Stages, types and grades
Most womb cancers start in specific cells in the womb lining, the endometrium. There are several types of endometrial cancer. Three of the more common types are:
Other types of endometrial cancers include:
undifferentiated carcinoma
mixed carcinoma
carcinosarcoma - has features of both endometrial cancer and sarcoma when looked at under a microscope. This is different form sarcoma of the womb
mesonephric-like carcinoma
gastrointestinal mucinous carcinoma
Doctors sometimes divide endometrial cancers into 2 types.
Type 1 cancers are the most common type. They are usually endometrioid adenocarcinomas, and are linked to excess oestrogen in the body. They are generally slow growing and less likely to spread.
Type 2 cancers are not linked to excess oestrogen. They are generally faster growing and more likely to spread. They include uterine serous carcinomas and clear cell carcinomas.
Sarcoma of the womb is different from carcinosarcoma. Carcinosarcoma is when there is a combination of sarcoma and carcinoma cells under the microscope. They are often type 2 cancers and more aggressive. Carcinosarcomas are treated as carcinomas and not sarcomas.
Sarcoma of the womb develop from cells in the muscle layer of the womb, rather than the lining. They are a type of soft tissue sarcoma and are much less common than endometrial cancer.
Soft tissue sarcomas are cancers of the supporting tissues of the body. There are many subtypes and they can develop from any type of soft tissue such as muscle or blood vessels. They tend to spread in the bloodstream to other parts of the body especially the lungs. The treatment you need for this type of womb cancer is not the same as other types of womb cancer.
Leiomyosarcoma is the most common sarcoma of the womb. It is a cancer of the muscle wall.
Because sarcomas are different and need different treatments, we have separate information about them.
Read about soft tissue sarcoma
Although the cervix is part of the womb, cervical cancer is very different from womb cancer.
Find out about cervical cancer
Grading is a way of dividing cancer cells into groups depending on how much the cells look like normal cells. This gives your doctor an idea of how quickly or slowly the cancer might grow and whether it is likely to spread.
The cells look very like normal cells. They are also called low grade or well differentiated. They tend to be slow growing and are less likely to spread than higher grade cancer cells.
The cells look more abnormal and are more likely to spread. This grade is also called moderately differentiated or moderate grade.
The cells look very abnormal and not like normal cells. They tend to grow quickly and are more likely to spread. They are called poorly differentiated or high grade.
When your doctor takes a sample of cells, a biopsy, it is sent to the laboratory. They also test the cancer they remove during surgery. A specialist doctor does various tests on the cells. This can help diagnose cancer and show which type of womb cancer it is.
Some womb cancers have changes in genes (mutations) that make the cancer grow and divide. Your doctor may test the cancer for changes in these genes to further classify your cancer. It also helps them decide on the best treatment for your type of womb cancer. This is also called molecular classification and includes the following groups:
MMRd
p53abn
POLE mutations
NSMP
They will also look for hormone receptors. The number of hormone receptors is linked to the effectiveness of hormone therapy.
When you have surgery, they look at the cancer to find out:
how fast growing your cancer is, also called the grade
how far it has grown into the womb's muscle layer or the cervix
whether it has spread into any lymph or blood vessels, also called lymphovascular space invasion (LVSI)
This information might help to describe the risk of your womb cancer spreading or coming back after treatment. It will also help your doctor decide about the best treatment for you. The risk can be:
low
intermediate
high-intermediate
high
advanced metastatic
To decide about what treatment you need your doctor looks at your type, grade and stage of your cancer.
Last reviewed: 19 Mar 2024
Next review due: 19 Mar 2027
The stage of a cancer tells you how big it is and whether it has spread. This helps your doctor decide which treatment you need.
Your treatment depends on several factors. These include what type of womb cancer you have, how big it is, whether it has spread (the stage) and the grade. It also depends on your general health.
There is support available during and after treatment to help you cope. This includes support from your clinical nurse specialist, cancer charities, community services, and family and friends.
You usually start by seeing your GP if you have symptoms that could be due to womb cancer. Your doctor will then decide whether to do tests or refer you to a specialist.
The most common symptom of womb cancer is abnormal bleeding from the vagina. This is especially in women who have stopped having periods (post menopausal women).
The womb is the pear shaped muscular bag that holds a baby during pregnancy. Most womb cancers start in the lining of the womb. They are also called uterine or endometrial cancer.
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