What is endometrial cancer?

Endometrial cancer is a type of cancer of the womb (uterus). It starts in the tissue lining the uterus, called the endometrium. You might hear endometrial cancer referred to as womb cancer, uterine lining cancer, or uterus cancer. 

The uterus is an organ in the female reproductive system. It’s roughly the size and shape of a pear and is where a baby develops during pregnancy. The uterus is attached to the cervix, but uterus cancer is very different to cervical cancer. 

Each year around 9,400 people in the UK are diagnosed with endometrial cancer, making it the 4th most common cancer in women. It becomes more common after age 55. Early diagnosis often improves treatment options and outcomes. 

Endometrial cancer risk factors

Risk factors increase the chances of developing endometrial cancer. Even without risk factors, you can still be affected, so never ignore symptoms. 

Factors known to increase the risk of endometrial cancer include:

• Being older – most people diagnosed with endometrial cancer have already been through the menopause 

• Being overweight or obese

• Having oestrogen-only hormone replacement therapy

• Being treated with tamoxifen for breast cancer 

• Starting periods at a young age

• Late menopause (after age 55) 

Most of the risk factors for endometrial cancer are related to having high oestrogen levels. 

Prevention of endometrial cancer

It’s not always possible to prevent endometrial cancer. But some things help lower your risk. 

1. Keeping within the recommended BMI range (19 - 24.9)

2. Regular exercise and a healthy diet – to reduce the risk of type two diabetes 

3. Taking the contraceptive pill 

Endometrial cancer early signs and symptoms

Usually, the first sign of endometrial cancer is unusual vaginal bleeding. This could be:

• Bleeding after the menopause (the most common symptom)

• Bleeding in between periods

• Heavier periods than usual

• A bloody or pink and watery vaginal discharge

 

Other endometrial cancer symptoms include: 

• Pain or discomfort in the pelvic area

• Pain during sex

• Blood in your urine with anaemia, thrombocytosis, or high blood sugar 

When to see a doctor

Types of uterine cancer

Uterine cancer is categorised depending on where in the womb it’s growing and the type of cell. The type affects the treatment and outlook of your cancer, but the symptoms are similar.  

• Carcinoma – the cancer began in the lining of the womb, which are the most common type and are called endometrial cancers

• Sarcoma – the cancer began in cells in the muscular layer instead of the lining. True sarcomas are treated differently and are not further discussed in this information

 Sometimes doctors describe endometrial cancers as type 1 or type 2:

• Type 1 endometrial cancer – the most common type, affecting the cells lining the uterus and usually growing more slowly  

• Type 2 endometrial cancer – can affect cells lining the uterus or the muscular layer of the uterus, and tends to grow quickly 

 Type 1 endometrial cancer is usually an endometrioid adenocarcinoma (low grade i.e. grade 1 or 2), which is the medical name for cancer cells affecting the womb lining. There are five different subtypes, which all tend to be diagnosed early, leading to positive outcomes.  

Type 2 includes serous carcinoma, clear cell carcinoma, grade 3 endometrioid adenocarcinoma, undifferentiated and carcinosarcoma of the womb. Serous means cells that produce serum. 

While the type 1 and 2 categories are still being used to classify the cancer type, endometrial cancer is also classed using the TCGA molecular classification. This classification groups endometrial cancers into four types based on specific genetic changes. These help guide treatment and give a better idea of how the cancer might behave.

 

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What causes endometrial cancer?

It’s not always possible to pinpoint the cause of endometrial cancer, but 1 in 3 cases are linked to being overweight or obese. This is related to oestrogen levels. 

Type 1 endometrial cancers are linked with higher levels of oestrogen. Fat cells produce small amounts of oestrogen. When you carry more fat, the higher your oestrogen levels may be. This increases the risk of type 1 endometrial cancers.  

Having a high BMI does not mean you will get endometrial cancer, and it can affect people with an in-range BMI too. 

 

 

 

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Stages of endometrial cancer

Endometrial cancer staging describes the size and spread of the cancer. This helps your doctor recommend the most appropriate treatment and understand your outlook. 

Staging of endometrial cancer can be complex. Your doctor is the best person to explain your stage and what it means for your outcomes. 

There are four main stages of endometrial cancer:

Stage 1Early stage cancer, which is only in the womb 
Stage 2The cancer has spread outside the womb to the cervix
Stage 3Also called locally advanced, where the cancer has spread within the pelvis
Stage 4Advanced or metastatic cancer, where it has spread to other parts of the body 

There is another system for endometrial cancer called Figo staging. This combines the location and tumour pattern with how aggressive the cancer is, based on the grade and other prognostic factors. 

Endometrial cancer treatment overview

There are treatments for all stages of endometrial cancer. At early stages, it’s often very treatable. 

The options for endometrial cancer therapy typically depend on the type of womb cancer you have, its size and spread, and your general health and treatment wishes.  

How is endometrial cancer treated?

The main treatment for endometrial cancer is surgery. But you may also have radiotherapy, chemotherapy, hormone therapy or immunotherapy. 

• Surgery – aims to remove all cancerous tissue with the intent to cure

• Radiotherapy – high-energy radiation beams are precisely delivered to destroy cancer cells while doing as little harm as possible to healthy cells

• Chemotherapy – anti-cancer (cytotoxic) drugs are used to destroy cancer cells

• Hormone therapy – hormones treatment may be used to affect the growth of cells in the womb lining

• Immunotherapy - helps the immune system recognise and attack cancer cells more effectively

 

Endometrial cancer treatment at GenesisCare

We’re the UK’s leading independent provider of private cancer care. By choosing us, you can be reassured that your treatment is managed by a team of specialists working together with you to design the best plan for your endometrial cancer diagnosis.

Our approach to world-class care for endometrial cancer includes:

·       A personalised plan built around you

·       Treatment starting within days if needed

·       14 outpatient cancer centres across the UK

·       State-of-the-art facilities specialising in advanced radiotherapy

·       Compassionate chemotherapy nurses available 24/7 by telephone

·       Integrative cancer care including wellbeing therapies and exercise medicine

·       Recognised by all leading private medical insurers and self-pay available 

We’re proud that so many patients rate our care as excellent as we help them through their cancer journey. Hear the unique experiences of people who have had their cancer diagnosis or treatment at GenesisCare in our patient stories section.

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Surgery at GenesisCare

Our cancer specialists work closely with top surgeons from local and nationally renowned hospitals and other gynaecological experts to design the best treatment plan for you.

If your consultant recommends surgery, this can be arranged conveniently at one of our partner hospitals. You can then continue your other treatments at GenesisCare.

Chemotherapy at GenesisCare

There are different types of systemic anti-cancer therapies for endometrial cancer, including chemotherapy and other drug treatments. Our expert teams continually review and assess new treatments to make these available to our patients as early as possible.

Depending on your treatment, you may attend one of our specialist suites, staffed by specialist nurses. The nursing team is available 24/7 on a dedicated on-call telephone service to answer questions about side effects, and symptoms, and arrange appropriate medical care during treatment, if needed. 

All GenesisCare centres have received the Macmillan Quality Environment Mark, which is awarded to cancer environments that go above and beyond to create welcoming and friendly spaces for people living with cancer.

Radiotherapy at GenesisCare

At GenesisCare, we’re the leading independent provider of radiotherapy in the UK and offer world-class expertise, state-of-the-art facilities and advanced radiotherapy techniques, overseen by teams of oncologists, radiotherapists and medical physicists

Our latest-generation radiotherapy machines deliver highly targeted radiation beams with sub-millimetre accuracy, which makes them extremely effective and minimises the radiation dose to healthy tissues.

At GenesisCare, we offer volumetric modulated arc therapy (VMAT) wherever possible, because it is widely recognised to be the highest standard of care currently available for patients needing this type of radiotherapy.

Together with surface-guided radiotherapy (SGRT), it’s possible to precisely target areas of cancer, adjusting the beam and intensity of the radiation dose, to allow for movements in the body and avoid healthy tissues, minimising side effects. 

• Other types of radiotherapy we offer for endometrial cancer include: 

Stereotactic ablative radiotherapy (SABR) uses very focused high-energy radiation beams to treat tumours in five or fewer sessions, which can also be used for retreatment 

• Internal radiotherapy (brachytherapy), where hollow tube applicators are inserted into the vagina to give radiotherapy directly to the top of the vagina. It’s usually given as an inpatient procedure at a hospital.

• Palliative VMAT radiotherapy for those living with advanced womb cancer (stage 4) to help to shrink the cancer and control symptoms. 

 

Palliative care

If your cancer has spread to other parts of the body, it may be called advanced, metastatic or stage 4 womb cancer. At GenesisCare, you can receive palliative drug treatment for advanced womb cancer to reduce the size and progress of your cancer and ease pain and other symptoms.

Personalised medicine

For some advanced cancers, we use specialist tests, such as liquid biopsy or genomic testing, to understand the genetic makeup of cancer cells. This helps us to identify which drugs are available to work against specific genetic mutations in a cancer, allowing us to start effective treatment without delay.

There may also be opportunities to access clinical trials for the newest treatments for womb cancer.

Integrative cancer care at GenesisCare

Every patient is supported through their journey with consultant-led integrative cancer care, which combines medical treatment with life-changing approaches including exercise medicine, wellbeing therapies and psychological support.

You’ll have optional access to a wellbeing expert to guide you through holistic therapies of your choice, such as counselling, acupuncture, massage and reflexology, through our unique partnership with the Penny Brohn UK charity. 

Exercise medicine includes a 12-week personalised programme provided by a specialist physiotherapist, with techniques shown to improve outcomes for cancer patients and reduce the impact of cancer by enhancing quality of life, reducing fatigue and improving strength. 

FAQs about endometrial cancer

Reviewed by:

Dr Gemma Eminowicz

Consultant Clinical Oncologist

July 2025

Dr Gemma Eminowicz

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