Comprehensive evaluation, staging and personalised treatment planning for endometrial cancer, based on the cancer type, grade, stage, pathology, molecular characteristics, overall health and individual treatment goals.
Endometrial cancer develops in the endometrium, the inner lining of the uterus. It is different from uterine sarcoma, which develops from the muscle or supporting tissues of the uterus.
Endometrial cancer includes several tumour types with different biological and pathological characteristics. The most common type is endometrioid adenocarcinoma, while other types include serous, clear cell and carcinosarcoma.
Treatment is not determined by the cancer name alone. Doctors consider the tumour's histology and grade, how far it has spread, lymph-node involvement, molecular or genetic findings and the person's overall health when developing a treatment plan.
For some people with early-stage disease, surgery may be the main treatment. Depending on the risk of recurrence and other findings, radiation therapy, chemotherapy, hormone therapy, immunotherapy or targeted treatment may also be considered.
Two people with endometrial cancer can have different treatment plans because their tumour type, grade, stage, molecular features, health and treatment goals may be different.
Pathology helps identify the type and grade of endometrial cancer. These findings contribute to risk assessment and treatment planning.
The most common histological type of endometrial cancer. Its treatment depends on factors such as grade, stage and other pathological or molecular findings.
A less common subtype that can behave differently from endometrioid tumours and may require a different treatment approach based on stage and risk features.
A less common histological subtype. Treatment planning takes into account its pathology, stage and other high-risk features.
A rare aggressive uterine tumour with both carcinomatous and sarcomatous components. Management is individualised according to stage and pathology.
Molecular classification can provide additional information about tumour biology and may contribute to modern risk assessment and treatment decisions.
Cancer that returns after treatment requires reassessment of the recurrence site, previous treatments, pathology and molecular features before further treatment is selected.
A treatment plan is developed after bringing together information from pathology, imaging, staging and the patient's overall health and priorities.
Endometrial cancer treatment may involve more than one specialist. Coordinated care can help bring together surgical, systemic and radiation treatment considerations when required.
Evaluates whether surgery is appropriate, the extent of surgery required and how the procedure fits into the overall treatment plan.
Assesses the role of chemotherapy, hormone therapy, immunotherapy, targeted treatment and systemic treatment when indicated.
Evaluates whether external-beam radiation or brachytherapy may have a role based on stage, pathology and recurrence risk.
A detailed review of pathology, imaging and clinical findings can help your oncology team understand the disease and discuss appropriate treatment options with you.
Book an Oncology ConsultationAbnormal vaginal bleeding is the most important warning sign of endometrial cancer. Symptoms can occur early, but they can also be caused by conditions other than cancer. Persistent or unusual symptoms should be medically evaluated rather than self-diagnosed.
Bleeding after menopause, bleeding between periods, or menstrual bleeding that is unusually heavy or different from your normal pattern should be discussed with a doctor. Abnormal bleeding does not automatically mean cancer, but it should not be ignored.
Any vaginal bleeding after menopause should be evaluated, including spotting or light bleeding.
Menstrual bleeding that becomes heavier, lasts longer or changes noticeably from your usual pattern may require evaluation.
Unexpected bleeding or spotting between menstrual periods can have many causes and should be assessed when persistent or unexplained.
Watery, blood-stained or otherwise unusual vaginal discharge can occur and should be discussed with a healthcare professional.
Some people may experience discomfort, pain or pressure in the pelvis, particularly as disease progresses.
Advanced disease may sometimes cause symptoms such as abdominal discomfort, urinary or bowel symptoms, fatigue or unexplained weight changes.
Many causes of abnormal bleeding are not cancer. However, timely evaluation can help identify the cause and, when cancer is present, support earlier diagnosis and treatment planning.
Several factors can increase the likelihood of developing endometrial cancer. Having one or more risk factors does not mean that a person will develop cancer, and endometrial cancer can also occur in people without obvious risk factors.
Risk generally increases with age, and most endometrial cancers are diagnosed around or after menopause.
Excess body weight and adult weight gain are associated with an increased risk of endometrial cancer, partly through hormonal and metabolic effects.
Endometrial hyperplasia causes abnormal thickening of the uterine lining. Some forms can increase the risk of developing endometrial cancer.
PCOS can be associated with irregular ovulation and prolonged exposure to oestrogen, which may increase endometrial cancer risk.
Oestrogen-only hormone therapy after menopause can increase endometrial cancer risk in people who still have a uterus.
Tamoxifen, which is used for some breast cancer treatments and risk-reduction settings, is associated with an increased risk of endometrial cancer.
Early menstruation, later menopause and never having been pregnant are associated with longer lifetime exposure to oestrogen and increased risk.
A close family history of endometrial cancer, and in some families colorectal or ovarian cancer, may indicate increased inherited risk.
Lynch syndrome is an inherited condition associated with an increased risk of several cancers, including endometrial and colorectal cancers. A personal or family history suggestive of an inherited cancer syndrome may lead doctors to consider genetic counselling and appropriate testing.
Risk factors help doctors understand who may have a higher likelihood of developing endometrial cancer. They do not establish a diagnosis. Diagnosis requires appropriate clinical assessment and, when indicated, diagnostic testing.
There is currently no standard or routine screening test for endometrial cancer in people who have no symptoms. A Pap test is designed primarily to screen for cervical cancer and does not screen for endometrial cancer.
When symptoms such as abnormal vaginal bleeding occur, doctors may use tests such as transvaginal ultrasound and endometrial biopsy to investigate the cause. The choice of tests depends on the person's symptoms and clinical situation.
A timely clinical evaluation can help determine the cause of abnormal bleeding or pelvic symptoms and identify whether further investigation is needed.
Book an Oncology ConsultationWhen abnormal vaginal bleeding or other concerning symptoms require investigation, the diagnostic process usually combines clinical assessment, imaging and tissue examination. The exact tests depend on the person's symptoms and clinical findings.
Medical history, menstrual and menopause history, symptoms, medications and examination help determine the next steps.
Ultrasound and, when appropriate, MRI or other imaging can provide information about the uterus and possible spread of disease.
Tissue from the endometrium can be obtained and examined by a pathologist to determine whether cancer is present.
Once cancer is confirmed, additional tests help determine its extent, risk characteristics and appropriate treatment strategy.
Not every person needs every test. Your doctor selects investigations according to symptoms, examination findings, biopsy results and the suspected extent of disease.
A pelvic examination may help assess the uterus, cervix and surrounding pelvic structures and identify findings that require further investigation.
Ultrasound can assess the uterus and endometrial lining and may help identify abnormalities that require tissue sampling.
A small sample of tissue from the endometrium is examined under a microscope to look for cancer and determine its pathological characteristics.
A thin camera can be used to directly examine the inside of the uterus. A targeted biopsy may be taken when clinically indicated.
Pelvic MRI can provide detailed information about the uterus, including the depth of tumour invasion and involvement of nearby structures.
In selected situations, CT or PET-based imaging may be used to assess lymph nodes or possible disease outside the pelvis.
Imaging can show abnormalities in the uterus, but a tissue sample is generally needed to establish whether endometrial cancer is present.
During an endometrial biopsy, a small amount of tissue is obtained from the lining of the uterus and sent to a pathology laboratory. The pathologist examines the tissue under a microscope.
Depending on the clinical situation, tissue may also be obtained during hysteroscopy or another procedure.
A biopsy can help establish the diagnosis and provide important information about tumour type and grade. Additional imaging and surgical or pathological assessment may be needed to determine how far the cancer has spread.
The pathology report provides information that helps the oncology team classify the cancer and assess its risk. Important findings may include histological type, grade and other pathological features.
Modern endometrial cancer assessment increasingly incorporates molecular classification alongside histology, grade and stage. Molecular findings can contribute to prognostic risk assessment and may influence some treatment decisions.
Staging describes the extent of cancer and is an important part of treatment planning. Endometrial cancer is commonly staged using the FIGO system, together with pathological and, increasingly, molecular information.
Cancer is confined to the uterus, with the precise stage depending on the extent of uterine involvement and other pathological features.
Cancer has extended beyond the body of the uterus to involve the cervix or other structures defined within the staging system.
Cancer has spread to nearby pelvic or regional structures or lymph nodes, depending on the specific stage category.
Cancer has spread to the bladder or bowel mucosa or to distant organs, depending on the specific stage classification.
Reviewing the biopsy, pathology, imaging and molecular findings together can help your oncology team understand the disease and develop an appropriate treatment plan.
Book an Oncology ConsultationTreatment is selected according to the extent and biology of the cancer. Depending on the situation, treatment may involve surgery, radiation therapy, chemotherapy, hormone therapy, immunotherapy, targeted treatment or a combination of these approaches.
Surgery is the main treatment for many people with endometrial cancer that is confined to the uterus or otherwise considered operable. The procedure may include removal of the uterus, fallopian tubes and ovaries, with lymph-node assessment when appropriate.
Radiation may be recommended after surgery for selected patients to reduce the risk of recurrence, or may be used as part of treatment when surgery is not appropriate.
Chemotherapy uses anti-cancer medicines that circulate through the body. It may be considered for higher-risk, advanced or recurrent disease and in selected patients after surgery.
Hormonal treatment may be considered for selected hormone receptor-positive tumours, particularly in certain advanced, recurrent or fertility-preservation situations.
Immunotherapy helps the immune system recognise and attack cancer cells. Its role depends on disease setting, previous treatment and tumour biomarkers such as mismatch-repair status.
Targeted treatments act on specific biological pathways or characteristics of cancer cells. They may be used in selected advanced or recurrent endometrial cancers.
Stage alone does not determine the complete treatment plan. Histological type, tumour grade, lymphovascular space invasion, molecular classification and other pathological findings can change the assessment of recurrence risk and the need for additional treatment.
Surgery is commonly the main treatment. Depending on the final pathology and risk group, some patients may not require additional treatment after surgery, while others may be offered vaginal brachytherapy or another form of adjuvant treatment.
Surgery may be followed by radiation therapy, chemotherapy or a combination of treatments depending on pathological and molecular risk features and the likelihood of recurrence.
Treatment often requires a multidisciplinary approach. Depending on whether the disease can be completely treated surgically, options can include surgery followed by systemic treatment and/or radiation, or non-surgical treatment approaches.
Treatment is individualised according to where the cancer has spread, symptoms, previous treatments, tumour biology and overall health. Systemic treatment, radiation, surgery in selected situations and clinical trials may all have a role.
Surgery may remove all visible cancer, but some patients have pathological or molecular features associated with a higher risk of recurrence. In these situations, additional treatment — called adjuvant therapy — may be recommended to reduce that risk. The decision depends on the individual's risk group rather than simply the fact that surgery was performed.
Systemic treatments travel through the bloodstream and can act on cancer cells throughout the body. They are particularly important when disease has a higher risk of recurrence, has spread beyond the uterus or has returned after earlier treatment.
Platinum-based chemotherapy combinations are commonly used in advanced or higher-risk disease. The exact regimen and number of cycles depend on the clinical situation.
Selected endometrial cancers that express hormone receptors may respond to hormonal approaches. These may be considered in selected recurrent, advanced or fertility-preservation settings.
Immune checkpoint inhibitors are used in selected advanced or recurrent settings, with tumour biomarkers and previous treatment helping guide treatment selection.
Targeted medicines may be considered when the tumour's biological characteristics and clinical setting make them appropriate.
In some advanced settings, systemic therapies may be combined with immunotherapy or other treatments according to current evidence and the individual's tumour profile.
Clinical trials may provide access to investigational treatments or new treatment combinations, particularly when standard treatment options are limited.
When endometrial cancer has returned or spread to other parts of the body, treatment is guided by the location and extent of disease, previous treatment, molecular characteristics and the person's overall health.
Doctors may review previous pathology and imaging and may recommend additional testing when necessary. In selected situations, a new biopsy can provide information about the recurrent tumour and its current biological characteristics.
The treatment plan is then developed around the current disease rather than simply repeating the original treatment.
Depending on the circumstances, treatment may include systemic therapy, radiation therapy, surgery for selected patients, supportive treatment or participation in a clinical trial.
Symptom control and quality of life remain important parts of care throughout treatment.
There is no single treatment plan that is appropriate for every person with endometrial cancer. Your oncology team brings together pathology, staging, molecular findings and individual health considerations before recommending treatment.
Your oncology team should explain the purpose of each recommended treatment, expected benefits, possible side effects, alternatives and the expected treatment timeline. This allows you to participate in decisions about your care with a clear understanding of the available options.
Bring your biopsy or pathology report, imaging reports and previous treatment records for a detailed oncology consultation and personalised treatment discussion.
Book an Oncology ConsultationSurgery is the most common treatment for endometrial cancer when the disease can be treated surgically. The operation is planned according to the suspected stage, tumour type, grade, molecular and pathological risk features and the patient's overall health.
Endometrial cancer surgery can provide both treatment and important information about the extent of disease. Depending on the individual case, the operation may include hysterectomy, removal of both fallopian tubes and ovaries, sentinel lymph-node mapping or other staging procedures.
Removal of the uterus and cervix is the standard surgical procedure for many patients with endometrial cancer.
Removal of both fallopian tubes and ovaries, known as bilateral salpingo-oophorectomy, is commonly performed as part of surgery, although selected younger patients may require individualised discussion about ovarian preservation.
Depending on tumour risk and stage, lymph nodes may be assessed using sentinel lymph-node mapping or lymph-node dissection.
In selected high-risk histological subtypes, the surgeon may assess or remove part of the omentum or examine the abdominal cavity as part of staging.
More extensive surgery may be considered in selected situations, such as certain cancers involving the cervix or surrounding tissues.
The tissues removed during surgery are examined by a pathologist. The findings help determine the final stage, risk group and need for additional treatment.
A total hysterectomy removes the uterus and cervix. For many patients with endometrial cancer, it forms the central part of the surgical treatment.
The uterus and cervix can be removed through different surgical approaches depending on the patient's anatomy, disease characteristics, surgeon expertise and clinical circumstances.
The final surgical plan is individualised rather than determined by the cancer diagnosis alone.
Lymph-node assessment helps determine whether cancer has spread beyond the uterus. The extent of lymph-node surgery is tailored to the patient's risk of nodal disease.
Sentinel lymph-node mapping identifies the first lymph nodes likely to receive drainage from the tumour. These nodes can be removed and examined for cancer cells.
In selected higher-risk situations, more extensive pelvic and/or para-aortic lymph-node assessment may be considered according to stage, pathology and surgical findings.
Finding cancer in lymph nodes can change the final stage and may influence recommendations for chemotherapy, radiation or other additional treatment.
Current evidence supports sentinel lymph-node biopsy as an important staging approach in many patients with presumed early endometrial cancer. Compared with more extensive lymph-node dissection, it can reduce complications such as lower-limb lymphoedema in appropriately selected patients.
The surgical approach is selected according to the patient's condition, tumour characteristics and the surgeon's assessment. Minimally invasive surgery is commonly used for appropriate early-stage cases and may allow faster recovery than open surgery.
Surgery is performed through several small abdominal incisions using a camera and specialised instruments. It may offer smaller incisions and faster recovery in appropriate patients.
Robotic-assisted minimally invasive surgery may be an option at centres with appropriate expertise. Suitability depends on the individual patient's anatomy and disease characteristics.
An abdominal incision may be required when minimally invasive surgery is not appropriate or when the extent of disease or surgical requirements make an open approach preferable.
Standard surgery for endometrial cancer removes the uterus and therefore prevents future pregnancy. In carefully selected younger patients who strongly wish to preserve fertility, non-surgical fertility-sparing treatment may sometimes be considered.
Fertility preservation is generally limited to carefully selected patients with favourable tumour characteristics, such as appropriately assessed early-stage, low-grade endometrioid disease without evidence of myometrial or extrauterine spread.
Progestin-based treatment may be used in selected cases, with regular clinical assessment and repeat endometrial sampling to determine whether the cancer is responding.
Fertility-sparing treatment requires coordinated care between oncology and fertility specialists. Pregnancy is generally considered after an appropriate response has been documented.
Fertility-sparing treatment is not appropriate for everyone. Definitive surgery may be recommended if the disease does not respond, progresses or when childbearing is complete.
Recovery varies according to the type of operation, surgical approach, overall health and whether additional procedures were performed.
The extent of surgery should be based on the cancer's pathology, suspected stage, molecular and risk features, and the patient's overall health. Lymph-node staging and additional procedures are not automatically identical for every patient.
A surgical oncology consultation can help you understand the proposed operation, lymph-node assessment, minimally invasive options, fertility considerations and possible next steps after surgery.
Book an Oncology ConsultationRadiation therapy uses high-energy radiation to destroy cancer cells or prevent them from growing. It may be recommended after surgery, used as part of treatment when surgery is not suitable, or used to control symptoms in selected recurrent or advanced disease.
External beam radiation directs radiation from a machine outside the body towards the treatment area. It may be used for selected patients with higher-risk or locally advanced disease.
Brachytherapy places a radiation source close to the area at risk, usually within the vagina. It can be used after surgery in selected patients to reduce the risk of local recurrence.
Radiation may also be used to treat selected local or regional recurrences or to relieve symptoms such as bleeding or pain.
Chemotherapy may be recommended for selected high-risk cancers, advanced disease or recurrent endometrial cancer. It may also be combined with other treatments depending on the stage and risk profile.
A commonly used chemotherapy backbone in advanced endometrial cancer is a platinum and taxane combination, such as carboplatin with paclitaxel. The exact regimen and treatment schedule are determined by the oncology team.
Chemotherapy may be given before or after surgery in selected situations, or as part of treatment when surgery is not feasible.
Chemotherapy uses medicines that travel through the bloodstream and can act on cancer cells throughout the body. Because some healthy cells are also affected, treatment can cause side effects, which are monitored and managed by the oncology team.
Some endometrial cancers use hormones such as oestrogen or progesterone to support their growth. When tumour cells express hormone receptors, hormonal treatment may be considered in selected clinical situations.
Progestins such as megestrol acetate or medroxyprogesterone may be used in selected advanced, recurrent or fertility-preservation settings.
Medicines that reduce oestrogen production may be considered for selected hormone-sensitive advanced or recurrent tumours.
Hormonal treatment can form part of carefully selected fertility-sparing management, with close monitoring and repeated assessment of the endometrium.
Immunotherapy uses medicines that help the immune system recognise and attack cancer cells. Its role has expanded particularly in advanced and recurrent endometrial cancer, and tumour mismatch-repair status is an important factor in treatment selection.
Tumours with mismatch-repair deficiency or microsatellite instability may be particularly responsive to immune checkpoint inhibitors.
In selected advanced or recurrent settings, an immune checkpoint inhibitor may be combined with chemotherapy and continued as maintenance according to the treatment strategy.
The choice of immunotherapy depends on whether the person has previously received chemotherapy or an immune checkpoint inhibitor and on the current disease setting.
Targeted treatments act on specific biological pathways or tumour characteristics. They are generally considered in selected advanced or recurrent cancers rather than being required for every patient.
Lenvatinib targets pathways involved in tumour growth and blood vessel formation. It may be combined with pembrolizumab in selected advanced endometrial cancers, particularly when other treatment criteria are met.
Bevacizumab targets vascular endothelial growth factor (VEGF) and may be considered in selected advanced or recurrent situations.
HER2 testing may be relevant in selected high-grade endometrial cancers. When HER2 is strongly overexpressed, HER2-directed treatment may be considered in appropriate clinical settings.
Molecular information is increasingly important when selecting systemic treatment for advanced or recurrent endometrial cancer.
Side effects vary according to the treatment, dose, combination of therapies and individual health. Your oncology team should discuss expected effects and explain when to report new symptoms.
Managing pain, nausea, fatigue, nutrition, emotional wellbeing, menopausal symptoms and other treatment effects is an important part of comprehensive cancer care. Supportive care can be provided alongside cancer-directed treatment.
Your pathology, stage, molecular findings and previous treatments can help determine whether radiation, chemotherapy, hormone therapy, immunotherapy or targeted treatment may have a role in your care.
Book an Oncology ConsultationTreatment usually progresses through several stages, from confirming the diagnosis and understanding the tumour biology to choosing treatment, monitoring response and planning long-term follow-up. The sequence varies according to each person's disease and treatment needs.
Symptoms, examination, imaging and endometrial tissue sampling establish the diagnosis.
Pathology, imaging, stage and molecular findings help define the disease and recurrence risk.
The oncology team discusses surgery, radiation and/or systemic treatment according to the clinical situation.
Treatment is delivered according to the agreed plan, with monitoring for response and side effects.
Follow-up addresses recurrence surveillance, late effects, wellbeing and ongoing health needs.
Endometrial cancer may require input from different oncology specialists. Bringing surgical, medical and radiation oncology perspectives together can help coordinate treatment when more than one modality is required.
Surgical assessment, operative planning, staging procedures and evaluation of whether surgery is appropriate for the individual disease.
View Doctor Profile →Evaluation of systemic treatment options including chemotherapy, hormone therapy, immunotherapy and selected targeted treatments.
View Doctor Profile →Assessment of the role of external-beam radiation and brachytherapy based on stage, pathology and recurrence risk.
View Doctor Profile →Personalised treatment does not mean choosing a different treatment simply because every patient is different. It means using the patient's specific clinical, pathological and molecular information to determine which evidence-based options are appropriate.
The microscopic type of endometrial cancer can affect recurrence risk and treatment planning.
Grade, myometrial invasion, lymphovascular space invasion and other pathological findings contribute to risk assessment.
POLE, MMR/MSI and p53-related findings can contribute to modern classification and treatment decisions.
The extent of disease determines whether treatment is primarily surgical, local, systemic or multimodal.
Prior surgery, radiation, chemotherapy, immunotherapy or other treatments are particularly important when disease recurs.
Other medical conditions, functional status, quality-of-life priorities and individual goals are considered in treatment discussions.
A second oncology opinion can be useful when you want another specialist to review your diagnosis, pathology, stage and proposed treatment options.
It does not necessarily mean that the first treatment recommendation is incorrect. The purpose is to help you understand the available evidence-based options and make an informed decision.
You may wish to seek another opinion when the diagnosis is complex, treatment involves several modalities, fertility preservation is being considered, the disease has recurred, or you are unsure about the proposed treatment sequence.
Reviewing the original pathology and imaging is important when seeking another opinion.
Having your previous medical records available can help the oncology team understand your diagnosis and avoid unnecessary repetition of investigations.
Follow-up is an important part of cancer care after treatment. The schedule and investigations should be individualised according to the original disease, treatment received, recurrence risk, other health conditions and patient needs.
Your doctor will explain symptoms and clinical changes that should be reported between scheduled appointments.
Follow-up can identify physical, hormonal, bowel, bladder, sexual or other effects that may persist after treatment.
Follow-up can also address general health, cardiovascular risk, lifestyle, emotional wellbeing and other survivorship needs.
Maintain a treatment summary, pathology reports, imaging and medication information for future healthcare visits.
New symptoms do not automatically mean that cancer has returned. However, unexplained vaginal bleeding, pelvic pain, persistent abdominal symptoms, unexplained weight changes or other new persistent symptoms should be discussed with your healthcare team rather than waiting for the next routine appointment.
Bring your pathology, imaging and previous treatment records for a detailed consultation. Your oncology team can review the diagnosis, stage, risk factors and available treatment options with you.
Book an Oncology ConsultationHere are answers to common questions about endometrial cancer symptoms, diagnosis, staging, surgery and treatment. Individual treatment recommendations depend on the patient's pathology, stage, molecular findings, overall health and treatment goals.
Endometrial cancer is a cancer that begins in the endometrium, the inner lining of the uterus. It is different from uterine sarcoma, which develops from the muscle or supporting tissues of the uterus.
Abnormal vaginal bleeding is the most common presenting symptom. This may include bleeding after menopause, bleeding between periods, or menstrual bleeding that is unusually heavy or different from the usual pattern.
No. Post-menopausal bleeding can have several causes and does not automatically mean cancer. However, any unexplained vaginal bleeding after menopause should be medically evaluated.
There is no standard routine screening test recommended for people without symptoms who have average risk. A Pap test is primarily a screening test for cervical cancer and does not screen for endometrial cancer.
Diagnosis may involve a clinical assessment, pelvic examination, ultrasound and endometrial tissue sampling. An endometrial biopsy or another form of tissue sampling is generally needed to establish the diagnosis.
Ultrasound can identify abnormalities of the uterus and endometrial lining, but imaging alone does not usually establish the diagnosis. Tissue examination by a pathologist is generally required to confirm endometrial cancer.
An endometrial biopsy provides tissue for microscopic examination. It can help establish whether cancer is present and provide information about the tumour's histological type and grade.
Molecular testing examines specific characteristics of the tumour. Important molecular groups include POLE-mutated, mismatch-repair deficient, p53-abnormal and no-specific-molecular- profile tumours. These findings can contribute to risk classification and treatment planning.
Endometrial cancer is commonly staged using the FIGO system. Broadly, Stage I is confined to the uterus, Stage II involves cervical stromal disease, Stage III involves specified regional spread, and Stage IV includes invasion of the bladder or bowel mucosa and/or distant or more extensive metastatic disease. Modern FIGO staging is more detailed than these broad descriptions.
Surgery is the most common treatment for endometrial cancer, particularly when the disease is localised and can be removed surgically. Depending on the stage, pathology and risk group, radiation therapy or systemic treatment may also be recommended.
A total hysterectomy with removal of both fallopian tubes and ovaries is commonly performed. Depending on the tumour's risk characteristics, lymph-node assessment or other staging procedures may also be performed.
Minimally invasive laparoscopic or robotic-assisted surgery may be appropriate for selected patients. The surgical approach depends on the disease, anatomy, overall health, surgical requirements and the treating team's assessment.
No. The need and extent of lymph-node assessment depend on the tumour's risk of nodal spread and other clinical and pathological factors. Sentinel lymph-node mapping may be used in many patients, while more extensive lymph-node assessment may be considered in selected higher-risk situations.
Fertility-sparing treatment may be considered for carefully selected younger patients with favourable tumour characteristics. It generally involves hormonal treatment and close monitoring rather than standard hysterectomy. It is not suitable for every patient and requires specialist assessment.
Radiation may be recommended after surgery for selected patients with an increased risk of local or regional recurrence. External beam radiation and vaginal brachytherapy have different roles, and radiation can also be used in selected recurrent or non-surgical situations.
Chemotherapy may be used for selected high-risk, advanced or recurrent endometrial cancers and may be combined with other treatments. The decision depends on stage, histology, molecular findings, recurrence risk and previous treatment.
Yes. Immunotherapy is used in selected advanced or recurrent endometrial cancers. Tumour characteristics such as mismatch-repair deficiency or microsatellite instability can influence whether an immunotherapy-based approach is appropriate.
Hormone therapy can be considered in selected hormone-sensitive endometrial cancers, including some advanced, recurrent or fertility-sparing situations. It is not appropriate for every type or stage of endometrial cancer.
Endometrial cancer can recur in some patients. The risk depends on factors including stage, histology, grade, molecular characteristics and other pathological findings. Follow-up helps monitor recovery and identify symptoms that may require investigation.
A second oncology opinion can be useful when you want another specialist to review your pathology, stage, molecular findings and proposed treatment options. It can help you understand the available options and their potential benefits and risks.
Bring your biopsy and pathology reports, imaging reports and scans, molecular or biomarker reports, previous treatment records, medication list, relevant medical history and family cancer history when available.
Follow-up is individualised according to the original cancer, recurrence risk, treatment received and other health needs. Your oncology team will advise you about appointments, symptoms to report and investigations when clinically indicated.
Bring your pathology, imaging and previous treatment records for a detailed consultation about diagnosis, staging and treatment options.
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