Stage 4 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 4 means the cancer has spread to another area of the body. There are 2 categories of stage 4 womb cancer:

  • 4A means the cancer has grown into the bowel or bladder, or both
  • 4B means the cancer has spread to lymph nodes further away, or to other parts of the body, such as the omentum Open a glossary item, peritoneum, Open a glossary item lungs, liver, bones or brain (secondary cancers or metastases), or both
Diagram showing stage 4 womb cancer

Your doctor might call stage 4 cancer advanced cancer.


The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • the type of womb cancer you have

  • how the cancer is likely to behave (the grade)

  • the risk of your cancer coming back after surgery (low, intermediate, high-intermediate, high)

  • whether your cancer has any gene changes (mutations)

  • your general health

  • your preferences


Depending on how far your cancer has spread, it may be possible to remove as much of the cancer as possible.

If you can't have surgery

There are several reasons why you might not have surgery, including:

  • your cancer is too difficult to remove

  • it has spread to areas further away in your body, such as the liver and lungs

  • you are not fit enough for surgery

  • you choose not to have it

You might have one or more of the following treatments:

  • chemotherapy

  • radiotherapy

  • immunotherapy

  • hormone therapy

Your doctor might also suggest you take part in a clinical trial.

Treatment after surgery

After surgery you may have one of the following treatments:

  • external radiotherapy with chemotherapy and then more chemotherapy
  • chemotherapy followed by radiotherapy
  • chemotherapy on its own

Some people may have treatment with immunotherapy or a targeted cancer drug. This will depend on your situation and whether you’ve had other treatments before. Possible treatments include:

  • immunotherapy with chemotherapy

  • immunotherapy on its own

  • immunotherapy and a targeted cancer drug

You doctor may recommend you have chemotherapy to try to slow the growth of the cancer and to relieve symptoms.

Other treatments

You will also have other more specific treatments that help with any symptoms you have. This might include pain killers for pain or medicines for sickness. 

There might be trials of experimental treatments which you could take part in. These might be looking at:

  • new treatments
  • ways to improve existing treatments such as radiotherapy or chemotherapy and when you have them

You can search our clinical trials database for womb cancer trials.

Other stages

  • Cancer of the corpus uteri (2021 update)

    M Koskas and others 

    International Journal of Gynaecology and Obstetrics, 2021. Volume 155, Supplement S1, Pages: 45 to 60

  • British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: recommendations for practice

    J Morrison and others

    European Journal of Obstetrics and Gynecology and Reproductive Biology, March 2022. Volume 270, Pages 50 to 89

  • Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
    A Oaknin and others
    Annals of Oncology, 2022. Volume 33, Issue 9, Pages: 860 to 877 

  • Endometrial cancer

    BMJ Best Practice, December 2023

    Accessed March 2024

Last reviewed: 
27 Mar 2024
Next review due: 
27 Mar 2027

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