The short answer: The standard treatment for endometrial cancer (cancer of the womb lining; in Hindi often called bachedani ka cancer, बच्चेदानी का कैंसर) is an operation to remove the womb, after which pregnancy is no longer possible. For a small, carefully selected group of younger women who still want children, hormone treatment can be tried first instead. It is considered only when the cancer is very early (stage 1A), low grade (grade 1, endometrioid type) and has not grown into the womb muscle on MRI. Treatment uses progestin (a man-made form of the hormone progesterone) as tablets or as a hormone-releasing coil in the womb, such as Mirena, with a repeat biopsy about every 3 months. If the cancer goes away, you are encouraged to try for pregnancy soon, often with fertility treatment. The womb is usually removed later, once your family is complete, or earlier if the cancer does not respond or comes back. This is not standard treatment for everyone, and there is a real chance that the cancer comes back.
On this page
- Who can be offered it
- What the treatment involves
- When is the womb removed?
- Results and risks
- Booking
- FAQs
Who can be offered fertility-sparing treatment?
Hormone treatment instead of surgery is considered only when all of these apply:
- The cancer is the endometrioid type and grade 1 (low grade) on a biopsy, ideally taken at hysteroscopy (a thin camera look inside the womb). Atypical hyperplasia, a pre-cancer of the womb lining, is treated in a similar way.
- An MRI shows no growth into the womb muscle (myometrial invasion) and no sign of spread outside the womb, for example to the ovaries or lymph glands.
- You strongly wish to keep the chance of pregnancy, you understand that this is not the standard treatment, and you can come for regular check-ups and biopsies.
- There is no medical reason that rules out hormone treatment or pregnancy.
It is not suitable for higher-grade or other types of endometrial cancer, for cancer that has grown into the womb muscle or beyond, or when regular follow-up is not possible. In these situations the standard operation is safer.
For the bigger picture, see our guide to uterine cancer care, our endometrial cancer overview and our page on fertility-preserving surgery in selected patients.
What the treatment involves
- Confirming the diagnosis: the biopsy is reviewed by an experienced pathologist, a hysteroscopy is done if needed, and an MRI of the pelvis checks the depth of the cancer.
- Hormone treatment: progestin tablets (such as megestrol acetate or medroxyprogesterone acetate) and/or a progestin-releasing coil placed in the womb (levonorgestrel IUD, such as Mirena). Sometimes a visible area of the cancer is first removed during hysteroscopy (hysteroscopic resection). The treatment itself is taken at home or in the clinic, without a hospital stay.
- Checking the response: a repeat biopsy of the womb lining, usually with hysteroscopy, about every 3 months. A response usually takes 6–12 months.
- Trying for pregnancy: once biopsies show no cancer, you are encouraged to try for pregnancy without long delay, often with help from a fertility specialist.
- Long-term follow-up: regular check-ups continue, because the cancer can come back.
Progestin tablets can cause side effects such as weight gain and, rarely, blood clots; the coil acts mainly inside the womb. Your doctor will explain what to expect and which option suits you.
When is the womb removed?
Removing the womb (hysterectomy, the standard treatment) is generally recommended once you have completed your family, if the cancer has not gone away within about 12 months, if it grows or comes back, or if you decide not to continue hormone treatment. The operation is usually done by keyhole (laparoscopic) or robotic surgery when it suits you; robotic surgery is available at Sterling Hospitals and KD Hospital. After keyhole or robotic surgery, the hospital stay is often about 3–4 days.
Results and risks
The evidence for this treatment comes mainly from observational studies and pooled analyses of published case series; there are no large randomised trials, so figures vary from study to study. Current European guidance (ESGO/ESHRE/ESGE, 2023) supports it only for carefully selected women treated in specialist centres. In the published series this page draws on, about 70% of women had a complete response (no cancer left on biopsy), 25–35% of those who responded became pregnant, and the cancer came back during follow-up in 25–40%. Results differ with body weight, the type of hormone treatment and whether hysteroscopic resection is used. These are averages and cannot predict what will happen to you, which is why biopsies continue and why the womb is usually removed once your family is complete.
External authoritative reference: NCCN Guidelines and ESGO Recommendations.
Booking
For an individualised treatment plan, share your reports on WhatsApp (+91 76988 00333) or book an appointment. Second opinions are available for patients already under care elsewhere.
FAQs
Where is early endometrial cancer fertility sparing performed in Ahmedabad?
Dr. Nishtha Tripathi Patel sees patients at Sterling Hospitals (Sindhubhavan Road), KD Hospital and Welcare Speciality Hospital in Ahmedabad. Hormone treatment is outpatient care, and the check-up hysteroscopy and biopsies are planned at the hospital that suits you. If the womb needs to be removed later, robotic surgery is done at Sterling Hospitals or KD Hospital; open or laparoscopic (keyhole) surgery is also possible at Welcare.
Will I need to stay in hospital?
Usually not for the hormone treatment itself, which is taken as tablets at home or given as a coil placed in the womb. Hysteroscopy and biopsy are short procedures, often without an overnight stay. If the womb is removed later, the stay after keyhole or robotic surgery is often about 3–4 days.
What is the likely outcome?
In the published series this page draws on, about 70% of women had a complete response, 25–35% of those who responded became pregnant, and the cancer came back in 25–40% during follow-up, so regular check-ups are essential. Figures vary between studies and are averages; your own chances depend on your biopsy, MRI, weight and the treatment used.
Can I get pregnant after hormone treatment for endometrial cancer?
Some women do. Pregnancy is attempted only after biopsies show that the cancer has gone, and many women need help from a fertility specialist. In published series, about a quarter to a third of women who responded became pregnant. Once your family is complete, removing the womb is usually advised.
Is a Mirena coil enough to treat early endometrial cancer?
For selected women, a progestin-releasing coil such as Mirena, used alone or together with progestin tablets, is one of the hormone options. It is not a replacement for surgery for most women with endometrial cancer, and it works only with close follow-up, including a repeat biopsy about every 3 months.
Can endometrial cancer come back after hormone treatment?
Yes. Even after a complete response, the cancer comes back in a significant number of women (25–40% in published series). This is why regular check-ups and biopsies continue, and why the womb is usually removed once you no longer wish to become pregnant.
Can I get a second opinion before deciding?
Yes. Share your reports on WhatsApp (+91 76988 00333). Dr. Nishtha provides independent review of stage, pathology, imaging and proposed treatment within 24-48 hours.
Reviewed by Dr. Nishtha Tripathi Patel, MBBS, DGO, DNB, Fellowship Gynaecological Oncology, ESGO-certified.