Stage 4 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 4 means the cancer has spread to another area of the body. There are 2 categories of stage 4 womb cancer:
- 4A means the cancer has grown into the bowel or bladder, or both
- 4B means the cancer has spread to lymph nodes further away, or to other parts of the body, such as the
omentum 
, peritoneum, lungs, liver, bones or brain (secondary cancers or metastases), or both
Your doctor might call stage 4 cancer advanced cancer.
Treatment
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
-
the type of womb cancer you have
-
how the cancer is likely to behave (the grade)
-
the risk of your cancer coming back after surgery (low, intermediate, high-intermediate, high)
-
whether your cancer has any gene changes (mutations)
-
your general health
-
your preferences
Surgery
Depending on how far your cancer has spread, it may be possible to remove as much of the cancer as possible.
If you can't have surgery
There are several reasons why you might not have surgery, including:
-
your cancer is too difficult to remove
-
it has spread to areas further away in your body, such as the liver and lungs
-
you are not fit enough for surgery
-
you choose not to have it
You might have one or more of the following treatments:
-
chemotherapy
-
radiotherapy
-
immunotherapy
-
hormone therapy
Your doctor might also suggest you take part in a clinical trial.
Treatment after surgery
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:
-
immunotherapy with chemotherapy
-
immunotherapy on its own
-
immunotherapy and a targeted cancer drug
