Stage 2 endometrial cancer has spread farther than stage 1, but it’s only in the uterus. The good news is that stage 2 still has a strong chance of successful treatment, and doctors have several ways to manage it. Your oncologist (cancer specialist) will create a treatment plan based on the specific details of your cancer.

This article gives an overview of stage 2 endometrial cancer. We’ll cover key facts about how doctors stage the disease and what symptoms to watch for. We’ll also talk about treatment options and the prognosis (outlook) for this type of cancer.

What Is Stage 2 Endometrial Cancer?

Stage 2 endometrial cancer affects the endometrium, which is the inner lining of the uterus. The cancer may also affect the cervix or deeper muscle layers of the uterus, called the myometrium. Staging is a key part of endometrial cancer diagnosis. The process helps your doctor figure out the best treatment option.

According to the National Cancer Institute (NCI), 66.8 percent of endometrial cancers are diagnosed at the localized stage, meaning the cancer is still confined to the uterus and hasn’t spread to nearby tissues.

What Are the Substages of Stage 2 Endometrial Cancer?

Staging is an important part of determining your treatment plan. Oncologists use two staging systems for endometrial cancer:

• The American Joint Committee on Cancer TNM system
• The International Federation of Gynecology and Obstetrics (FIGO) system

These systems take into account three pieces of information about your cancer. Doctors use the acronym TNM, which stands for:

• T — Tumor size, referring to how big the tumor is and where it has spread
• N — Whether the cancer has spread into nearby immune system structures called lymph nodes
• M — Metastasis, meaning the cancer has spread to the lymph nodes or distant parts of the body

Stage 2 Endometrial Cancer

If you have stage 2 endometrial cancer, there are a few ways your tumor may have spread from the main part of the uterus. Stage 2 tumors can spread into the myometrium. They may also be found in the supportive connective tissue in the cervix, called the cervical stroma. In stage 2 endometrial cancer, there are also cancer cells in tissues outside the main tumor.

Besides how far the cancer has spread, doctors also look at how fast the tumor is likely to grow. Tumors with aggressive cancer cells can grow and spread more quickly.

Stage 2A, 2B, and 2C Endometrial Cancer

Stage 2 endometrial cancer can be broken down into substages A, B, and C. A is the least severe of the substages, while C is the most severe. The substages are:

• Stage 2A — Nonaggressive cancer (grows and spreads slowly) that has spread to the uterus and surface of the cervix
• Stage 2B — Nonaggressive cancer with cells outside the main tumor or spread to the deeper layers of the cervix
• Stage 2C — Aggressive cancer (grows and spreads quickly) that has spread into the myometrium

What Are the Symptoms of Stage 2 Endometrial Cancer?

Abnormal vaginal bleeding is often the first sign of endometrial cancer. For people who still get their period, this may show up as changes in their menstrual cycle. They may bleed between periods or have a shorter cycle than normal.

If you’ve gone through menopause and no longer have periods, any new vaginal bleeding — even light spotting — is a warning sign. Be sure to tell your doctor if this happens. Unusual vaginal discharge with or without blood, and regardless of color or texture, can also be a sign of endometrial cancer.

After going over your symptoms, your doctor will likely order some tests to diagnose or rule out endometrial cancer. They include:

• Ultrasound to look at your uterus and other nearby reproductive organs
• Endometrial biopsy to check the lining of the uterus for cancer cells
• Hysteroscopy to look for signs of cancer or other abnormal growths
• Dilation and curettage (D&C) to scrape the tissue lining the inside of the uterus

How Do Doctors Treat Stage 2 Endometrial Cancer?

Stage 2 endometrial cancer treatments include surgery and radiation therapy. Surgery typically involves removing the uterus, cervix, fallopian tubes, and ovaries. This procedure is known as a total hysterectomy and bilateral salpingo-oophorectomy. Your doctor will also remove lymph nodes in your pelvis and those around the aorta. The aorta is the main blood vessel that carries oxygen-rich blood from your heart to the rest of your body.

Your doctor will check the lymph nodes for cancer cells. If your cancer has spread, it may be restaged as stage 3C endometrial cancer.

Radiation Therapy

Most people with stage 2A and all people with stage 2B endometrial cancer get radiation therapy, unless there’s a medical reason they can’t receive it. Radiation therapy helps kill any cancer cells left behind after surgery to lower the chances of the cancer returning, known as a recurrence. The two options for radiation therapy are external beam radiation therapy (EBRT) and vaginal brachytherapy.

EBRT targets the deeper tissues where cancer is found. EBRT treatment is typically given five days a week for up to six weeks.

Brachytherapy is a type of internal radiation therapy that places a radioactive source right next to the cancer. For endometrial cancer, doctors use a cylinder about the size and shape of a tampon that holds the radioactive material. They insert the cylinder into the vagina during treatment sessions, which typically last 10 to 20 minutes. You’ll likely receive at least three doses of brachytherapy, either once a day or once a week, depending on your treatment plan.

Both types of radiation treatments can be given after you recover from surgery. Your doctor may also suggest radiation before surgery.

Chemotherapy

Chemotherapy is a systemic treatment, meaning it works throughout your whole body. It uses drugs to kill any remaining cancer cells. Doctors usually give chemotherapy after surgery, over a set number of cycles. You’ll receive chemotherapy through an intravenous (IV) infusion, which means the medicine goes into a vein.

Most treatment plans involve a combination of medications. For stage 2 endometrial cancer, treatment may include cisplatin or carboplatin, often given along with paclitaxel.

Outlook With Stage 2 Endometrial Cancer

Doctors predict the prognosis with stage 2 endometrial cancer using data from thousands of people with and without cancer. Stage 2 endometrial cancer is considered localized, meaning it hasn’t spread outside the uterus or immediate tissues.

The NCI provides the five-year relative survival rate with endometrial cancer. This refers to the chances of a person being alive after five years when compared to the general population. The five-year relative survival rate with localized endometrial cancer is 95 percent. This means you’re 95 percent as likely to be alive after five years when compared to someone without endometrial cancer.

Remember that survival rates are only estimates. They can’t predict your exact life expectancy or outlook with endometrial cancer. Your gynecologist, oncologist, or a specialist in reproductive cancers can help you better understand your outlook based on your specific case. They can also explain how newer treatments for endometrial cancer are helping people live longer and have a better quality of life.

Talk With Others Who Understand

On MyEndometrialCancerTeam, the site for people with endometrial cancer and their loved ones, members come together to gain a new understanding of endometrial cancer and connect with others who understand life with this condition.

Are you or a loved one living with stage 2 endometrial cancer? Do you have any tips for someone recently diagnosed with this stage? Share your story in the comments below, or start a conversation on your Activities page.