Treatment for uterine cancer will most likely include some form of surgery. Other options may include chemotherapy, radiation, targeted therapy, and hormone therapy.

Uterine cancer is the most common type of cancer of the female reproductive tract. In 2021, an estimated 862,875 people in the United States had uterine cancer. About 67,880 new diagnoses are expected in 2024.

The majority of uterine cancers are endometrial cancers, which develop in the inner lining of the uterus. Uterine sarcoma, which forms in the muscle tissue of the uterus, is much less common.

The lifetime risk of developing uterine cancer is 3.1%. There are many things that can increase your risk, including older age, obesity, and factors affecting estrogen levels, like hormone replacement therapy or menstrual history.

If you or a loved one has recently received a uterine cancer diagnosis, you may be wondering what treatment options are available. This article explores this topic in more detail.

The treatment you receive for uterine cancer can depend on a variety of factors. These include:

  • the type of uterine cancer
  • the cancer’s stage, which is a measure of the extent of the cancer
  • the cancer’s grade, which estimates how likely the cancer is to grow and spread quickly
  • the size of the tumor
  • your age and overall health
  • your preferences

Your doctor will take into account the above factors when recommending which of the following treatment options are appropriate for you.


Surgery is often the first treatment for many people with uterine cancer. Typically, surgery for uterine cancer involves an operation called a total hysterectomy bilateral salpingo-oophorectomy. The surgery removes:

  • the uterus
  • both fallopian tubes
  • both ovaries

Removing the ovaries leads to menopause and the effects associated with it. Due to this, if you’re younger and have early stage uterine cancer that’s not aggressive, your ovaries may not be removed during surgery.

Sometimes, doctors also remove nearby lymph nodes during surgery. If your cancer is more aggressive, has spread further, or has come back after initial treatment (recurred), it’s possible that additional tissues may be removed as well, such as the:


Chemotherapy uses drugs that disrupt the growth of rapidly dividing cells, such as cancer cells. It may be used for all stages of uterine cancer, specifically:

  • before surgery to help shrink the cancer
  • after surgery to help kill remaining cancer cells when there’s a higher risk of the cancer coming back
  • as a main part of treatment if you cannot or choose not to have surgery

Often, a combination of chemotherapy drugs is used. Additionally, chemotherapy can sometimes be combined with radiation therapy.

Neoadjuvant chemotherapy (used before surgery) may improve short- and long-term outcomes in metastatic endometrial cancer. However, some research has shown conflicting findings. Therefore, it’s important to discuss all your treatment options with your healthcare team.

Radiation therapy

Radiation therapy uses high energy radiation to kill cancer cells. Like chemotherapy, it can be used at all stages of uterine cancer, such as:

  • before surgery to help shrink the cancer
  • after surgery to help kill remaining cancer cells when there’s a higher risk of the cancer coming back
  • as a main part of treatment if you cannot or choose not to have surgery

Radiation therapy may be given internally or externally:

  • Internal radiation therapy, also called brachytherapy, involves placing the radiation source inside your body. In the case of uterine cancer, it’s typically placed in the upper part of the vagina.
  • External beam radiation therapy uses a machine outside of your body to deliver radiation.

Hormone therapy

Hormone therapy works by using hormones or drugs that block hormones to keep cancer from growing. Some examples of hormone therapy for uterine cancer include:

Hormone therapy is often used to treat more advanced uterine cancer or cancer that’s come back. It may also be used alongside other treatments, such as chemotherapy or targeted therapy.

If you have early stage endometrial cancer that’s not aggressive and you still wish to get pregnant, surgery may be postponed, and you may receive progestin therapy instead. Your doctor will continue to monitor you. Surgery is often done after you have children.

Targeted therapy

Targeted therapy involves drugs that target certain markers found inside or on the surface of cancer cells. This type of treatment is typically used when uterine cancer is advanced or has recurred.

Some examples of targeted therapy drugs for endometrial cancer include everolimus (Afinitor) or bevacizumab (Avastin).

Targeted therapy drugs that may be used for uterine sarcoma include:

  • larotrectinib (Vitrakvi)
  • entrectinib (Rozlytrek)
  • pazopanib (Votrient)


Immunotherapy helps your immune system respond to cancer cells. Like targeted therapy, it’s typically used for uterine cancers that are advanced or have come back.

An example of an immunotherapy drug that may be used for endometrial types of uterine cancer is pembrolizumab (Keytruda).

Certain uterine cancers are more aggressive than others. This can be reflected by the cancer’s grade. Higher grade cancers are more aggressive and more likely to grow and spread quickly.

Endometrial cancers are broken down into type 1 and type 2 cancers:

  • Type 1 cancers are unlikely to be aggressive. This includes grades 1 and 2 endometrial cancers.
  • Type 2 cancers are more aggressive. Examples include:
    • grade 3 endometroid cancer
    • papillary serous carcinoma
    • uterine carcinosarcoma
    • undifferentiated carcinoma

Overall, uterine sarcomas are often more aggressive than endometrial cancers. The most common type of uterine sarcoma, called uterine carcinosarcoma, typically grows and spreads rapidly.

Researchers have found that the rates of more aggressive types of uterine cancer have been increasing overall. This rise was particularly high in Black individuals, potentially due to racial disparities in healthcare.

Many factors influence the outlook of people with uterine cancer. Many of these are the same as those that affect treatment recommendations, such as:

  • the type of uterine cancer
  • the cancer’s stage
  • the cancer’s grade
  • the size of the tumor
  • how the cancer responds to the recommended treatment
  • whether the cancer has come back
  • your age and overall health

Five-year relative survival rates give an idea of the percentage of people with a specific type and stage of cancer who are alive 5 years after their diagnosis.

According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, the 5-year relative survival rates for uterine cancer diagnosed between 2014 and 2020 are:

  • 94.8% when the cancer is only found in the uterus
  • 69.7% when the cancer has spread to regional lymph nodes or nearby tissues
  • 18.9% when the cancer has spread distantly (metastasized)
  • 80.8% overall

When looking at 5-year relative survival rates, remember that they include data from many people over a number of years. Because of this, they don’t reflect individual factors or more recent advances in uterine cancer treatment.

Most people with uterine cancer will have some form of surgery to treat the cancer. Other treatment options that may be used alone or in combination include chemotherapy, radiation therapy, and targeted therapy.

If you receive a diagnosis of uterine cancer, have an open conversation with your care team about your treatment. They can give you a better idea of what treatments are available to you and how they may affect your outlook.