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Uterine Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Uterine Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this complete guide.

About the uterus

The pear-shaped uterus is hollow and located in a woman’s pelvis between the bladder and rectum. The uterus is also called the womb. It is where a baby grows when a woman is pregnant. The uterus has 3 sections: the narrow, lower section called the cervix; the broad section in the middle called the isthmus; and the dome-shaped top section called the fundus. The wall on the inside of the uterus has 2 layers of tissue: endometrium (inner layer) and myometrium (outer layer), which is muscle tissue.

During a woman's childbearing years, her ovaries typically release an egg every month and the lining of the uterus grows and thickens in preparation for pregnancy. If the woman does not get pregnant, this thick lining passes out of her body through her vagina, a process known as menstruation. This process continues until menopause, when a woman’s ovaries stop releasing eggs.

About uterine cancer

Uterine cancer is the most common cancer occurring in a woman’s reproductive system. Uterine cancer begins when healthy cells in the uterus change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor can grow but generally will not spread into other tissues.

Noncancerous conditions of the uterus include:

  • Fibroids: Benign tumors in the muscle of the uterus

  • Benign polyps: Abnormal growths in the lining of the uterus

  • Endometriosis: A condition in which endometrial tissue, which usually lines the inside of the uterus, is found on the outside of the uterus or other organs.

  • Endometrial hyperplasia: A condition in which there is an increased number of cells and glandular structures in the uterine lining. Endometrial hyperplasia can have either normal or atypical cells and simple or complex glandular structures. The risk for developing cancer in the lining of the uterus is higher when endometrial hyperplasia has atypical cells and complex glands.

There are 2 major types of uterine cancer:

  • Adenocarcinoma. This type makes up more than 80% of uterine cancers. It develops from cells in the endometrium. This cancer is commonly called endometrial cancer. One common endometrial adenocarcinoma is called endometrioid carcinoma, and treatment varies depending on the grade of the tumor, how far it goes into the uterus, and the stage or extent of disease (see Stages and Grades). Less common types of uterine cancers include serous, clear cell, and carcinosarcoma.

  • Sarcoma. This type of uterine cancer develops in the supporting tissues of the uterine glands or in the myometrium, which is the uterine muscle. Sarcoma accounts for about 2% to 4% of uterine cancers. In most situations, sarcomas are treated differently from adenocarcinomas. Types of endometrial sarcoma include leiomyosarcoma, endometrial stromal sarcoma, and undifferentiated sarcoma. Learn more about sarcoma.

Cancer confined to the uterine cervix is treated differently from uterine cancer; learn more about cervical cancer. The rest of this section covers the more common endometrial (adenocarcinoma) cancer.

About genetics and family history and uterine cancer

A higher risk for uterine cancers can be inherited, meaning it is passed from generation to generation, or may skip a generation to appear in the next. This happens about 5% of the time. The syndrome most commonly associated with inherited uterine cancer is called Lynch syndrome. Lynch syndrome is also associated with several other types of cancer, including types of colon, kidney, bladder, and ovarian cancers.

When cells divide and multiply, DNA errors can occur. There are 6 proteins in the body that fix these errors. If 1 of these proteins does not work properly, errors in the DNA can accumulate and yield enough DNA damage that cancer may develop. This problem with DNA repair is called mismatch repair defect (dMMR). dMMR is the main sign of Lynch syndrome.

Cancer can be tested for Lynch syndrome through a special staining process called immunohistochemistry (IHC). If IHC shows that your cancer lacks 1 of these DNA repair proteins or if you have a family history of a cancer associated with Lynch syndrome, discuss this with your doctor and/or talk with a genetic counselor. Family members may wish to be tested, too. People affected by Lynch syndrome should tell their doctors so they can receive increased screening for Lynch-associated cancers. Other family members may consider preventive surgery for uterine and ovarian cancer.

If you have uterine cancer, ask your doctor if the cancer can be tested for Lynch syndrome and other possible inherited conditions. Learn more about Lynch syndrome in another section on this website.

Looking for More of an Introduction?

If you would like more of an introduction, explore this related item. Please note that this link will take you to another section on Cancer.Net:

  • ASCO Answers Fact Sheet: Read a 1-page fact sheet that offers an introduction to uterine cancer. This free fact sheet is available as a PDF, so it is easy to print out.

The next section in this guide is Statistics. It helps explain the number of people who are diagnosed with uterine cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find information about the number of women who are diagnosed with uterine cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors. Use the menu to see other pages.

This year, an estimated 61,880 women in the United States will be diagnosed with uterine, or endometrial, cancer. Uterine cancer is the fourth most common cancer for women in the United States.

More than 90% of uterine cancers occur in the endometrium. The number of women diagnosed with endometrial cancer is increasing, mostly because of an increase in obesity, which is an important risk factor for this disease. From 2006 to 2015, the number of white women diagnosed with cancer increased by 1% each year. During that same time period, uterine cancer diagnoses in black women increased by 2% each year. However, more than 67% of women with uterine cancer are diagnosed at an early stage.

It is estimated that 12,160 deaths from this disease will occur this year. It is the sixth most common cause of cancer death among women in the United States. Although uterine cancer rates are slightly higher among white women than black women, black women are more likely to die from uterine cancer than white women. From 2007 to 2016, deaths from uterine cancer increased by 2% each year for white and black women.

The 5-year survival rate tells you what percentage of women live at least 5 years after the cancer is found. Percentage means how many out of 100. The 5-year survival rate for women with uterine cancer is 81%. The 5-year survival rates for white and black women with the disease are 83% and 62%, respectively. Black women are less likely to be diagnosed with early-stage disease, and their survival rate at every stage is lower.

When the cancer is diagnosed, if it is still located only in the area where it started, it is called “local,” and the 5-year survival rate is about 95%. Approximately 69% of white women are diagnosed at this stage, compared with 54% of black women. If the cancer has spread regionally, the 5-year survival rate is about 69%. If it is diagnosed after the cancer has spread into other areas of the body, the survival rate is 16%.

It is important to remember that statistics on the survival rates for women with uterine cancer are an estimate. The estimate comes from annual data based on the number of women with this cancer in the United States. Also, experts measure the survival statistics every 5 years. So the estimate may not show the results of better diagnoses or treatments available for less than 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's (ACS) publication, Cancer Facts & Figures 2019, and the ACS website (January 2019).

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by uterine cancer. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find a basic drawing of the main body parts affected by uterine cancer. To see other pages, use the menu.

This illustration shows a frontal and sagittal (side) view of a woman’s reproductive system. The frontal section shows the fallopian tubes, 2 small ducts that link the 2 ovaries (1 on each side) to the hollow, pear-shaped uterus. The lower, narrow part of the uterus is called the cervix, which leads to the vagina. The uterus is located in the pelvis, between the bladder and rectum, and the vagina is located behind the urethra, which connects to the bladder. Copyright 2003 American Society of Clinical Oncology. Robert Morreale/Visual Explanations, LLC.

The next section in this guide is Risk Factors and Prevention. It explains the factors that may increase the chance of developing uterine cancer. Use the menu to choose another section to read in this guide.

Uterine Cancer - Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find out more about the factors that increase the chance of developing uterine cancer. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a woman’s risk of developing uterine cancer:

  • Age. Uterine cancer most often occurs in women over 50. The average age at diagnosis is 60. Uterine cancer is not common in women younger than 45.

  • Obesity. Fatty tissue in women who are overweight produces additional estrogen, a sex hormone that can increase the risk of uterine cancer. This risk increases with an increase in body mass index (BMI), which is the ratio of a person's weight to height. About 70% of uterine cancer cases are linked to obesity.

  • Race. White women are more likely to develop uterine cancer than women of other races/ethnicities. However, black women have a higher chance of being diagnosed with advanced uterine cancer. Black women and Hispanic women also have a higher risk of developing aggressive tumors.

  • Genetics. Uterine cancer may run in families where colon cancer is hereditary. As explained in the Introduction, women in families with Lynch syndrome, also called hereditary non-polyposis colorectal cancer (HNPCC), have a higher risk for uterine cancer. It is recommended that all women under the age of 60 with endometrial cancer should have their tumor tested for Lynch syndrome, even if they have no family history of colon cancer or other cancers. The presence of Lynch syndrome has important implications for women and their family members. About 2% to 5% of women with endometrial cancer have Lynch syndrome. In the United States, about 1,000 to 2,500 women diagnosed with endometrial cancer each year may have this genetic condition. Read more about Lynch syndrome in a guide on this website.

  • Diabetes. Women may have an increased risk of uterine cancer if they have diabetes, which is often associated with obesity (see above).

  • Other cancers. Women who have had breast cancer, colon cancer, or ovarian cancer have an increased risk of uterine cancer.

  • Tamoxifen. Women taking the drug tamoxifen (Nolvadex) to prevent or treat breast cancer have an increased risk of developing uterine cancer. The benefits of tamoxifen usually outweigh the risk of developing uterine cancer, but all women who are prescribed tamoxifen should talk with their doctor about the benefits and risks.

  • Radiation therapy. Women who have had previous radiation therapy for another cancer in the pelvic area, which is the lower part of the abdomen between the hip bones, have an increased risk of uterine cancer.

  • Diet/nutrition. Women who eat foods high in animal fat may have an increased risk of uterine cancer.

  • Estrogen. Extended exposure to estrogen and/or an imbalance of estrogen is related to many of the following risk factors:

    • Women who started having their periods before age 12 and/or go through menopause later in life. Learn more about menopause and cancer risk.

    • Women who take hormone replacement therapy (HRT) after menopause, especially if they are taking estrogen alone. The risk is lower for women who take estrogen with progesterone, which is another sex hormone.

    • Women who have never been pregnant.

Prevention

Different factors contribute to different types of cancer. Researchers continue to investigate what factors increase risk for this type of cancer, including ways to prevent it. Although there is no proven way to completely prevent uterine cancer, you may be able to lower your risk. Talk with your health care team for more information about your personal risk of cancer.

Research has shown that certain factors can lower the risk of uterine cancer:

  • Taking birth control pills. Birth control pills have a combination of estrogen and progesterone that are taken cyclically to produce a monthly menstrual period, which reduces the risk of an overgrowth of the uterine lining, especially when taken over a long period of time.

  • Using a progestin-secreting intrauterine device (IUD), which is a form of birth control.

  • Considering the risk of uterine cancer before starting HRT, especially estrogen replacement therapy alone. Using a combination of estrogen and progesterone for HRT may help lower risk.

  • Maintaining a healthy weight.

  • If you have diabetes, good disease management, such as regularly monitoring blood glucose levels, can lower risk.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems uterine cancer can cause. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

Women with uterine cancer may experience the following symptoms or signs. Sometimes, women with uterine cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer.

  • Unusual vaginal bleeding, spotting, or discharge. For premenopausal women, this includes menorrhagia, which is an abnormally heavy or prolonged bleeding, and/or abnormal uterine bleeding (AUB).

  • Abnormal results from a Pap test (see Diagnosis)

  • Pain in the pelvic area

The most common symptom of endometrial cancer is abnormal vaginal bleeding, ranging from a watery and blood-streaked flow to a flow that contains more blood. Vaginal bleeding during or after menopause is often a sign of a problem.

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This conversation helps identify the cause of the problem, called a diagnosis.

If uterine cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They do tests to learn whether cancer has spread to a different part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

This section describes options for diagnosing this type of cancer. Not all tests listed will be used for every woman. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of previous medical tests

In addition to a physical examination, the following tests may be used to diagnose uterine cancer:

  • Pelvic examination. The doctor feels the uterus, vagina, ovaries, and rectum to check for any unusual findings. A Pap test, often done with a pelvic examination, is primarily used to check for cervical cancer. Sometimes a Pap test may find abnormal glandular cells, which are caused by uterine cancer.

  • Endometrial biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

    For an endometrial biopsy, the doctor removes a small sample of tissue with a very thin tube. The tube is inserted into the uterus through the cervix, and the tissue is removed with suction. This process takes a few minutes. Afterward, the woman may have cramps and vaginal bleeding. These symptoms should go away soon and can be reduced by taking a nonsteroidal anti-inflammatory drug (NSAID) as directed by the doctor. Endometrial biopsy is often a very accurate way to diagnose uterine cancer. People who have abnormal vaginal bleeding before the test may still need a dilation & curettage (D&C; see below), even if no abnormal cells are found during the biopsy.

  • Dilation and curettage (D&C). A D&C is a procedure to remove tissue samples from the uterus. A woman is given anesthesia during the procedure to block the awareness of pain. A D&C is often done in combination with a hysteroscopy so the doctor can view the lining of the uterus during the procedure. During a hysteroscopy, the doctor inserts a thin, lighted flexible tube through the cervix into the vagina and uterus. After endometrial tissue has been removed, during a biopsy or D&C, the sample is checked for cancer cells, endometrial hyperplasia, and other conditions.

  • Transvaginal ultrasound. An ultrasound uses sound waves to create a picture of internal organs. In a transvaginal ultrasound, an ultrasound wand is inserted into the vagina and aimed at the uterus to take pictures. If the endometrium looks too thick, the doctor may decide to perform a biopsy (see above).

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill or liquid to swallow.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye is injected into a patient’s vein or given as a pill or liquid to swallow. MRI is very useful for getting detailed images if the treatment plan will include hormone management (see Types of Treatment). MRI is often used in women with low-grade uterine cancer to see how far the cancer has grown into the wall of the uterus. Knowing this can help determine whether a woman’s fertility can be preserved.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, additional testing will be performed to discover how far the disease has grown. This helps to categorize the disease by stage and grade and directs the type of treatment that will be needed.

The next section in this guide is Stages and Grades. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Stages and Grades

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage and grade. Use the menu to see other pages.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to discover the cancer's stage, and they may need information based on samples of tissue from surgery, so staging may not be complete until all of the tests are finished and the surgery to remove the tumor has been done (see Types of Treatment). Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a woman's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For uterine cancer, the staging system developed by the International Federation of Obstetrics and Gynecology (FIGO) is used.

FIGO stages for uterine cancer

The stage provides a common way of describing the cancer, enabling doctors to work together to plan the best treatments. Doctors assign the stage of endometrial cancer using the FIGO system.

Stage I: The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.

  • Stage IA: The cancer is found only in the endometrium or less than one-half of the myometrium.

  • Stage IB: The tumor has spread to one-half or more of the myometrium.

Stage II: The tumor has spread from the uterus to the cervical stroma but not to other parts of the body.

Stage III: The cancer has spread beyond the uterus, but it is still only in the pelvic area.

  • Stage IIIA: The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.

  • Stage IIIB: The tumor has spread to the vagina or next to the uterus.

  • Stage IIIC1: The cancer has spread to the regional pelvic lymph nodes.

  • Stage IIIC2: The cancer has spread to the para-aortic lymph nodes with or without spread to the regional pelvic lymph nodes.

Stage IV: The cancer has metastasized to the rectum, bladder, and/or distant organs.

  • Stage IVA: The cancer has spread to the mucosa of the rectum or bladder.

  • Stage IVB: The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs.

Grade (G)

Doctors also describe this type of cancer by its grade (G). The grade describes how much cancer cells resemble healthy cells when viewed under a microscope.

The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer appears similar to healthy tissue and has different cell groupings, it is called "differentiated" or a "low-grade tumor." If the cancerous tissue looks very different from healthy tissue, it is called "poorly differentiated" or a "high-grade tumor." The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the prognosis.

The letter "G" is used to define a grade for uterine cancer.

GX: The grade cannot be evaluated.

G1: The cells are well differentiated.

G2: The cells are moderately differentiated.

G3: The cells are poorly differentiated.

Recurrent uterine cancer

Recurrent cancer is cancer that has returned after treatment. Uterine cancer may come back in the uterus, pelvis, lymph nodes of the abdomen, or another part of the body. If there is a recurrence, this tends to occur within 3 years of the original diagnosis, but later recurrences can sometimes occur.

If there is a recurrence, more testing will help to determine the extent of disease. You and your doctor should talk about treatment options. This is discussed more in the next section of the guide.

Information about the cancer’s stage and grade will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with uterine cancer. Use the menu to see other pages.

This section explains the types of treatments that are the standard of care for uterine cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

Treatment overview

In cancer care, different types of doctors, called a multidisciplinary team, often work together to create a patient’s overall treatment plan, which combines different types of treatments. Your health care team should include a gynecologic oncologist, which is a doctor who specializes in the cancers of the female reproductive system.

Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Descriptions of the common types of treatments used for uterine cancer are described below, followed by an outline of treatments based on the stage of the disease. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, your overall health, age, and personal preferences, including whether or how treatment will affect your ability to have children, called fertility. Uterine cancer is treated by 1 or a combination of treatments, including surgery, radiation therapy, chemotherapy, and hormone therapy. Combinations of treatments are often recommended, but they depend on the stage and characteristics of the cancer.

Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. These types of talks are called “shared decision making.” Shared decision making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision making is particularly important for uterine cancer because there are different treatment options. Learn more about making treatment decisions.

Concerns about sexual health and having children

Women with uterine cancer may have concerns about if or how their treatment may affect their sexual health and fertility. These topics should be discussed with the health care team before treatment begins. Premenopausal women who are still potentially able to get pregnant and want to preserve their fertility should talk with their oncologist and/or a reproductive endocrinologist (REI), also called a fertility specialist, before treatment begins. During these conversations, ask what options for fertility preservation are covered by your health insurance.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue, called a margin, during an operation. It is typically the first treatment used for uterine cancer. A gynecologic oncologist is a doctor who specializes in treating gynecologic cancer using surgery. Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have (see “Side effects of surgery” below). Learn more about the basics of cancer surgery.

Common surgical procedures for uterine cancer include:

  • Hysterectomy. Depending on the extent of the cancer, the surgeon will perform either a simple hysterectomy (removal of the uterus and cervix) or a radical hysterectomy (removal of the uterus, cervix, the upper part of the vagina, and nearby tissues). For patients who have been through menopause, the surgeon will typically also perform a bilateral salpingo-oophorectomy, which is the removal of both fallopian tubes and ovaries.

    A hysterectomy may be performed by abdominal incision, by laparoscopy or robotically, which uses several small incisions, or vaginally. A hysterectomy is usually performed by a gynecologic surgeon, which is a surgeon who specializes in surgery of the woman’s reproductive system. In robotic-assisted surgery, a camera and instruments are inserted through small, keyhole-size incisions. The surgeon directs the robotic instruments to remove the uterus, cervix, and surrounding tissue. Talk with your doctor about the risks and benefits of the different surgical approaches and which approach might be best for you.

  • Lymph node removal. At the same time as a hysterectomy, the surgeon may remove lymph nodes near the tumor to determine if the cancer has spread beyond the uterus. This may be done through a procedure called a sentinel lymph node biopsy or lymphadenectomy. A sentinel lymph node biopsy might involve an injection of dye into the uterus during the hysterectomy and removal of the few lymph nodes where dye collects. This procedure has become more common in uterine cancer than lymphadenectomy. A lymphadenectomy, or lymph node dissection, is a surgical procedure in which a group of lymph nodes is removed.

Side effects of surgery

After surgery, the most common short-term side effects include pain and tiredness. If a woman is experiencing pain, her doctor will prescribe medications to relieve the pain. Other immediate side effects may include nausea and vomiting as well as difficulty emptying the bladder and having bowel movements. The woman's diet may be restricted to liquids, followed by a gradual return to solid foods.

If the ovaries are removed, this ends the body's production of sex hormones, resulting in early menopause (if the woman has not already gone through menopause). While removal of the ovaries substantially reduces the sex hormones that are produced by the body, the adrenal glands and fat tissues will still provide some hormones. Soon after removing the ovaries, a woman is likely to experience menopausal symptoms, including hot flashes and vaginal dryness.

If a lymphadenectomy is done, some women may get swelling in their legs, called lymphedema.

After a hysterectomy, a woman can no longer become pregnant. For this reason, premenopausal women who wish to preserve their fertility and have children in the future should talk with their doctor about all their options before any treatment begins. Sometimes, fertility preservation is possible and might include less extensive surgery followed by hormone therapy (see below). Your doctor can talk with you about the potential risks and benefits of this approach and provide information to help you make an informed decision.

Before any operation for uterine cancer, women are also encouraged to talk with their doctors about sexual and emotional side effects, including ways to address these issues before and after cancer treatment.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body.

Some women with uterine cancer need surgery (see above) and radiation therapy. The radiation therapy is most often given after surgery to destroy any remaining cancer cells. Radiation therapy is occasionally given before surgery to shrink the tumor. If a woman cannot have surgery, the doctor may recommend radiation therapy instead.

Options for giving radiation therapy to treat uterine cancer may include radiation therapy directed towards the whole pelvis and/or applied only to the vaginal cavity, often called vaginal brachytherapy.

Researchers are always looking for new ways to improve radiation therapy to reduce side effects and improve its effectiveness. One method being studied is MRI-guided radiation therapy. During this treatment, an MRI is combined with a linear accelerator, which delivers the radiation therapy. The MRI provides real-time pictures of the area being treated with radiation therapy, so the radiation can be directed with more accuracy and precision. This helps reduce the amount of healthy tissues exposed to the radiation and focuses the treatment more on the tumor and affected organs. There is currently 1 system for MRI-guided radiation therapy approved by the U.S. Food and Drug Administration (FDA). Other methods of MRI-guided radiation therapy are being studied.

Side effects from radiation therapy will depend on the extent of radiation therapy given and may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished, but long-term side effects are possible. Talk with your radiation oncologist about what you can expect and how side effects will be managed.

Learn more about the basics of radiation therapy. For more information on radiation therapy for gynecologic cancers, see the American Society for Therapeutic Radiology and Oncology's pamphlet, Radiation Therapy for Gynecologic Cancers (PDF; please note that this link takes you to a separate, external website).

Therapies using medication

Systemic therapy is the use of medication to destroy cancer cells. This type of medication is given through the bloodstream to reach cancer cells throughout the body. Systemic therapies are generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. It may also be prescribed by a gynecologic oncologist, a doctor who specializes in treating women’s reproductive cancer with medication.

Common ways to give systemic therapies include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

The types of systemic therapies used for uterine cancer include:

  • Chemotherapy

  • Hormone therapy

  • Targeted therapy

  • Immunotherapy

Each of these types of therapies is discussed below in more detail. A person may receive 1 type of systemic therapy at a time or a combination of systemic therapies given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications. Learn more about your prescriptions by using searchable drug databases.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. When recommended for endometrial cancer, chemotherapy usually is given after surgery, either with or without radiation therapy. Chemotherapy is also considered if the endometrial cancer returns after initial treatment.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.

The goal of chemotherapy is to destroy cancer remaining after surgery or to shrink the cancer and slow the tumor's growth if it comes back or has spread to other parts of the body. Although chemotherapy can be given orally, most drugs used to treat uterine cancer are given by IV. IV chemotherapy is either injected directly into a vein or through a catheter, which is a thin tube inserted into a vein.

The side effects of chemotherapy depend on the individual, the type of chemotherapy, and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished. Advances in chemotherapy during the last 10 years include the development of new drugs for the prevention and treatment of side effects, such as antiemetics for nausea and vomiting and growth factors to prevent low white blood cell counts.

Other potential side effects of chemotherapy for uterine cancer include the inability to become pregnant in the future and experiencing early menopause, if the patient has not already had a hysterectomy (see “Surgery” above). Talk with your doctor before treatment starts if you want to preserve your fertility. Rarely, some drugs cause some hearing loss. Others may cause kidney damage. Patients may be given extra fluid intravenously to protect their kidneys. Talk with your doctor about what side effects you may experience with chemotherapy and how they can be prevented or managed.

Learn more about the basics of chemotherapy.

Hormone therapy

Hormone therapy is used to slow the growth of certain types of uterine cancer cells that have receptors to the hormones on them. These tumors are generally adenocarcinomas and are grade 1 or 2 tumors.

Hormone therapy for uterine cancer often involves a high dose of the sex hormone progesterone given in pill form. Other hormone therapies include hormone-expressing intrauterine devices (IUDs) and the aromatase inhibitors (AIs), such as anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin), which are often used for the treatment of breast cancer. An AI is a drug that reduces the amount of the hormone estrogen in a woman's body by stopping tissues and organs other than the ovaries from producing it. Hormone therapy may also be used for women who cannot have surgery or radiation therapy, or it can be used in combination with other types of treatment.

Side effects of hormone therapy may include fluid retention, increase in appetite, insomnia, muscle aches, and weight gain. Most side effects are manageable with the help of your health care team. Talk with your doctor about what you can expect.

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.

Not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the most effective treatment whenever possible. In addition, research studies continue to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

Targeted therapy for uterine cancer is available in clinical trials and includes:

  • Anti-angiogenesis therapy. Anti-angiogenesis therapy is focused on stopping angiogenesis, which is the process of making new blood vessels. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. Bevacizumab (Avastin) is a type of anti-angiogenesis therapy used to treat uterine cancer.

  • Mammalian target of rapamycin (mTOR) inhibitors. In endometrial cancer, mutations in a pathway called mTOR are commonly found. People with advanced or recurrent uterine cancer may be treated with a drug that blocks this pathway, such as everolimus (Afinitor). Other drugs that target this pathway are being studied, such as ridaforolimus and temsirolimus (Torisel), a targeted therapy approved to treat a type of kidney cancer called renal cell carcinoma.

Talk with your doctor about possible side effects for a specific medication and how they can be managed.

Immunotherapy (updated 09/2019)

Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.

Uterine cancers with mismatch repair defects (dMMR; see Introduction) are more sensitive to immunotherapy. The immunotherapy drug pembrolizumab (Keytruda) is approved to treat tumors that have either high microsatellite instability (MSI-high) or dMMR, regardless of the tumor's location in the body. Pembrolizumab can be used to treat uterine tumors with dMMR if other previous treatments have not worked.

A combination of lenvatinib (Lenvima) and pembrolizumab is approved to treat advanced endometrial cancer. This combination can be used to treat disease that is not MSI-high or dMMR, has not been controlled by systemic therapy, and cannot be cured with surgery or radiation therapy.

Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

Metastatic uterine cancer

If cancer spreads to a part of the body that is different from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include radiation therapy, especially for recurrent cancer in the pelvis, or surgery. Hormone therapy may be used for cancer that has spread to distant parts of the body. A cancer that is high grade or that does not respond to hormone therapy is treated with chemotherapy. Women with stage IV uterine cancer are encouraged to consider participating in clinical trials. Palliative care will be important to help relieve symptoms and side effects.

For most people, a diagnosis of metastatic cancer is very stressful and may be difficult to bear. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of the health care team. It may be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. A key goal of follow-up care is to watch for a recurrence and to manage possible late effects and long-term side effects from treatment. Learn more about coping with the fear of recurrence.

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence). Some symptoms of recurrent cancer are similar to those experienced when the disease was first diagnosed:

  • Vaginal bleeding or discharge

  • Pain in the pelvic area, abdomen, or back of the legs

  • Difficulty or pain when urinating

  • Weight loss

  • Persistent cough/shortness of breath

When a recurrence occurs, a new cycle of testing will begin again to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as hormone therapy, radiation therapy, and chemotherapy, but they may be used in a different combination or given at a different pace. Sometimes, surgery is suggested when a cancer recurrence is small or confined, called a localized recurrence. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

If treatment does not work

Recovery from uterine cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with uterine cancer. Use the menu to choose a different section to read in this guide.

Uterine Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for women with uterine cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the FDA was tested in clinical trials.

Clinical trials are used for all types and stages of uterine cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

Women who participate in clinical trials can be some of the first to get a treatment before it is available to the public. There are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

Women decide to participate in clinical trials for many reasons. For some women, a clinical trial is the best treatment option available. Because standard treatments are not perfect, people are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other people volunteer for clinical trials because they know that these studies offer a way to contribute to the progress in treating uterine cancer. Even if they do not benefit directly from the clinical trial, their participation may yield future benefits for women with uterine cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company before starting treatment to learn if and how your participation in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that they might not receive active treatment in a clinical trial but instead receive a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, women must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that she understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different from the risks of standard treatment.

  • Explain what will be required of each person while participating in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Clinical trials have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. This may include that the new treatment is not working or there are serious side effects. Clinical trials are closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for uterine cancer, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials in another section of this website.

The next section in this guide is Latest Research. It explains areas of scientific research for uterine cancer. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will read about scientific research being done to learn more about uterine cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about uterine cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

  • New types of targeted therapy. The most notable development in the treatment of endometrial cancer is an increasing understanding of tumor genomics. This area of science seeks to identify mutations in the tumor’s genes that might “drive” or cause the tumor to grow. Testing can be done on your tumor sample to look for these genetic mutations, and the results will help decide whether your treatment options include a type of treatment called targeted therapy, which may be available in clinical trials. Many targeted treatments are being studied for the treatment of uterine cancer, including ridaforolimus and temsirolimus (Torisel).

  • Targeted therapy to treat a rare type of uterine cancer. Uterine serous carcinoma is a rare but aggressive type of endometrial cancer. About 30% of these tumors express the HER2 gene. In a phase II clinical trial, researchers found that trastuzumab (Herceptin) combined with a combination of chemotherapy was effective in treating these kinds of tumors. Trastuzumab is a HER2 targeted therapy mostly used to treat HER2-positive breast cancer. In the women in this study, trastuzumab stopped the progression of the disease for a median of 12.6 months compared to 8.0 months for those who received only standard chemotherapy. The median is the midpoint, meaning that half of the patients had their disease stopped for less than the median and half had their disease stopped for more than the median.

  • MRI-guided radiation therapy. As described in Types of Treatment, MRI-guided radiation therapy combines MRI with a linear accelerator to deliver the radiation with more accuracy and precision. This helps reduce the amount of healthy tissues exposed to the radiation and focuses the treatment more on the tumor and affected organs. Systems to deliver this treatment are being studied.

  • Immunotherapy. Other research includes immunotherapy, also called biologic therapy, which is designed to boost the body's natural defenses to fight the cancer. There is interest in a specific area of immunotherapy called “checkpoint inhibitors,” such as PD-1 or CTLA4 targeted immunotherapies. They help activate the immune system and can shrink tumors. Some of these immunotherapies work better in combination with other treatment types. There are ongoing clinical trials examining different drugs and various combinations in uterine cancer.

  • Palliative care/supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current endometrial cancer treatments to improve comfort and quality of life for patients.

Patients are strongly encouraged to talk with the doctor about clinical trials when decisions are being made about their treatment options.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding uterine cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers guidance in how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care" or "supportive care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for uterine cancer are described within the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health, sexual health, and fertility depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to explain any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, physical side effects can last after treatment ends. Doctors call these “long-term side effects.” They call side effects that occur months or years after treatment “late effects.” Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects along with physical effects after a cancer diagnosis. These may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Cancer treatment can be expensive. It is often a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care prevents them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with uterine cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, and social effects of cancer.

Ask how much care you may need at home with daily tasks during and after treatment. This can help you make a caregiving plan. Create a caregiving plan with this 1-page fact sheet that includes an action plan to help make caregiving a team effort. This free fact sheet is available as a PDF, so it is easy to print out.

Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

  • Cancer.Net Mobile: The free Cancer.Net mobile app allows you to securely record the time and severity of symptoms and side effects.

  • ASCO Answers Managing Pain: Get this 36-page booklet about the importance of pain relief that includes a pain tracking sheet to help patients record how pain affects them. The free booklet is available as a PDF, so it is easy to print out.

  • ASCO Answers Fact Sheets: Read 1-page fact sheets on diarrhea and rash that provide a tracking sheet to record the timing and severity of the side effect. These free fact sheets are available as a PDF, so they are easy to print out.

The next section in this guide is Follow-up Care. It explains the importance of checkups after you finish cancer treatment. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations and medical tests. Doctors want to keep track of your recovery in the months and years ahead. In addition to a physical examination with a pelvic examination, follow-up care may include blood tests and x-rays. These tests may be done more frequently in the first and second year after treatment. Tell your doctor about any new symptoms, especially a loss of appetite, bladder or bowel changes, pain, vaginal bleeding, chronic cough, pain in the pelvic area, or weight changes. These symptoms may be signs that the cancer has come back or signs of another medical condition.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of undetected cancer cells may remain in the body. Over time, these cells may increase until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer originally diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects while receiving treatment. It is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects, called late effects, may develop months or even years afterwards. Long-term and late effects can include physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you during your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Survivorship

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, either to reduce the risk of recurrence or manage chronic disease.

Survivorship is one of the most complicated parts of having cancer because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life.

Survivors may feel stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

Changing role of caregivers

Family members and friends may go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer. Like survivors, caregivers may find an in-person support group or online community helpful.

As treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will be reduced or end. Caregivers can learn more about adjusting to life after caregiving.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from uterine cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Heart health is particularly important for uterine cancer survivors. It’s important to have regular physical activity to help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health. Regular breast and colon cancer screenings are important. Cancer rehabilitation may be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including those in different age groups.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with your health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are encouraged to ask questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for a digital list and other interactive tools to manage your care. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask about the risk of developing uterine cancer

  • Do I have a genetic predisposition to uterine cancer?

  • Are my family members at risk of this cancer? What should I tell them? How can they be tested?

Questions to ask after getting a diagnosis

  • What type of uterine cancer do I have?

  • Can you explain my pathology report (laboratory test results) to me?

  • What is the stage of the cancer? What does this mean?

  • What is the grade of the tumor? What does this mean?

  • Has the cancer been tested for a genetic change, or mutation, such as mismatch repair defect to see if I have Lynch Syndrome?

Questions to ask about choosing a treatment and managing side effects

  • What are my options for treatment?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • Is hormone therapy a treatment option for this type and stage of uterine cancer?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of each treatment, both in the short-term and the long-term?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • Will this treatment affect my ability to become pregnant? Should I talk with a fertility specialist before treatment begins?

  • Could this treatment affect my sex life? If so, how and for how long?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • What type of surgery will I have?

  • Will lymph nodes be removed? If so, what is the risk of lymphedema?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this surgery?

Questions to ask about having radiation therapy or systemic therapy using medication

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers some more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Uterine Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 01/2019

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Uterine Cancer. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the woman diagnosed and her family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Uterine Cancer. Use the menu to choose a different section to read in this guide.