuvant treatment. It lowers the chance of the cancer coming back. Most stage 2 cancers are treated with adjuvant treatment.
Low risk
Stage 2 cancers are rarely classified as low risk.
Intermediate risk
You usually have internal radiotherapy (brachytherapy) if you have an intermediate risk stage 2 grade 1 cancer.
High-intermediate risk
If you have a high-intermediate risk stage 2 grade 1 or stage 2 grade 2 to 3 cancer, you may have one of the following treatments after surgery;
- external radiotherapy – this is the most common treatment after surgery
- chemotherapy with radiotherapy or chemotherapy followed by radiotherapy, or both
- internal radiotherapy instead of external - this is sometimes considered if the risk is lower and lymph nodes that were removed during surgery are clear of cancer
High risk
After surgery you may have one of the following:
- external radiotherapy with chemotherapy and then more chemotherapy
- chemotherapy followed by radiotherapy
- chemotherapy on its own
If you have a carcinosarcoma, your treatment is the same as treatment for high-risk womb cancer.
