Treatment for womb cancer
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). Your doctor will talk to you about your treatment options, their benefits, and the possible side effects.
Most people are referred to a womb cancer MDT. You might go to a different hospital if there isn't a specialist MDT at your local hospital.
The team usually includes:
a doctor who treats conditions of the female reproductive system (gynaecologist)
a specialist surgeon
cancer specialists (oncologists) who specialise in treating cancer with cancer drugs (medical oncologist) and radiotherapy (clinical oncologist)
a specialist cancer nurse (also called clinical nurse specialist)
a pathologist (an expert who examines any cancer or tissue the surgeon removes)
a pharmacist
a radiologist (who looks at your scans and x-rays)
a dietician (who offers support and advice about eating and drinking)
The MDT may also include health professionals who look after people with advanced (metastatic) womb cancer. They can help with symptom control. They include:
the palliative care team
a clinical nurse specialist for palliative care
Your doctor will talk to you about the treatment they suggest. They will explain its benefits and the possible side effects.
Your treatment will depend on:
where your cancer is
how big it is and whether it has spread (the stage)
the type of cancer
how abnormal the cells look under a microscope (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 and level of fitness
your preferences
Deciding about treatment can be difficult when you have advanced cancer.
It helps to understand:
what treatment can do for you
how it might affect your quality of life
what side effects it has
Your doctor or specialist nurse can talk to you about the benefits and possible side effects. You can ask them questions.
You might also find it helps to talk things over with a close relative, a friend or a counsellor at the hospital.
For information and support you can contact our Cancer Research UK nurses on 0808 800 4040, from Monday to Friday, 9am to 5pm.
Your doctor might offer you a choice of treatments. Discuss each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:
whether you need extra appointments
if you need more tests
the distance you need to travel to and from hospital
You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.
You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness or pain.
Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to support you at home.
The main treatments are:
and
You have one or more of these treatments. This depends on the stage and risk group of your cancer and also how well the treatment works.
Find out about the stages of womb cancer
Surgery is the main treatment for early stage womb cancer. Generally, your surgeon removes:
your womb and cervix (hysterectomy)
both ovaries and fallopian tubes
They might also remove lymph nodes in your pelvis to check for cancer cells.
When you are diagnosed with womb cancer your doctors will do various tests on your cancer. After your operation they do more tests on the tissue they remove.
These tests along with the scans you had to diagnose your cancer find out more about the cancer. It also helps them know more about the risk of it coming back after surgery. This helps them to decide on the best treatment for you.
Find out more about risk groups
You have surgery to remove the womb, fallopian tubes and ovaries. This is a hysterectomy. You usually don’t need any other treatment. If you can’t have surgery, you may be able to have radiotherapy.
For those with stage 1A low grade cancer and who are premenopausal it may be possible to keep your ovaries. Talk to your doctor about this if this is a concern for you.
Your first treatment is surgery, a hysterectomy. Your surgeon will remove your womb, fallopian tubes and ovaries. They may also remove some lymph nodes in the pelvis.
After surgery you usually have internal radiotherapy (brachytherapy).
For those under 60 years of age your doctor may say you don’t need to have any other treatment after your operation. They will discuss the risks and follow-up with you.
You have surgery to remove the womb, fallopian tubes and ovaries. This is a hysterectomy. This usually includes your surgeon checking the nearby lymph nodes for cancer cells. This is also called a biopsy.
After surgery you may have one of the following treatments:
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
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
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
If you have a carcinosarcoma, your treatment is the same as treatment for high-risk womb cancer.
Your treatment will depend on what treatment you have already had.
If you've had surgery you may have surgery again and you usually have radiotherapy with internal radiotherapy. Your doctor may suggest chemotherapy as well.
If you had radiotherapy your doctor may suggest surgery to remove the cancer. They may also suggest cancer drug treatment after surgery. Cancer drug treatments include:
chemotherapy – usually carboplatin with paclitaxel
hormone treatments – you may be offered this if you have a low grade cancer. Hormone treatments include: medroxyprogesterone or megestrol acetate, letrozole, arimidex, fulvestrant
targeted treatments and immunotherapies – this includes pembrolizumab, lenvatinib and dostarlimab
Most treatments for womb cancer will affect your ability to have children. Hearing this when you haven’t started a family or haven’t finished will be difficult.
Whether it is possible to have fertility preserving treatment will depend on:
how big your cancer is and how far it has grown, this is the stage of your cancer
how abnormal the cancer cells are, this is the grade of your cancer
To have fertility preserving treatment, your cancer needs to be at an early stage. This means it needs to be stage 1A grade 1 womb cancer.
The usual treatment for early stage womb cancer is surgery. This gets rid of the cancer for nearly all those having it. Choosing to have fertility preserving treatment means you aren’t having standard treatment. Your doctor will talk to you about the possible risks of not having surgery straight away.
Anyone wanting to have fertility preserving treatment is usually seen at a specialist centre. First, they will want to confirm the stage of your cancer. This means that you will need to have a sample of tissue taken. This is called a biopsy. You will also need to have an scan.
Fertility preserving treatment means taking the hormone treatment progesterone. This aims to shrink the cancer, and for some, it may go away. Then, after six months of hormone treatment, you have another biopsy of your womb and an MRI scan to check how well it is working.
If treatment hasn’t worked, your doctor will recommend you have surgery to remove the cancer. If it is working you have a chance to get pregnant. Your doctor may refer you to a fertility specialist.
Your doctors will want to see you regularly, and you will need tests. This is to monitor the cancer and whether it has grown.
Once you have had your children, your specialist will recommend that you have surgery to remove your womb.
Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.
Last reviewed: 28 Mar 2024
Next review due: 28 Mar 2027
Most women with womb cancer have surgery to remove the womb. The operation you have depends on how far the cancer has grown.
Radiotherapy uses high energy x-rays to kill womb cancer cells. You might have radiotherapy after surgery to reduce the risk of cancer coming back or to help control the symptoms of advanced cancer. You might also have internal radiotherapy (brachytherapy).
Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.
Hormones are substances that occur naturally in the body. They control the growth and activity of our cells. You might have hormone therapy for advanced womb cancer or womb cancer that has come back.
After treatment for womb cancer, you have checkups at the hospital. You also have tests, including blood tests, x-rays and scans.
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.
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