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    Endometrial Cancer: Faina Linkov, PHD Research Assistant Professor University of Pittsburgh Cancer Institute

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    WenNy RupiNa
    Endometrial cancer is the most common gynecological cancer in the US, with obesity being a major risk factor due to excess estrogen exposure. Symptoms include abnormal bleeding, especially after menopause, and early detection through screening and treatment of precancerous lesions can help improve outcomes. Lifestyle factors like diet, exercise, weight control, and hormonal therapies may help reduce risk, but more research is still needed on modifiable risk factors.

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    Endometrial Cancer: Faina Linkov, PHD Research Assistant Professor University of Pittsburgh Cancer Institute

    Uploaded by

    WenNy RupiNa
    148 views22 pages
    Endometrial cancer is the most common gynecological cancer in the US, with obesity being a major risk factor due to excess estrogen exposure. Symptoms include abnormal bleeding, especially after menopause, and early detection through screening and treatment of precancerous lesions can help improve outcomes. Lifestyle factors like diet, exercise, weight control, and hormonal therapies may help reduce risk, but more research is still needed on modifiable risk factors.

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    Endometrial cancer is the most common gynecological cancer in the US, with obesity being a major risk factor due to excess estrogen exposure. Symptoms include abnormal bleeding, especially after menopause, and early detection through screening and treatment of precancerous lesions can help improve outcomes. Lifestyle factors like diet, exercise, weight control, and hormonal therapies may help reduce risk, but more research is still needed on modifiable risk factors.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    148 views22 pages

    Endometrial Cancer: Faina Linkov, PHD Research Assistant Professor University of Pittsburgh Cancer Institute

    Uploaded by

    WenNy RupiNa
    Endometrial cancer is the most common gynecological cancer in the US, with obesity being a major risk factor due to excess estrogen exposure. Symptoms include abnormal bleeding, especially after menopause, and early detection through screening and treatment of precancerous lesions can help improve outcomes. Lifestyle factors like diet, exercise, weight control, and hormonal therapies may help reduce risk, but more research is still needed on modifiable risk factors.

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    of 22

    Endometrial Cancer

    Faina Linkov, PhD


    Research Assistant Professor
    University of Pittsburgh Cancer Institute
    GENERAL OVERVIEW OF
    GYNECOLOGIC CANCERS
    • 79,480 new cases/yr of female genital system
    cancers in the U.S.
    • 28,910 deaths in U.S. from genital system
    cancers in 2005
    • Diet, exercise and lifestyle choices play
    important roles in the prevention of cancer
    • Knowledge of family history also increases
    prevention and early diagnosis rates
    • Regular screening and self-examinations for
    appropriate cancers  early detection early
    intervention & therapy
    Endometrial Cancer

    • Strong association with


    excess weight
    Adipose tissue: Consequences of
    Obesity on Cancer Development
    Obesity has been implicated in the development of
    • Type 2 diabetes
    • Heart disease
    • Stroke
    • Hypertension
    • Gallbladder disease
    • Osteoarthritis
    • Sleep apnea
    • Asthma
    • Psychological disorders or difficulties
    • Some cancers, including ovarian,
    cervical, breast, and endometrial
    • Dyslipidemia
    • Complications of pregnancy
    • Hirsuitism
    • Menstrual abnormalities
    • Stress incontinence
    • Increased surgical risk
    Endometrial Cancer and Lifestyle
    Important Definitions
    • Obesity: having a very high amount of body fat in
    relation to lean body mass, or Body Mass Index
    (BMI) of 30 or higher for adults.
    • Body Mass Index (BMI): a measure of weight in
    relation to height, specifically weight in kilograms
    divided by the square of his or her height in meters.
    • Morbid Obesity-100 pounds above ideal weight or
    BMI over 40 (indication for bariatric surgery)
    • Bariatric surgery is the term for operations to help
    promote weight loss.
    Obesity Trends* Among U.S. Adults
    BRFSS, 2005
    (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

    No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%


    ENDOMETRIAL CANCER

    • Cancer of the uterine endometrial lining


    • Most common female reproductive
    cancer
    – 40,000 new cases/year
    – 7,000 deaths/year
    • Most of these malignancies are
    adenocarcinoma
    Incidence and Prevalence
    • Most common gynecologic cancer
    • 4th most common in women (US)
    • 2nd most common in women (UK)
    • 5th most common in women (worldwide)
    • Western developed > Southeast Asia
    • Increase in the 1970’s
    – Increased use of menopausal estrogen therapy
    RISK FACTORS FOR
    ENDOMETRIAL CANCER
    • Early menarche • Diabetes
    (<age 12) • Age greater than 40
    • Late menopause • Caucasian women
    (>age 52) • Family history of
    • Infertility or nulliparous endometrial cancer or
    hereditary nonpolyposis
    • Obesity colon cancer (HNPCC)
    • Treatment with tamoxifen • Personal history of breast
    for breast cancer or ovarian cancer
    • Estrogen replacement • Prior radiation therapy for
    therapy (ERT) after pelvic cancer
    menopause
    • Diet high in animal fat
    Endometrial Carcinoma
    Etiology
    • Unnoposed estrogen
    hypothesis: exposure to
    unopposed estrogens
    Pathology
    • Spreads through uterus,
    fallopian tubes, ovaries
    and out into peritoneal
    cavity
    – Metastasizes via blood and
    lymphatic system
    SYMPTOMS OF
    ENDOMETRIAL CANCER
    • Symptoms
    – Non-menstrual bleeding or discharge
    • Especially post-menopausal bleeding
    – Heavy bleeding
    – Dysuria
    – Pain during intercourse
    – Pain and/or mass in pelvic area
    – Weight loss
    – Back pain
    ENDOMETRIAL CANCER

    • Diagnosis • Treatment
    – Pelvic examination – Surgery
    – Pap smear (detect cancer • Hysterectomy
    spread to cervix)
    • Salpingo-oophorectomy
    – Endometrial biopsy
    • Pelvic lymph node
    – Dilation and curettage dissection
    – Transvaginal ultrasound • Laparoscopic lymph node
    sampling
    – Radiation therapy
    – Chemotherapy
    – Hormone therapy
    • Progesterone
    • Tamoxifen
    Endometrial hyperplasia
    • Overgrowth of the glandular epithelium of
    the endometrial lining
    • Usually occurs when a patient is exposed
    to unopposed estrogen, either
    estrogenically or because of anovulation
    • Rates of neoplasm
    – simple hyperplasia: 1%.
    – complex hyperplasia with atypia: 30%
    Endometrial Hyperplasia
    • Complex hyperplasia with atypia
    – One study found incidence of concomitant
    endometrial cancer in 40% of cases
    – Hysterectomy or high dose progestin tx
    • Simple
    – Often regress spontaneously
    – Progestin treatment used for treating bleeding
    may help in treating hyperplasia as well
    • Estrogen dependent disease
    – Prolonged exposure without the balancing effects
    of progesterone
    • Premalignant potential
    – Endometrial hyperplasia
    – Simple => 1%
    – Complex => 3%
    – Simple with atypia => 8%
    – Complex with atypia => 29%
    Reduced Risk
    • Oral Contraceptives
    – Combined OC => 50% reduced rate
    – Actual reduction number small because
    uncommon in women of child bearing age
    – Long term offers protection
    – Reduced risk presumably => progesterone
    • Tobacco Smoking
    – Some evidence that it reduces the rate
    – Smokers have lower levels of estrogen and lower
    rate of obesity
    Prevention and Survival
    • Early detection is best prevention
    • Treating precancerous hyperplasia
    – Hormones (progestin)
    – D&C
    – Hysterectomy
    – 10 ~ 30% untreated develop into cancer
    • Average 5 year survival
    – Stage I => 72 ~ 90%
    – Stage II=> 56 ~ 60%
    – Stage III => 32 ~ 40%
    – Stage IV => 5 ~ 11%
    Potentially modifiable risk factors

    Dietary factors
    Isoflavones:
    Phytoestrogens that
    have properties
    similar to selective
    estrogen receptor
    modulators

    Soy, beans, chick peas…


    Dietary fiber
    Increases estrogen
    excretion and
    decreases estrogen
    reuptake: whole
    grains, vegetables,
    fruits, and seaweeds
    Exercise?
    Summary points
    • Endometrial cancer is one of the leading
    gynecological cancers in the US
    • Obesity is one of the key factors involved
    in Endometrial cancer development
    • More research is needed to explore
    modifiable risk factors in endometrial
    cancer development

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