|Is There Any Screening For Endometrial Cancer?
Currently there is no acceptable general screening process for endometrial cancer. The risks associated with endometrial biopsy and D&C such as infection, discomfort and uterine perforation means these procedures can only be justified if there is a suspicion of cancer already and a diagnosis of endometrial cancer is a possibility. While a routine Pap test can sometimes detect cancerous cells in the lining of the endometrium, in 4 out of 5 cases cancerous cells will appear normal. For this reason, the American College of Obstetricians and Gynecologists does not currently recommend any routine screening. Nor do they support routine biopsies for women taking estrogen replacement therapy (ERT).
Can It Be Prevented?
As scientists still do not fully understand the causes of endometrial cancer, the best thing a woman can do to safeguard her womb is to reduce her exposure to known risk factors. She should also consider increasing her protective factors; those are activities or actions which will decrease her chance of developing the disease.
Reducing Risk Factor Exposure
Estrogen Replacement Therapy
Women who are taking supplemental estrogens for treating menopause symptoms, or because their ovaries were removed with a hysterectomy should be sure to take progesterone as well. Taking both supplementary hormones may be referred to as hormone replacement therapy (HRT), hormone therapy (HT) or combined HT. Taking progesterone (or progestin which is the man-made version) will reduce a woman’s exposure to womb cancer. However adding progestins has its own side effects including a bloated stomach, depression and breast tenderness, in other words symptoms similar to premenstrual syndrome (PMS). Experts generally agree that HRT is safe to take for up to 5 years, after this it may increase the risk of heart disease in women, blood clots, breast cancer and stroke in women.
Breast Cancer Drugs
Women who take tamoxifen for breast cancer prevention have a slightly increased risk of developing endometrial cancer. The risk appears to be higher if the drug is taken for more than 2 years after menopause. Tamoxifen is part of a group of drugs called SERMs (selective estrogen receptor modulators) which block the effects of estrogen on the breasts but acts like estrogen on other parts of the body like the womb. Women who are taking tamoxifen should have regular pelvic examinations and should be examined immediately if they have any abnormal vaginal bleeding. Meantime, other SERMs are being tested in cancer clinical trials.
Managing Inherited Conditions
Women who have a history of Lynch Syndrome (also known as Hereditary nonpolyposis colon cancer, or HNPCC) should talk to a genetic counselor about a genetic test for the syndrome. As women with this condition have a 65 percent chance of developing uterine cancer, knowing you are in a risk category will ensure that doctors monitor you more closely. The sooner cancer is diagnosed the sooner it can be treated and the better the prognosis for the patient (endometrial cancer survival rates). Women with polycystic ovary syndrome (PCOS) and Cowden syndrome should also have regular pelvic examinations and report any abnormal vaginal bleeding instantly to their doctor.
What Are The Signs? See Symptoms of endometrial cancer.
How Is It Treated? See Endometrial cancer treatment.
What Are The Stages? See Endometrial cancer staging.
Increasing Protective Factors
Maintain A Healthy Body Weight
It may be possible for women to reduce their risk of the disease by controlling obesity. However this is still speculative advice because it has not been established whether obesity itself predisposes a woman to cancer, or if there is some other underlying cause that causes both obesity in women and endometrial cancer. What is known is that fat cells secrete estrogen into the body, even after menopause when the ovaries no longer produce hormones. The more excess fat, the more estrogens are secreted. The risk of endometrial cancer triples for women who are 21 to 50 pounds overweight and increases 10 times for those 50 pounds overweight. That said, it still has not been conclusively established if losing weight decreases the risk of endometrial cancer. Nevertheless, there are plenty of other established health reasons for maintaining a healthy body weight including coronary heart disease prevention and diabetes and hypertension prevention.
Eating A Healthy Diet
The increasing numbers of women worldwide who are developing uterine cancer suggests that environmental factors or dietary factors may be involved. Cancer has been linked to a diet high in saturated (animal) fat and the consumption of saturated fat is increasing worldwide. To reduce your exposure, follow a healthy eating plan which has a balance of 'good' carbohydrates, lean protein and vitamins and minerals. The Low GI Diet is recommended by many health experts as it contains lots of cancer diet foods.
Physical activity has numerous benefits including helping to control weight, aiding osteoporosis prevention and reducing the risk of heart attacks and premature death. It now also appears to help with cancer prevention. Several studies report links between physical activity and a reduced risk of endometrial cancer. Despite the benefits, recent studies still show that more than 50 percent of American women do not engage in enough regular physical activity. How much exercise is enough? The Centers for Disease Control and Prevention (CDC) recommend moderate-intensity physical activity (walking, water aerobics) for at least 30 minutes 5 or more days a week or vigorous-intensity physical activity (brisk walking, jogging, running, step aerobics) for at least 20 minutes 3 or more days a week.
Women who take oral contraceptives which combine estrogen and progestin decrease their risk of endometrial cancer. The protective factor of 'the pill' increases with the length of time it is used – that is between 1 and 15 years after the woman stops taking it. The downside of oral contraceptives is that they can slightly increase the risk of heart attacks in women, blood clots and stroke, particularly in women who smoke or who take it after the age of 35.
Estrogen levels are lower when a woman is pregnant and breastfeeding. The more pregnancies she has and the longer she breastfeeds, the lower her lifetime exposure to estrogen and the lower her risk of cancer. If you do have children, then it is worth considering breastfeeding for as long as is practical.
This is particularly strange, but studies show that smoking may reduce the risk of endometrial cancer - probably because smoking reduces the body's ability to produce estrogen. Needless to say, this is not a good enough reason to start smoking! Both smoking and passive smoking have other serious consequences, particularly for women.
According to a study published by the American Association for Cancer Research, longterm drinking of coffee may help prevent endometrial cancer. The study monitored the cumulative coffee intake of over 67,000 women who enrolled in the Nurses Health Study. It found that drinking 4 or more cups of coffee a day was linked to a 25 percent reduced risk for the cancer. Between 2 and 3 cups was linked with a 7 percent reduction. Decaffeinated coffee had the same effect which leads scientists to believe that it is not caffeine that offers the protection but rather antioxidants in the coffee.