Uterine Cancer

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with uterine cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with this cancer and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with uterine cancer?

In 2023, an estimated 66,200 people 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. Worldwide, an estimated 417,367 people were diagnosed with uterine cancer in 2020.

More than 90% of uterine cancers occur in the endometrium. The number of people diagnosed with uterine cancer in the United States is rising by nearly 2% each year in women 49 and under and by 1% each year in older women. The average age of diagnosis for uterine cancer is 60. It is uncommon in people younger than 45.

An estimated 69% of people with uterine cancer are diagnosed at an early stage. This is largely due to the presence of abnormal vaginal bleeding as an early symptom, particularly when it occurs after menopause. Anyone with vaginal bleeding after menopause should tell their doctor.

It is estimated that 13,030 deaths from this disease will occur in the United States in 2023. It is the sixth most common cause of cancer death among women in the United States. Uterine cancer is more common in Black women than White women, and Black women are more likely to die from the disease. From 2016 to 2020, deaths from uterine cancer increased by close to 1% each year. In 2020, an estimated 97,370 people worldwide died from uterine cancer.

What is the survival rate for uterine cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from uterine cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with uterine cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with uterine cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 5-year relative survival rate for uterine cancer in the United States is 81%. The 5-year relative survival rates for White and Black women with the disease are 84% and 64%, respectively. Black women are more likely to be diagnosed with more aggressive endometrial cancers with lower survival rates. Learn more about health disparities and cancer.

The relative survival rates for uterine cancer also vary based on several other factors. These include the stage and grade of cancer, a person’s age and general health, and how well the treatment plan works.

When uterine cancer is diagnosed, if it is still located only in the area where it started, it is called “localized,” and the 5-year relative survival rate is 95%. If the cancer has spread regionally, the 5-year relative survival rate is 70%. If the uterine cancer is diagnosed after the cancer has spread into other areas of the body, the 5-year relative survival rate is 18%. Approximately 44% of Black women are diagnosed with regional, distant, or unstaged uterine cancer, compared with 29% of White women. Unstaged means there is not enough information available to determine the stage of disease. The survival rate for Black women is lower at all stages of the disease.

Today in the United States, there are over 600,000 uterine cancer survivors.

Experts measure relative survival rate statistics for uterine cancer every 5 years. This means the estimate may not reflect the results of advancements in how uterine cancer is diagnosed or treated from the last 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 2023, the ACS website, and the International Agency for Research on Cancer website. (All sources accessed March 2023.)

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.

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.

What are the risk factors for uterine cancer?

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 that may help you minimize your cancer risk.

The following factors may raise the risk of developing uterine cancer:

• Age. Uterine cancer most often occurs after age 50. The average age at diagnosis is 60. Uterine cancer is uncommon before age 45.

• Obesity. Fatty tissue in people 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. Learn more about body weight and cancer risk .

• Race. 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 more aggressive tumors.

• Genetics. Uterine cancer may run in families where colon cancer is hereditary. As explained in the Introduction , people 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 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 and genetic testing in separate sections of this website.

• Type 2 diabetes. A person may have an increased risk of uterine cancer if they have type 2 diabetes, which is often associated with obesity (see above).

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

• Tamoxifen. People taking the drug tamoxifen (Nolvadex) to reduce the risk of developing breast cancer or a breast cancer recurrence have an increased risk of developing uterine cancer. The benefits of tamoxifen usually outweigh the risk of developing uterine cancer, but anyone who is prescribed tamoxifen should talk with their doctor about their personal benefits and risks.

• Radiation therapy. Previous radiation therapy for another cancer in the pelvic area, which is the lower part of the abdomen between the hip bones, increases the risk of uterine cancer.

• Diet/nutrition. Eating foods high in animal fat may bring 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:

  • Starting their menstrual periods before age 12 and/or going through menopause later in life. Learn more about menopause and cancer risk .

  • Taking hormone replacement therapy (HRT) after menopause , especially if they are taking estrogen alone. The risk is lower when estrogen is taken with progesterone, which is another sex hormone.

  • Never having been pregnant.

• Hair straightening products. People who have used hair straightening products , also called relaxers, may be at increased risk for developing uterine cancer. Research has shown this risk may be higher for people who use these products frequently.

Are there ways to prevent uterine cancer?

Different factors contribute to different types of cancer. Researchers continue to investigate what factors cause uterine 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. This 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, which is associated with an increased risk. Using a combination of estrogen and progesterone for HRT may help lower risk. However, combined HRT is associated with breast cancer risk.

• Maintaining a healthy weight, ideally a BMI less than 25.

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

Learn more about cancer prevention and healthy living.

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

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 the cancer has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only way to make a definite diagnosis, even if other tests can suggest that cancer is present. During 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.

How uterine cancer is diagnosed

There are different tests used for diagnosing uterine cancer. Not all tests described here will be used for every person. 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 screen 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. A pathologist analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells and tissue samples 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 vagina to reach the uterus through the cervix, and the tissue is removed with suction. This process takes a few minutes. Afterward, you 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. Patients who have abnormal vaginal bleeding before the test may still need a dilation and 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. The patient 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, flexible tube with a light on it through the cervix into the vagina and uterus. After endometrial tissue has been removed, during a biopsy or D&C, the sample is checked by a pathologist for cancer cells, endometrial hyperplasia, and other conditions.

• Transvaginal ultrasound. An ultrasound creates a picture of the internal organs using sound waves. 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 is most commonly injected into a patient’s vein, but it can also be given as a pill or liquid to swallow.

• Magnetic resonance imaging (MRI). An MRI produces detailed images of the inside of the body using magnetic fields, not x-rays. MRI can be used to measure the tumor’s size. Like with a CT scan, a special dye called a contrast medium can be given intravenously or orally before the scan to create a clearer picture. MRI is very useful for getting detailed images if the treatment plan will include hormone management (see Types of Treatment ). MRI is often used to see how far low-grade uterine cancer (see Stages and Grades ) has grown into the wall of the uterus.

• Biomarker testing of the tumor. Your doctor may recommend running laboratory tests on a tumor sample to identify specific genes, proteins, and other factors unique to the tumor. This may also be called molecular testing of the tumor. Results of these tests can help determine your treatment options .

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.

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, also known as therapies, that are the standard of care for uterine cancer. “Standard of care” means the best treatments known. Information in this section is based on medical standards of care for uterine cancer in the United States. Treatment options can vary from one place to another.

Clinical trials may also be an option for you, which is something you can discuss with your doctor. A clinical trial is a research study that tests a new approach to treatment. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How uterine cancer is treated

In cancer care, different types of doctors who specialize in cancer, called oncologists, often work together to create a patient’s overall treatment plan. This is called a multidisciplinary team. Your cancer care team should include a gynecologic oncologist, which is a doctor who specializes in the cancers of the female reproductive system, and may include other types of oncologists, such as a radiation oncologist. In addition to physicians, cancer care teams often include other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, occupational therapists, and others. Learn more about the clinicians who provide cancer care.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, your overall health, your age, and your personal preferences. This includes 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, and/or cancer medications. Combinations of these cancer 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 conversations 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 important for uterine cancer because there are different treatment options. Learn more about making treatment decisions .

The common types of treatments used for uterine cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

READ MORE BELOW:

• Concerns about sexual health and having children

• Surgery

• Radiation therapy

• Chemotherapy

• Hormone therapy

• Targeted therapy

• Immunotherapy

• Physical, emotional, social, and financial effects of cancer

• Metastatic uterine cancer

• Remission and the chance of recurrence

• If treatment does not work

Concerns about sexual health and having children

Patients may have concerns about if or how their uterine cancer treatment may affect their sexual health and fertility . These topics should be discussed with the health care team before treatment begins. Premenopausal patients 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. There may also be charitable funds available to provide assistance with these costs.

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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 surgical 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 either 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 female reproductive system. In robotic-assisted surgery, a camera and instruments are inserted through small, keyhole-sized incisions. The surgeon directs the robotic instruments to remove the uterus, cervix, and surrounding tissue. If the patient has no cancer remaining in the tissue removed during a hysterectomy, additional treatment may not be needed. However, regular screening and testing to check for a return of the cancer is recommended.

• 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.

Talk with your doctor about the risks and benefits of the different surgical approaches and which approach might be best for you.

Side effects of surgery

After surgery, the most common short-term side effects include pain and tiredness. If a patient is experiencing pain, their 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. After surgery, the patient'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 patient 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, the patient is likely to experience menopausal symptoms, including hot flashes and vaginal dryness. Talk with your doctor about ways to relieve and manage these menopausal symptoms .

If a lymphadenectomy is done, some people may experience swelling in their legs , which is a side effect called lymphedema. Lymphedema can also be a long-term side effect of the procedure.

After a hysterectomy, pregnancy is no longer possible. For this reason, premenopausal patients 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 can provide information to help you make an informed decision.

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

The treatment options after surgery for endometrial cancer depend on the stage and grade of the cancer. For people who have had surgery and have grade 1 or 2 cancer that either has not spread to the myometrium or more than halfway through the myometrium, additional treatment may be avoided.

When considering your options for treatment after surgery, talk with your doctor about how each treatment will affect you. It’s important to weigh the benefits of treatment to possibly keep the cancer from returning with the risks of the treatment. The risks of treatment may include the short- and long-term side effects and a possible decrease in your quality of life. What you consider a decrease in quality of life is very personal. This is why it is important to talk with your doctor about possible side effects, how long they will last, and how they might affect you now and in the future. Learn more about the general side effects of surgery .

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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 of time.

Radiation therapy can be delivered externally or internally. External-beam radiation therapy uses a machine outside the body to deliver radiation to the pelvic region or the area designated by your radiation oncologist. Radiation can also be delivered internally. This form of radiation is called brachytherapy. External-beam radiation therapy can be given alone or in combination with brachytherapy. For some people, brachytherapy alone will be recommended. The most common type of radiation treatment is external-beam radiation therapy.

Some people 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 person 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. A number of factors play into decisions about what type of radiation is best, but some patients with low-risk disease may be able to undergo vaginal brachytherapy instead of radiation to the pelvis.

For some patients, radiation therapy to the pelvis may be the best option to help prevent a return of the cancer. These patients include those with a grade 3 cancer that has spread through half or more of the myometrium; those with a cancer of any grade that has spread to tissue in the cervix; and those with a cancer that has spread outside the uterus to nearby tissue or organs. In these situations, the patient may need only radiation therapy after surgery, only chemotherapy, or a combination of radiation therapy and chemotherapy. Your doctor will be able to advise you on what treatment options are right for you.

Radiation therapy to the pelvis may also be considered for some people with grade 1 or 2 cancer that has spread through half or more of the thickness of the myometrium, depending on factors such as age and whether the cancer has spread to blood or lymphatic vessels.

Side effects from radiation therapy will depend on the extent of radiation therapy given and may include fatigue, skin reactions, changes in urinary frequency, 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.

Researchers are always looking for new ways to improve radiation therapy to reduce its side effects and improve its effectiveness.

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, independent website).

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Therapies using medication

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy.

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. It may also be prescribed by a gynecologic medical oncologist, a doctor who specializes in treating cancers of the female reproductive system with medication.

Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications to take at home, be sure to ask your health care team about how to safely store and handle them.

The types of medications 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 medication at a time or a combination of medications 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, causing unwanted side effects or reduced effectiveness. 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. Chemotherapy is also considered if the endometrial cancer returns after the initial treatment, called a recurrence (see below).

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. 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. There have also been advances in chemotherapy during the last 10 years that 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 and reduce the risk of infection.

Other potential side effects of chemotherapy for uterine cancer include the inability to become pregnant in the future (infertility) 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 .

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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 adenocarcinoma and are grade 1 or 2.

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 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 person's body by stopping tissues and organs other than the ovaries from producing it. Hormone therapy may also be used for people who cannot have surgery or radiation therapy, or it can be used in combination with other types of treatment. Learn more about the basics of hormone therapy .

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.

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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 and limits 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, in some instances, as part of standard-of-care treatment plans. Targeted therapy for uterine cancer 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 that may be 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.

• 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.

Different targeted therapies have different side effects. Talk with your doctor about these possible side effects and how they can be managed.

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Immunotherapy

Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system’s ability to attack cancer cells.

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), a targeted therapy drug, and pembrolizumab is also 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. Lenvatinib may cause high blood pressure, among other side effects, and requires close monitoring to reduce and manage side effects.

In 2021, the FDA approved the immunotherapy drug dostarlimab (Jemperli) to treat recurrent or advanced endometrial cancer with dMMR that has progressed either while on or after completing platinum-containing chemotherapy. In 2023, the FDA also approved the use of dostarlimab to treat people with recurrent or advanced endometrial cancer that is dMMR or MSI-high in combination with carboplatin and paclitaxel. Dostarlimab is given by vein every 3 weeks. Its most common side effects are fatigue, nausea, diarrhea, and constipation.

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

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Physical, emotional, social, and financial effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional and social effects. Managing all of these effects is called palliative and supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer. Cancer treatment can also have financial side effects . You can bring financial concerns up with your multidisciplinary team, which may have social workers or financial counselors available to help.

Palliative and supportive 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 and supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that 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, such as chemotherapy, surgery, or radiation therapy, to improve symptoms.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative and supportive care options. Many patients also benefit from talking with a social worker and participating in support groups. Ask your doctor about these resources, too.

Cancer care is often expensive, and navigating health insurance can be difficult. Ask your doctor or another member of your health care team about talking with a financial navigator or counselor who may be able to help with your financial concerns .

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 and supportive care in a separate section of this website.

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Metastatic uterine cancer

If cancer spreads to a part of the body that is different from where it started, doctors call it metastatic cancer or stage IV 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 and/or targeted therapy. People with stage IV uterine cancer have many standard-of-care treatment options. They are also encouraged to consider participating in clinical trials . Palliative and supportive care will also be important to help relieve symptoms and side effects.

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

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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.

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). 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 .

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

If a recurrence happens, a new cycle of testing will begin 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. Your doctor may suggest clinical trials that are studying new ways to treat recurrent uterine cancer. Whichever treatment plan you choose, palliative and supportive care will be important for relieving symptoms and side effects.

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

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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 some 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.

Planning for your future care and putting your wishes in writing is important, especially at this stage of disease. Then, your health care team and loved ones will know what you want, even if you are unable to make these decisions. Learn more about putting your health care wishes in writing.

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 your doctor or a member of your palliative 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 .

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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.

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. A major 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 determine whether your treatment options include a type of treatment called targeted therapy (see Types of Treatment ), which may be available in clinical trials. Many targeted treatments are being studied for the treatment of uterine cancer, including ridaforolimus and temsirolimus.

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

• Immunotherapy. Other research includes immunotherapy (see Types of Treatment ), 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 many ongoing clinical trials examining different drugs and various combinations in uterine cancer.

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

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

Looking for More About the Latest Research?

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

• To find clinical trials specific to your diagnosis, talk with your doctor or search online clinical trial databases .

• Visit the Cancer.Net Blog to review news and information about uterine cancer, including research announced at recent scientific meetings or in the American Society of Clinical Oncology's (ASCO’s) peer-reviewed journals.

• Get updates from Cancer.Net delivered right to your inbox. Subscribe to the Inside Cancer.Net email newsletter.

• Visit the website of Conquer Cancer, the ASCO Foundation , to find out how to help support cancer research. Please note that this link takes you to a different ASCO website.

The next section in this guide is Coping with Treatment . It offers guidance on 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.

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 for uterine cancer 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.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, pelvic floor 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 as possible. Learn more about cancer rehabilitation.

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 first diagnosed and the types of treatment given.

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

Managing long-term and late side effects

Most people expect to have 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 after treatment has ended. 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 your diagnosis, 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. The American Society of Clinical Oncology (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 primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, treatments received, 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 them 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.

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?

• Are there any risk factors for uterine cancer I can control?

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 types of research are being done for uterine cancer in clinical trials? Do clinical trials offer additional treatment options for me?

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

• What treatment plan do you recommend? Why? Are there other treatment plans or approaches to consider?

• 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?

• Could this treatment cause early menopause?

• 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?

• Will I have a sentinel lymph node biopsy or more extensive lymph node removal? How will you decide what needs to be removed?

• 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 or late effects of having this surgery?

• What can be done to prevent or relieve the side effects?

Questions to ask about having radiation therapy

• What type of treatment is recommended?

• What is the goal of this treatment?

• How long will it take to give this treatment?

• Will I receive this treatment at a hospital or clinic? Or will I take it at home?

• Will I receive external radiation or internal radiation (brachytherapy)?

• 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 or late effects of having this treatment?

• What can be done to prevent or relieve the side effects?

Questions to ask about systemic therapy using medication, such as chemotherapy, immunotherapy, targeted therapy, or hormone therapy

• What type of treatment is recommended? Which drug(s) will be used?

• What is the goal of this treatment?

• How long will it take to give this treatment?

• Will I receive this treatment at a hospital or clinic? Or will I take it at home?

• 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 or late effects of having this treatment?

• What can be done to prevent or 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 those tests be needed?

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

• When should I return to my primary care doctor for regular medical care?

• 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 more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.