The short answer
Surgery leads treatment for cancer of the uterine lining, and tumor testing can change what comes after it. NCI says extra treatment after surgery is avoided in the group defined by a POLE change.
NCI's option table for early stage disease starts with surgery, with or without sampling of lymph nodes.
A large gene study sorted this cancer into four molecular groups, and NCI says a POLE result can mean skipping treatment after surgery.
Radiation after surgery lowers the chance of return nearby, but NCI says better survival has not been confirmed and side effects go up.
Brachytherapy at the top of the vagina causes less harm than beams aimed at the whole pelvis, and in early stage disease NCI reports no difference in recurrence or survival at 5 years.
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This page is for people with endometrial cancer (cancer of the uterine lining) and those helping them. It covers surgery, test results, and follow-up treatment, with questions to ask your care team.
The operation, and what it takes out
Surgery is the backbone of treatment for cancer of the uterine lining. NCI's option table for early stage disease starts with surgery, with or without sampling of lymph nodes.
Sentinel lymph node mapping, which finds and removes the first few nodes the cancer would drain to, is one way to check nodes without removing all of them. Ask whether it is offered where you are being treated, and who does it.
The four molecular groups
A large gene study sorted this cancer into four groups. NCI names them and says the categories help sort people into lower and higher risk.
One group stands out for patients. In the group defined by a POLE change, NCI says extra treatment after surgery is avoided. That is a rare piece of good news in cancer care: a test result that can mean less treatment, not more.
Ask whether your tumor will be tested, and when the result will be back.
Do you need treatment after surgery?
NCI is careful here. Radiation after surgery lowers the chance of the cancer returning nearby, but better survival has not been confirmed, and side effects go up.
It compares two kinds. Brachytherapy (radiation placed inside the body) at the top of the vagina causes less harm than beams aimed at the whole pelvis, and in early stage disease NCI reports no difference in recurrence or survival at 5 years.
There is a long-term finding worth asking about. In a trial with more than 20 years of follow-up, adding whole-pelvis radiation to brachytherapy did not improve survival, and second cancers were more common in the group that had it.
If you hope to carry a pregnancy
The NCI pages used for this article do not cover pregnancy after this cancer. Ask whether any option other than hysterectomy fits your tumor, and what follow-up would look like.
Ask for a fertility referral before anything is scheduled, not after.
Cell types that change the plan
Not all tumors of the lining behave alike. NCI groups serous, clear cell and carcinosarcoma with grade 3 disease, and its table pairs that group with chemotherapy, with or without radiation.
Ask which cell type is on your report and where it sits in that table.
Questions before you agree to surgery
- Will a gynecologic cancer surgeon do this operation?
- Will you use sentinel node mapping, or remove all the pelvic nodes?
- Will my tumor be tested for POLE and mismatch repair?
- Could a POLE result mean I skip treatment after surgery?
- If I need radiation, would it be the vagina alone or the whole pelvis?
- What cell type is on my report, and does it call for chemotherapy?
- Do my ovaries have to come out?
Related pages
Cancer Staging and Biomarker Testing explain the terms used in an endometrial cancer treatment discussion. Clinical Trial vs Standard Treatment, Palliative Care, and Questions to Ask Your Doctor help you prepare for the endometrial cancer appointment itself.
Where this comes from
These questions were drawn from current patient guidance for endometrial cancer:
Common questions
Could a test result mean I need less treatment?
Yes. In the group defined by a POLE change, NCI says extra treatment after surgery is avoided. Ask whether your tumor will be tested for POLE and mismatch repair, and when the result is due.
Is vaginal brachytherapy different from pelvic radiation?
Yes. Brachytherapy at the top of the vagina causes less harm than beams aimed at the whole pelvis. In a trial with more than 20 years of follow-up, adding whole-pelvis radiation did not improve survival, and second cancers were more common.
Can I still try to carry a pregnancy?
The NCI pages used for this article do not cover pregnancy after this cancer. If you hope to carry a pregnancy, ask for a fertility referral before any surgery is scheduled, and ask whether any option other than hysterectomy fits your tumor.
Questions to ask your doctor
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Sources last checked: 2026-10-02 what this meansLast updated: 2026-10-02Next planned review: 2027-07-30
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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