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Endometrial Cancer

Uterine cancer occurs in the endometrium which is the inner lining of the uterus. Most patients with this disease are typically women between the ages of 50-65. The cause of uterine cancer is not fully understood. However, women who have elevated levels of estrogen, that are not offset by progesterone, are more likely to develop this type of cancer. Considering progesterone levels drop after menopause, postmenopausal women have an elevated risk of developing uterine cancer. 

This type of cancer is often detected at an early stage because a common symptom is abnormal vaginal bleeding. If endometrial cancer is discovered early, a hysterectomy will often eradicate endometrial cancer.

Symptoms

Signs/symptoms of uterine cancer can include:

       ●    Pelvic pain

       ●    Abnormal bleeding between periods

       ●    Vaginal bleeding after menopause

If you have any persistent signs or symptoms that concern you, schedule an appointment with your doctor.

Causes

Scientists and doctors don’t yet know the exact cause(s) of endometrial cancer. What we do know is that something occurs to create mutations in the DNA of cells in the lining of the uterus (endometrium).

Mutations transform normal, healthy cells into abnormal cells. Healthy cells grow, multiply and die at a set pace. On the other hand, abnormal cells grow/multiply uncontrollably, and they don’t die after a set amount of time. The accumulating abnormal cells combine to create a tumor or mass. The cancer cells can separate from an initial tumor and then infiltrate surrounding tissues spreading elsewhere in the body.

Types

The most common type of female reproductive system cancer is uterine cancer. Other types of cancer can also grow in the uterus, including uterine sarcoma, but this is much less common than endometrial cancer. 

Risk factors

Factors that increase the risk of endometrial cancer can include:

Changes in the body’s balance of female hormones: Estrogen and progesterone are the two main female hormones the ovaries make. Hormone fluctuations can cause changes in the endometrium.

       ●    Examples:

                     ○    Polycystic ovary syndrome, obesity, and diabetes can all trigger irregular ovulation patterns. 

                     ○    Taking postmenopausal medication that contains estrogen, but doesn’t contain progesterone, can increase the patient’s risk of endometrial cancer.

                     ○    A rare type of ovarian tumor, called a sex cord tumor, that secretes estrogen also can raise the patient’s risk of endometrial cancer.

More years of menstruation: If a patient began menstruating at an early age (before age 12) or began menopause later in life increases their risk of endometrial cancer. To put it simplistically, the more periods a patient has had, the more exposure their endometrium has had to estrogen and therefore, the more likely they are to develop uterine cancer.

Never having been pregnant: If a patient has never been pregnant, they have a higher risk of endometrial cancer when compared to someone who has been pregnant at least once.

Older age: As patients age, their risk of endometrial cancer increases. Endometrial cancer most often occurs postmenopause.

Obesity: Obese patients are at an increased risk of developing uterine cancer. This may be due to the fact that excess body fat alters the body’s hormonal balance.

Hormone therapy for breast cancer: Taxomifen, a hormone therapy drug for breast cancer, can increase a patient’s risk of developing endometrial cancer. We encourage patients taking this drug to discuss this risk with their doctor. For most patients, the benefits of tamoxifen outweigh the small increased risk of endometrial cancer.

Lynch syndrome: is an inherited colon cancer syndrome that is also called hereditary nonpolyposis colorectal cancer (HNPCC). This syndrome increases the patient’s risk of developing specific types of cancers, including endometrial cancer. Lynch syndrome is caused by a hereditary gene mutation. Therefore, if a patient has a family member who has been diagnosed with Lynch syndrome, we encourage them to discuss their risk of developing this genetic syndrome with their doctor. Additionally, if a patient has been diagnosed with Lynch syndrome, they should ask their doctor what cancer screening tests they should partake in. An inherited colon cancer syndrome. 

Prevention

A patient can reduce their risk of endometrial cancer by:

Talking to their doctor about the risks of hormone therapy after menopause: If a patient is considering hormone replacement therapy to help control their menopausal symptoms, they should weigh the pros and cons with their health care provider. Unless a patient has received a hysterectomy, replacing estrogen alone after menopause can increase their risk of endometrial cancer. Taking a combination of estrogen and progesterone can reduce this risk.

Taking oral contraceptives: Using oral contraceptives (birth control pills) for at least one year can reduce a patient’s risk of developing endometrial cancer. This risk reduction is thought to last for several years even after the patient stops taking oral contraceptives. However, oral contraceptives have other side effects, therefore patients should weigh the benefits and risks with their doctor.

Maintain a healthy weight: Obesity increases a patient’s risk of developing endometrial cancer, therefore it’s important for patients to do their best to maintain a healthy weight with a proper diet and exercise. 

If you are a uterine cancer patient who wants additional resources or if you’re concerned that you might have a gynecological problem that is undiagnosed, please contact Mangrove Women’s Health at (530) 345-0064, Ext 281 to set up an appointment.

Come back next week for part two where we will be discussing vaginal cancer.

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