After womb (endometrial) cancer treatment

The survivorship issues here are mostly not about the cancer coming back — they are about living for potentially decades in a body that went through surgical menopause overnight, sometimes with lymphoedema and pelvic radiotherapy effects. Those are the things worth pushing on in follow-up appointments, because they are the ones affecting daily life.

• Clinical review with examination, most frequent in the first two to three years, commonly to five years.
• Routine scans are not standard for everyone; imaging is used where symptoms or examination raise a question.
• Some services use patient-initiated follow-up with clear symptom guidance and a fast route back — ask what yours does and get the contact route in writing.
• Report any vaginal bleeding or unusual discharge, pelvic or abdominal pain, leg swelling, or unexplained weight loss.

• Removal of the ovaries causes immediate menopause, which is more abrupt and often more intense than the natural version — see menopause caused by treatment.
• HRT after womb cancer is an individual decision that depends on the type and stage, and for some people it is appropriate — particularly where menopause has come very early and long-term bone and heart risk is a real consideration. Ask for a proper conversation rather than assuming the answer is no.
• Bone density and cardiovascular risk both deserve monitoring after early menopause — see heart and bone health.
• Vaginal dryness and painful sex are common and very treatable; local treatments are often possible. See sex and intimacy.
• If you had brachytherapy, ask about dilator use — it keeps examinations possible and sex comfortable.

• Report heaviness, tightness or swelling in a leg, the genital area or lower abdomen — early referral to a lymphoedema service changes the outcome substantially. See lymphoedema.
• Pelvic radiotherapy can affect the bowel and bladder, sometimes months or years later. Urgency, bleeding or recurrent infections are treatable, not inevitable.
• Pelvic floor physiotherapy helps with bladder symptoms, pelvic pain and sexual function, and is under-used.
• Skin care on the legs matters: treat cuts and bites promptly, and seek help quickly for redness, heat or fever in a swollen limb.

• Tumour testing for mismatch repair proteins is now routine, and an abnormal result can lead to germline testing for Lynch syndrome — which changes bowel screening for you and testing for relatives. Ask what your tumour testing showed. See genetic testing and family risk.
• Womb cancer is strongly associated with weight, and after treatment weight, blood pressure and diabetes control matter both for general health and, on current evidence, for outcomes.
• That is a reason for support rather than blame: ask for referral to a dietitian or an exercise programme rather than being told to lose weight — see exercise after cancer.
• Fertility loss, where it applies, is a real bereavement and deserves support — see fertility after treatment.