Stage 3 womb cancer
The stage of a cancer tells you how big the tumour is and how far it has spread. It helps your doctor decide which treatment you need.
Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system for womb cancer. There are four stages, numbered 1 to 4.
Although a 2023 version of the FIGO system is available, doctors in the UK generally use the 2021 version.
Stage 3 womb cancer means the cancer has spread outside the womb, but is still within the pelvis. Your doctor may call this locally advanced womb cancer. There are 3 categories of stage 3 womb cancer:
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3A means the cancer has grown into the outer covering of the womb (the serosa), or to the ovaries or fallopian tubes, or both
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3B means the cancer has grown into the vagina or the tissues surrounding the womb (parametrium), or both
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3C means the cancer has spread to nearby lymph nodes (pelvic lymph nodes) or to lymph nodes around a major blood vessel called the aorta, or both
Treatment
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
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the type of womb cancer you have
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how the cancer is likely to behave (the grade)
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the risk of your cancer coming back after surgery (low, intermediate, high-intermediate, high)
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whether your cancer has any gene changes (mutations)
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your general health
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your preferences
Surgery
Surgery is the main treatment for stage 3 womb cancer if you are otherwise fit and well.
Your surgeon will aim to remove all of the cancer. This usually means they will remove your:
- womb and cervix (simple or total hysterectomy)
- both ovaries and fallopian tubes
They may also remove
- the top of your vagina and some of the surrounding tissue
- lymph nodes in your pelvis
This is called a radical hysterectomy.
The surgeon who does the surgery is a specialist in this type of surgery called a gynaecological oncologist.
If you can't have surgery
Some people might not be able to have surgery for stage 3 womb cancer. This might be because:
- you are not fit enough for surgery
- your cancer is too difficult to remove completely
- you have chosen not to have surgery
You might be able to have other treatments. The type of treatment will depend on your situation. You might have one of the following treatments:
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chemotherapy to shrink the cancer first, followed by surgery
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external and internal radiotherapy (brachytherapy) for a high grade cancer
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hormone therapy if you can't have surgery or radiotherapy
Treatment after surgery
Stage 3 womb cancer has a high risk of coming back.
After surgery you may have one of the following treatments:
- external radiotherapy with chemotherapy and then more chemotherapy
- chemotherapy followed by radiotherapy
- chemotherapy on its own
Some people may have treatment with immunotherapy or a targeted cancer drug. This will depend on your situation and whether you’ve had other treatments before. Possible treatments include:
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immunotherapy with chemotherapy
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immunotherapy on its own
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immunotherapy and a targeted cancer drug
