The endometrium is the inner lining of the uterus, or womb. Its primary function is to preserve a state of patency throughout this female reproductive organ. In other words, the endometrium prevents adhesions between the various tissues of the uterus, thereby forestalling any blockages or obstructions.
When cells displaying uncontrolled growth, invasion, and/or metastasis arise in the endometrium, a cancer may develop. These cells, having undergone an anomalous transformation that causes them to proliferate abnormally, form a structure called a neoplasm. If this neoplasm destroys adjacent tissues, and/or spreads to other areas of the body, a cancer is formed. Endometrial cancers represent the vast majority of gynecological cancers, accounting for 35,000 annual diagnoses in the Unites States. The disease typically develops in the decades following menopause.
Endometrial Cancer Risk Factors
The female reproductive system is responsible for the production of estrogen and progesterone. During the menstrual cycle, the balance between these two hormones changes, resulting in the thickening of the endometrium in the beginning of the monthly cycle, and if no pregnancy occurs, the endometrium is shed at the end of the monthly cycle. Estrogen is the hormone that stimulates the thickening of the endometrium, whereas progesterone stimulates the endometrium’s shedding. If this hormonal balance leans towards the overproduction of estrogen, a woman is more likely to develop endometrial cancer. In fact, most of endometrial cancer’s risk factors are related to an overabundance of estrogen.
- Irregular Ovulation: Irregular ovulation (the monthly release of an egg through menstruation) or a failure to ovulate may increase a woman’s risk of developing endometrial cancer.
- History of Pregnancy: Women that have never been pregnant are more likely to develop endometrial cancer than women who have had at least one pregnancy. The large amounts of progesterone produced during a pregnancy are though to offset rising estrogen levels as you age.
- Early Menstruation and/or Late Menopause: Women who have started menstruating before the age of 12 and/or women who entered menopause late in life are more likely to develop endometrial cancer.
- Obesity: Obese women are more likely to develop endometrial cancer. Although the ovaries are the body’s primary source of estrogen, fat tissue also produces the hormone. In fact, obese women are three times more likely to develop the disease than are women of a normal weight.
- Diabetes: Diabetic women have an elevated risk of developing endometrial cancer. This relationship is not completely understood, but is perhaps due to the fact that diabetes type 2 often coincides with obesity.
- Ovarian Tumors: Many benign tumors of the ovaries may lead to the overproduction of estrogen. Even if these tumors present no symptoms, they may warrant removal simply to prevent excessive estrogen levels in the body.
- Estrogen-Only Replacement Therapy (ERT): Many women are prescribed ERT after menopause. These therapies increase estrogen levels in the body, thus elevating the risk of endometrial cancer.
- High-Fat Diet: Fatty foods promote estrogen production and obesity, which will promote further estrogen production.
Endometrial Cancer Outlook
This disease usually presents obvious symptoms immediately following its onset. For this reason, most women seek medical attention before the disease has metastasized to other structures in the body. 70-75% of all endometrial cancers are diagnosed in stage I, making them a highly treatable disease. Only 10-15% of these cancers are diagnosed in stage III or higher. Early detection yields a very positive outlook (prognosis) for endometrial cancer patients.
Endometrial Cancer Prevention
- Progestin: If you are currently taking an estrogen-only therapy, talk to your doctor about therapies that also include progestin. Progestin is a synthetic form of progesterone, which offsets many of the negative effects of estrogen. It should be noted, though, that progesterone has side effects of its own, such as blood clots and elevated breast cancer risk.
- Birth Control: The long-term use of oral contraceptives may reduce your chances of developing endometrial cancer.
- Diet and Exercise: A diet low in fats may help reduce your body’s estrogen production. Furthermore, regular exercise will help you maintain a healthy weight, also resulting in lower estrogen production.