Surgery is the most common treatment for endometrial cancer. Most doctors recommend either the surgical removal of the uterus alone (hysterectomy), or, more likely, the surgical removal of the uterus, fallopian tubes and ovaries (complete hysterectomy). Lymph nodes in the area also may be removed during surgery. Lymph nodes are small, bean-shaped structures found throughout the body that produce and store infection-fighting cells, but may also be invaded by cancer cells.

A hysterectomy is a major operation, and because you can't get pregnant after your uterus has been removed, it can be a difficult decision for women who are still in their reproductive years and may desire a first or future pregnancy. However, surgery can often eliminate the cancer and the need for further treatment.

If you have an aggressive form of endometrial cancer or the cancer has spread to other parts of the body, you may need additional treatments. These may include:

• Radiation. Radiation therapy is the use of high-dose X-rays to kill cancer cells. If your doctor believes you're at high risk of cancer recurrence, he or she may suggest that you have radiation therapy after a hysterectomy. Your doctor may also recommend radiation therapy if the cancerous tumor is fast-growing, invades deeply into the muscle of the uterus or involves blood vessels. Rarely is radiation used before or instead of surgery.

• Hormone therapy. If the cancer has spread to other parts of your body, synthetic progestin, a form of the hormone progesterone, may stop it from growing. The progestin used in treating endometrial cancer is in different doses than the progestin used in hormone replacement therapy for menopausal women. Some different medications may be used as well. Treatment with progestin may be an option for women with early endometrial cancer who want to have children and, therefore, don't want to have a hysterectomy. However, this approach is new and not without risk that the cancer will return.

• Chemotherapy. Chemotherapy is the use of drugs to kill cancer cells. In some cases, your doctor may recommend chemotherapy for endometrial cancer. You may receive chemotherapy drugs by pill (orally) or through your veins (intravenously). These drugs enter your bloodstream and then travel through your body, killing cancer cells outside the uterus.

Each type of treatment for endometrial cancer can have side effects that may last for a few months or longer. Ask your doctor what side effects you can expect and what can be done to manage them.

If you have late-stage or recurrent endometrial cancer, you may be at decreased odds for successful treatment with standard therapies.

Following treatment for endometrial cancer, your doctor will likely recommend regular follow-up examinations to check that the cancer hasn't returned. Checkups may include a physical exam, a pelvic exam, a Pap smear, a chest X-ray and laboratory tests.

• chemotherapy

Prevention

Although most cases of endometrial cancer aren't preventable, certain factors can lower your risk of developing the disease. These include:

• Being on hormone replacement therapy (HRT) using progestin. Estrogen stimulates growth of the endometrium. Replacing estrogen alone after menopause may increase your risk of endometrial cancer. Taking synthetic progestin, a form of the hormone progesterone, with estrogen causes the lining of the uterus to shed. This kind of combination HRT lowers your risk. But not all effects of HRT are positive. Taking HRT as a combination therapy can result in serious side effects and health risks. Work with your doctor to evaluate the options and decide what's best for you.

• A history of using birth control pills. Use of oral contraceptives can reduce endometrial cancer risk. The risk is lowest in women who take oral contraceptives for many years, and this protection continues for at least 15 years after a woman stops taking them.

• menopause

You can also help prevent endometrial cancer by maintaining a healthy weight. Excess fat tissue can change some hormones into estrogen, increasing the levels of estrogen in your body and increasing your risk of endometrial cancer. Maintaining a healthy weight as you age lowers your risk of endometrial cancer as well as other diseases.