Womb cancer

Your health expert: Mr Joseph Yazbek, Consultant Gynaecologist and Gynaecological Oncology Surgeon
Content editor review by Pippa Coulter, Freelance Health Editor, April 2023
Next review due April 2026

Womb cancer (uterine cancer) is a common cancer in the UK – around 9,700 people are diagnosed each year.

Womb cancer happens when cells in your womb (uterus) grow in an abnormal and uncontrolled way, forming a lump or tumour. Your womb is part of the female reproductive system and is where a baby develops if you get pregnant.

Types of womb cancer

The main type of womb cancer is called endometrial cancer. This is when the cancer starts in the lining (endometrium) of your womb.

Different subtypes of endometrial cancer affect different types of cells. Your doctor might tell you that you have type 1 or type 2 endometrial cancer.

Type 1 is most common. These are usually a type called endometrioid cancers. They tend to grow more slowly and are less likely to spread.
Type 2 is less common. They include uterine serous carcinomas and clear cell carcinomas. These are faster growing cancers, and more likely to spread.

There are less common types of womb cancer too. These include uterine sarcoma. This is a cancer that starts in the cells in the muscle wall of your womb.

Womb cancer can sometimes spread to surrounding tissues or to other parts of your body. This is known as metastasis.

This topic is about endometrial cancer. Other types of womb cancer, such as uterine sarcoma, may be treated differently.

Womb cancer causes

It’s not always clear exactly what causes womb cancer. But certain things make you more likely to develop it. Some of these are linked to having a higher level of the hormone oestrogen in your body.

You’re more likely to get womb cancer as you get older. You're also more likely to develop womb cancer if you:

are overweight or obese
have ever taken tamoxifen – a medicine sometimes used to treat breast cancer
have Lynch syndrome (hereditary non-polyposis colorectal cancer) – a genetic condition that increases risk of certain cancers
have polycystic ovary syndrome (PCOS)
have a thickened womb lining (endometrial hyperplasia), which can cause heavy periods and bleeding between periods
have diabetes
have never had children
started periods at a young age (before age 12) or have a late menopause (after age 55)
have taken oestrogen-only hormone replacement therapy (HRT)
have close relatives who have had womb cancer or bowel cancer

Womb cancer symptoms

The first sign of womb cancer is usually unusual bleeding from your vagina. This may be:

bleeding after you’ve been through the menopause
unusually heavy bleeding during your period
bleeding between periods
a pink, watery vaginal discharge

Other, less common womb cancer symptoms include:

pain or swelling in your tummy or pelvis
pain during sex
blood in your pee

There are lots of different conditions that can cause unusual bleeding from your vagina. Only a small number of people with this symptom will have womb cancer. But if you do have unusual bleeding or any of the other symptoms above, it’s important to see your GP.

Diagnosis of womb cancer

Your GP will ask about your symptoms and examine you. They’ll ask about your medical history too. Your GP will usually need to do an internal examination by looking inside your vagina. You can ask that another member of staff (a chaperone) stays in the room with you while you have the examination if you like. Your GP may also arrange for you to have a blood test.

Your GP may refer you to a gynaecologist. This is a doctor who specialises in female reproductive health. Your GP or gynaecologist may arrange for you to have further tests to confirm whether or not you have womb cancer. These may include the following.

A scan of your womb. This is called a transvaginal ultrasound scan. It’s done by inserting a small ultrasound probe into your vagina. The test measures the thickness of your womb lining, which can help to diagnose womb cancer.
Taking a tissue sample from your womb lining to check for cancer. This is called an endometrial biopsy. Your doctor inserts a thin plastic tube into your vagina and through your cervix to gently suck cells from the lining of your womb. The tissue may also be tested for any genetic problems that may lead to endometrial cancer.
A hysteroscopy to look inside your womb. Your doctor uses a narrow, flexible tube with a light and camera on the end to see inside your womb. A hysteroscopy can be done at the same time as a biopsy. Or, your doctor may suggest a separate hysteroscopy if a biopsy couldn’t confirm a diagnosis.

Your doctor may also suggest you have a cervical screening test if you haven’t had one recently. Cervical screening tests can’t diagnose womb cancer. But they can sometimes pick up on abnormal cells, which may show you need further tests.

Further tests after womb cancer diagnosis

If you’re diagnosed with womb cancer, you may need to have more tests to find out how advanced it is. This process is known as staging. It looks at how far the cancer has spread and how big it is. Tests may include:

an MRI scan
a CT scan
a PET (positron emission tomography) scan
a chest X-ray

Your doctor may also offer you a genetic test to check for Lynch syndrome. This is a rare condition that increases your risk of getting certain types of cancer, including womb cancer and bowel cancer. The test involves taking a sample of your tissue to test.

If you do have Lynch syndrome, your doctor can talk to you about ways to reduce the risk of getting another cancer. They may also be able to offer you monitoring to help diagnose any cancers early. Your relatives may also be offered tests for Lynch syndrome.

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Treatment of womb cancer

If you’re diagnosed with womb cancer, your treatment and care will be managed by a team of specialists. You should have a specialist nurse or key worker to support you and act as your main point of contact.

What treatment you’ll be offered depends on the type of womb cancer you have. It will also depend on how fast the cancer is growing and how far it’s spread, as well as your general health. Your doctor or nurse will discuss your treatment options with you.

Surgery

The main treatment for womb cancer is surgery. When possible, surgery aims to completely remove the cancer. But if you have advanced womb cancer, the aim of surgery may be to improve your symptoms and quality of life. Surgery usually involves:

removing your womb and cervix (known as a total hysterectomy)
removing your fallopian tubes and ovaries (known as a bilateral salpingo-oophorectomy, or BSO)
checking or removing lymph nodes, to see if the cancer has spread

You’ll usually have your surgery done via keyhole (laparoscopic) surgery, rather than open surgery. This means your surgeon will do the operation by inserting tiny instruments through small cuts in your abdomen (tummy), rather than one large cut. You usually recover from keyhole surgery faster than open surgery. You may need to have open surgery if your womb is large and can’t be removed easily, or if the cancer is advanced.

Sometimes, if you’re unable to have a standard hysterectomy, you may be able to have a vaginal hysterectomy. This means your womb is removed through your vagina. You won’t have any cuts in your tummy.

It’s important to understand that you won’t be able to get pregnant once you have had your womb removed. Tell your doctor or nurse if you would like to be able to have children in the future. If you have an early-stage cancer, your doctor may be able to offer you alternative treatments to surgery. You will need specialist monitoring and care if you want to get pregnant.

Non-surgical treatments

You may have other, non-surgical treatments alongside surgery to reduce the chances of cancer coming back. Or, you may be offered non-surgical treatments on their own if you have advanced cancer or you’re unable to have surgery. Treatments are then aimed at keeping your cancer under control and reducing symptoms.

Non-surgical treatments include the following.

Radiotherapy – this uses radiation to kill cancer cells. You might have external radiotherapy, which means the radiation comes from a scanner outside your body. Or you may have internal radiotherapy (brachytherapy), which means a radiation source is put inside your vagina.
Chemotherapy – this uses medicines to destroy cancer cells. You’ll usually be offered treatment with chemotherapy if your cancer has spread outside your womb, or if it keeps coming back. You might have it in combination with radiotherapy.
Hormone therapy – this means having treatment with the hormone progesterone. Progesterone can help to shrink your cancer and control symptoms. You may be offered hormone therapy if you’re unable to have surgery. You may also have it if you have an early-stage cancer and wish to try for a baby before having surgery. Hormone therapy is also an option if you have advanced womb cancer or if you’re cancer has come back after other treatments.
Targeted therapies – these are drugs that work directly to attack and destroy cancer cells. You might be offered these if you have womb cancer that has spread or keeps coming back. An example is dostarlimab. This is only available to people with a certain type of womb cancer, who have already tried other treatments.

After treatment

Your doctor or nurse will discuss with you what will happen once your treatment has finished. It’s possible for womb cancer to come back (recur) after treatment. When this happens, it’s most likely to come back in the first two years. If it comes back in the same area, it can often be treated successfully.

Your doctor may ask you to have regular check-ups, to see if the cancer has returned. Or, you may just be asked to contact your cancer team if you develop any new symptoms or are worried about anything. Your doctor or nurse will give you information about symptoms to look out for.

Your doctor or nurse will talk to you about any other concerns you have or support you need once your treatment finishes. This may include the effects of treatment on your sex life and ways to manage this. If you have your ovaries removed as part of your hysterectomy, this will cause the menopause. Your doctor or nurse can discuss this with you and whether hormone replacement therapy (HRT) may be an option for you.

Prevention of womb cancer

For most people, it’s not possible to completely prevent womb cancer. But being overweight or obese is one of the strongest preventable risk factors for womb cancer. Losing weight if you’re obese or maintaining a healthy weight can help to reduce this risk. Keeping active is also thought to help reduce the risk of womb cancer. This is probably partly linked to weight.

If you have polycystic ovary syndrome, your doctor may offer you medicine to give you regular periods. This will help to prevent abnormal thickening of your womb lining (endometrium), which can lead to cancer.

People who have Lynch syndrome are at increased risk of womb cancer, as well as certain other types of cancer. If you have Lynch syndrome, your doctor will talk to you about symptoms to look out for. They may also offer you regular screening tests for womb cancer. You may also want to consider having a hysterectomy to remove your womb once you have finished having children. This is called a risk-reducing hysterectomy, and can prevent womb cancer.

The first sign of womb cancer for most people is unusual bleeding from your vagina. This is most often bleeding when you’ve already been through the menopause. If you haven’t been through menopause yet, you might have heavier periods than usual or bleeding between your periods. Always get unusual bleeding from your vagina checked out with your GP. See our Symptoms section for more information.

This will depend on the type of cancer you have and whether it’s spread. Surgery may cure your cancer if the cancer can be completely removed. If you have advanced cancer, treatments may aim to keep your cancer under control and reduce your symptoms, rather than cure it. Your doctor will discuss your treatment options with you. You can find out more in our Treatment section.

There are several things that can increase your risk of womb cancer. You can’t change some of these things, like your age and family history. But one of the biggest preventable risk factors for womb cancer is being overweight or obese. Maintaining a healthy weight can help to reduce your risk of womb cancer. See our Causes section to find out more about womb cancer causes.

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