Tuesday, September 15, 2009

Am I At Risk for Endometrial Cancer?

There are pap smears for cervical cancer, mammography for breast cancer, and colonoscopy for colon cancer. But there is no commonly recommended screening test for endometrial cancer. Most patients with endometrial cancer will have gone through menopause. Consequently, vaginal bleeding after menopause is the most important symptom for patients and their doctors to recognize. For younger women, particularly heavy women, irregular or heavy periods should prompt evaluation.

Certain factors can make you more likely to get this cancer. These are your risk factors. But the fact you have one or more risk factors does not mean you will get endometrial cancer. In fact, you can have all the risk factors and still not get it. Or you can have no known risk factors and get it.

Most of the risks linked to endometrial cancer come from too much exposure to the hormone estrogen. Estrogen and progesterone are the two main types of female hormones. The balance between them in your uterus changes every month during your menstrual cycle. These hormones need to be in the right balance for your uterus to be healthy.

Patients with characteristics listed below may have a higher risk for endometrial cancer. Many of these risk factors may be out of your control. For example, you can’t control your age or family history. Some risk factors, though, you can control. For example, you can control the types of food you eat. Ask your healthcare team and your loved ones to help you think of ways to succeed at lowering your risk.

Uterine cancer or colon cancer runs in my family.

Most cases of endometrial cancer are “sporadic.” That means they do not occur because of genetic changes passed from one generation to the next. About 5%, though, do occur as a result of inherited genetic changes. If several family members have had uterine or colon cancer, you are at greater risk for endometrial cancer. Your risk is even higher if the cancers occurred at a young age (before menopause). It’s also higher if several generations have been affected. You may have inherited a genetic problem called the Lynch II syndrome. This is also known as nonpolyposis colorectal cancer (HNPCC). It is the most common type of hereditary endometrial cancer syndrome. Family members can develop cancers arising from the colon, uterus, small intestine, kidney system, or the ovaries. Women with this family history have a 40% to 60% lifetime risk of developing endometrial as well as other cancers. If you are at risk or think you might be at risk for Lynch syndrome, talk with your doctor. Ask about seeing a cancer genetic counselor. The counselor can help better determine your actual risk.

If you are at risk, you should be screened for endometrial cancer. Screening involves an endometrial biopsy starting at age 35.

To learn more about genetics and cancer, click here.

I have used tamoxifen.

Tamoxifen is a drug used to treat women with breast cancer. It’s also used to prevent breast cancer in women at high risk. If you take tamoxifen, you have a higher risk of endometrial cancer. This is a risk that’s balanced by the substantial reduction in risk of breast cancer. If you’ve used tamoxifen, tell your doctor right away if you have any unusual vaginal bleeding.

I use estrogen replacement therapy.

Estrogen is used to help deal with the effects of menopause. However, if you take estrogen alone, you have a greater risk of endometrial cancer. If you need estrogen replacement therapy, ask your doctor about using a combination of estrogen and progesterone. This helps protect your uterus from developing cancer. Keep in mind, though, that taking estrogen and progesterone together can increase your risk for breast cancer. It can also increase your risk of blood clots. If you use hormone replacement therapy, see your doctor regularly for follow-up care.

I have been exposed to a lot of estrogen over the years.

Exposure to excess estrogen raises your risk for endometrial cancer. You could be exposed to too much estrogen for any of these reasons:

  • I am overweight. Fat cells can change other hormones into estrogen. So having more fat can increase your estrogen level.
  • My periods started before I was age 12. If your periods started at an early age, your uterus has been exposed to estrogen for longer than average. The total number of years you have menstruated matters, too. If your periods started early, but you went through menopause early, your risk of getting endometrial cancer is not raised.
  • I went through menopause after age 52. If you went through menopause after age 52, your uterus has been exposed to estrogen for longer than average. The total number of years you menstruated matters, too. If you went through menopause late, but your periods started later in your teens, your risk of getting endometrial cancer is not raised.
  • I have never been pregnant. During pregnancy, more progesterone is present. This helps protect the uterus from too much estrogen. If you’ve never been pregnant, than your uterus may have been exposed to higher levels of estrogen.
I have diabetes.

If you have diabetes, you have a greater risk of getting endometrial cancer. The reason for this is not totally known. Obesity and one kind of diabetes are linked. But even women with diabetes who are not overweight still have higher rates of endometrial cancer.

I have high blood pressure.

High blood pressure has been associated with endometrial cancer. But the risk is not as strong as some of the other risk factors. The relationship between high blood pressure and endometrial cancer may be due to the fact that many women with high blood pressure are also obese. Obesity is a very strong risk factor for uterine cancer.

I eat a diet high in fat.

A high-fat diet increases your risk for several cancers. That includes endometrial cancer. Eating fatty foods is also a quick route to obesity. Obesity increases your risk for endometrial cancer.

I am older than age 50.

As you get older, your risk of getting endometrial cancer goes up. Most cases of it occur after menopause.

I have none of these characteristics.

Some women with endometrial cancer have none of the known risk factors. Nevertheless, they still develop an endometrial cancer. About 10% of endometrial cancers develop in women without these risk factors.

Source: MedicineNet.com

Posted: True Health Is True Wealth

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