Endometrial cancer originates in the lining of the uterus

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Endometrial cancer arises in the uterine mucosa. Since the development and spread of endometrial cancer largely depends on the presence of estrogen in the body, hormone therapy is usually prescribed after surgery to reduce the likelihood of future cancer recurrence.

Endometrial cancer

Age is a risk factor for endometrial cancer, according to MedlinePlus. In most cases, the disease affects women between the ages of 60 and 70, with cases affecting people under the age of 40 being extremely rare. Symptoms include abnormal or excessive bleeding, lower abdominal pain, or whitish vaginal discharge that occurs after menopause.

Endometrial cancer treatment

When a tumor is caught in time, an effective treatment is surgery, in which all of the ovaries are removed. In other cases, chemotherapy or radiation, consisting of drugs or high levels of directional radiation used to destroy cancer cells, are effective alternatives.

Hormone therapy

According to the American Cancer Society, the goal of hormone therapy in treating endometrial cancer is to lower estrogen levels in the body to reduce the likelihood of future cancer recurrence, or to slow the spread of cancer cells that exist until they can be effectively treated with other treatments.

Hormone therapy medications

According to the ACS, the main drugs used in hormone therapy are progestagens. These medications reduce circulating levels of estrogen in the body, slowing the development of cancer cells. Another commonly used drug is tamoxifen, which is often used to fight breast cancer, although it can also work to prevent estrogen from stimulating cancer cell growth. A third alternative prescription is drugs called gonadotropin-releasing hormone agonists, which cause the ovaries to produce less estrogen. Side effects of these medications include menopausal symptoms such as hot flashes, weight gain, vaginal dryness, and possibly decreased bone density.

Methods of hormonal therapy

In addition to prescribing medications to change the hormonal balance of the body, other, more radical measures may be necessary. According to the ACS, additional options for fighting endometrial cancer with hormone therapy include either surgical removal of the ovaries or radiotherapy aimed at incapacitating the ovaries by removing the body’s main source of estrogen production. p>

Experimental treatment

New classes of drugs are constantly being studied for their potential usefulness in hormone therapy for endometrial cancer. According to the ACS, a class of drugs with potential is called aromatase inhibitors. These drugs act to prevent the conversion of other substances to estrogens, which further reduces the natural level of estrogen in the body. Side effects include muscle pain and hot flashes.

 

Health advice: Breast cancer, Tamoxifen and hair loss

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Breast cancer, Tamoxifen, and hair loss – “A woman’s solution!”

Two years ago a beautiful day in late spring, but it soon turned to tragedy for two women (Helen and Denise) in their late 40s when both were diagnosed with invasive cancer
Hormone Hormone Positive for Cancer.The receptors of these two women were very similar. Both were happily married. Both had three children, and both were waiting for full termination. They were two brilliant and ambitious women who, unknowingly, bound themselves together in marriage on that paralyzing spring afternoon.

Both had undergone several lymph node transplants and a lumpectomy. Immediately the effects of 6 weeks of radiotherapy went away. Neither of them had to endure the effects of grueling chemotherapy. Both were determined to defeat this monster that had invaded their bodies. Both bonded as close friends, and when feelings of despair began to creep into their thoughts, they were each other’s confidant to lift their spirits. They were together without ever alerting their relatives to their internal fears that the tumor would return.

After completing treatment, both resumed their daily routine and tried to regain a sense of normalcy in their lives. Both were prescribed Tamoxifen for the next five years. Tamoxifen was very effective in preventing recurrence in invasive hormone-receptor-positive breast cancer. Unbeknownst to Denise, he was not yet done with the problems this demon called cancer had caused her.

Although tamoxifen has some side effects, it is relatively safe, and thousands and thousands of women take it every day without any side effects. Helen barely noticed a change during her treatment with this drug. At first she returned to work part-time, but immediately resumed her role as wife, mother, and full-time employee. One could almost believe that she had ever been treated for cancer, and she was shining again with signs of good health.

Denis, on the other hand, is not equally good. He immediately realized that his hair was starting to fall. Sometimes averaging 200 lines a day. After two weeks on tamoxifen and such rapid hair loss, it was decided to stop taking it. The radiotherapy that was used to save her life left her tired and lethargic. Tamoxifen, which was used to prevent the cancer from returning, was thinning her hair and, above all, destroying her self-esteem.

He researched the prescription drug Rogaine, but found that the chemical name (minoxidil) also had side effects. Rogaine was also very expensive and time-consuming. He envisioned the removal of the ovary. He reasoned that it was positive that his family was complete. He immediately stated that he didn’t think he wanted to undergo multiple surgeries.

He then looked into the FDA’™s approved aromatase inhibitor Aromasin. Aromazine was prescribed to women with early stage disease, but who had already endured 2-3 years of tamoxifen. The following inhibitor, which appeared in the state of Femara. Although it was approved by the FDA to treat early-stage breast cancer, a 5-year course of tamoxifen had to be taken. The third inhibitor was called Ariminex. Prescribed to patients in the early stages of the disease and immediately after surgery. After discussing it with the doctor, she immediately switched from Tamoxifen to Ariminec.

Hair loss was the main reason Denise switched from Tamoxifen to Ariminec. He had no other side effects of this drug, but out of vanity he wanted to keep her from going bald. After taking Ariminex for just under four months, he realized that she had traded the cosmetic effect for the other side, the physical. Denise still had minor hair loss, but now suffered from excruciating joint pain.

The doctor explained that by taking Tamoxifen, your hair loss continued because it could have been caused by the drug giving you an elbow at menopause. Women who have entered menopause sometimes experience hair loss due to decreased estrogen levels. He also explained that everyone has a different tolerance to these products and could have prescribed Femara instead of Ariminex. At this time Denise was taking prolonged-release tramadol for joint pain and feeling exhausted and defeated. She had not yet been able to return to work, even though it had been almost a year since she was first diagnosed with breast cancer.

Financially, Denise and her family were barely making ends meet. Without his much-needed paycheck, bills have piled up. His marriage, once vibrant, began to suffer, and talk of them breaking up was drowned out only by the tears in the eyes of their children. After a year, everything she and her family had worked for seemed ready to collapse!

Denise was still thinking about whether she should start taking Femara or stop taking all her medication altogether.

That morning he received a phone call that changed his life. That was Helen. His confidant in the toughest of times called to see how he was doing. It wasn’t long before Denise emerged from her emotions. Through tears and laughter, Elena and Denise are reunited again, and Denise was no longer in this battle, apparently alone.

Helen, who worked and continues to work in the organic and natural food sector, is saddened that Denise did not trust the precedent of her struggle. She was happy at the thought of being able to help her friend in need.

After listening to Denise’s story, it became clear to Helen that the only side effect of taking Tamoxifen briefly was hair loss. Because of those two simple four letter words (hair loss), the past year had turned into a roller coaster of a downward spiral for Denise and her family.

After a long, detailed conversation with Helen, Denise decided to take her advice and start taking Femara. Shen Minute is an herbal product that literally changed Denise’s life. He interrupted his Ariminex and immediately felt a difference with his joints.After that, she was able to stop taking tramadol for her joint pain because she was no longer in pain. She decided not to start taking Femara, but to resume taking Tamoxifen, since her hair had fallen out after that, and there were no other side effects.

Like Helen, who explained to Denise, Shen Minute Advanced Formula for Women actually prolonged the hair growth stage, thereby reducing the amount of hair that rested and recurred. This herbal supplement has no side effects, and results were found after just one month. A seemingly simple solution, but Denise agonized for almost a year taking medications that led to side effects, unaware that there were natural remedies that could be taken along with conventional medications.

Helen introduced Denise to “Shen Minute,” literally life-changing. It works great with taking tamoxifen with no side effects. Her hair loss is at an acceptably normal level, and she has returned to work full-time. She no longer takes any pain medication, and her marriage is getting stronger and back on track.

Although this story of hair loss from cancer is a little confusing, it is heartfelt. If Denise had known when she would start taking tamoxifen, she would have saved herself months of suffering with severe joint pain due to ariminex. Although the aromatase inhibitor Ariminex is a free side effect for most of her prescribed patients, Denise’s body, for some reason, was unable to tolerate the drug.

The bottom line is that there is no help for those who have lost unwanted hair. Shen Minute offers natural products consisting of capsules, topical formulas and even herbal shampoos that can help with hair loss in both men and women. If you or someone you know suffers from hair loss, even if it is due to genetics, this could be your answer to the problem of thinning hair.

Tamoxifen in the medical therapy of gynecomastia

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Gynecomastia (GM) is a condition of increased breast volume in men that can recognize a variety of clinical conditions 1:

  • – situations dependent on glandular hyperplasia (so-called true GM);
  • – situations where the increase in volume depends on the accumulation of adipose tissue (false GM or lipomastia);
  • – Mixed hyperplasia, with an increase in various proportions of both glandular and fatty components.

The most common situation is pubertal or postpubertal GM, when – usually without identifiable hormonal abnormalities – we observe the development of GM, which tends to regress to acceptable levels within 2 to 3 years after puberty . These situations, also defined as physiological GM, are explained by the hypersensitivity of the mammary gland tissue to stimulation by hormones produced during puberty.

In clinical practice, there are situations (28 to 40%, depending on the series) where the problem is temporally related to the medication intake (See. table). For this reason – especially in adults with a recent problem – a recent pharmacologic history is especially important 2.

Situations due to systemic hormonal changes are in the minority, but initial clinical evaluation should not neglect examination of estradiol, total testosterone, LH, FSH, prolactin and hCG levels to detect hypogonadism, hyperprolactinemia or very rare cases of secretory estrogenic neoplasms or paraneoplastic hCG syndromes.

In most cases where there are no significant hormonal changes and no drug can be traced, the idiopathic condition of GM is due to an increased sensitivity of the breast tissue to circulating estrogens. In these cases, it can lead to persistent situations, sometimes – especially in adolescents – with strong emotional impact: it is usually an aesthetic problem or, less commonly, a painful disorder for which there are few alternatives to surgical resolution 3. Nevertheless, the demand for a nonsurgical approach to achieve the most lasting results with well tolerated and comfortable medications is common.

Because the pathogenesis is explained by an overreaction of estrogen receptors, attention was focused on drugs with anti-estrogenic effects, while dopamine agonist drugs were effective only in cases (a minority) with documented hyperprolactinemia 4 – 5. Experiments with synthetic anti-estrogens used in the 70s (clomiphene and cyclofenil) 6 through 9 have yielded inconsistent results, for which experiments have focused mainly on tamoxifen, a very widely used molecule in hormonal therapy for breast cancer.

Website Tamoxifen is a synthetic non-steroidal molecule belonging to the so-called SERMs (Selective Estrogen Receptor Modulators), drugs that can behave as receptor antagonists in some tissues and agonists in other organs. Tam plays an antagonist role at the breast and bone tissue agonist receptors, whereas at the endometrium it is a partial agonist 10. This drug, because of its anti-estrogenic effect on breast tissue, has been evaluated in numerous studies performed in patients with puberal GM, as well as in patients with GM secondary to medication, especially in cases resulting from treatment with anti-androgens in androgen block in prostate adenocarcinoma.

Overall, published studies present data on 869 patients treated with Tam: most results are from studies in which the drug was used – in idiopathic HM, in men without proven systemic hormonal disease; – in anti-androgen therapy in patients with prostate carcinoma.

In idiopathic GM, the most evaluated dose was 20 mg/day in one or two doses of 11 to 15. Non-significant data – 10 or 40 mg. The duration of the studies varied: with a therapy duration of 3 to 6 months, the result, evaluated clinically or by ultrasound, was found to be favorable in 70 to 80% of cases. Treatment effects are inevitably transient, and in clinical practice, therapy is usually discontinued after 6-8 months, followed by a waiting period to monitor the development of the problem. In cases of relapse, an additional period of treatment is often suggested, but data on this issue from randomized clinical trials are completely lacking. Tamoxifen was generally well tolerated, even at a mongi duration of 16 to 17; side effects noted were mild and only in 6 cases resulted in discontinuation of treatment. No serious adverse events, particularly liver damage or thrombotic episodes, have been reported. Tamoxifen use caused predictable hormonal responses according to its receptor action profile and did not result in changes in hemocoagulation parameters or other risk factors 18 – 19. Efficacy was superior to that of danazol, compared to which Tam is also better tolerated 20. The efficacy of tamoxifen was slightly lower than that of raloxifene in the only comparative study 21.

The efficacy of tamoxifen is clinically more evident and more prolonged in cases of GM secondary to medication 22. The 20 mg/day dose administered to patients with adenocarcinoma of the prostate, operated or unoperated, was effective in both therapy and prevention of GM with bicalutamide 23 – 24. At the same dose, anastrozole 25 – 26 and breast radiotherapy 27 – 28 were also more effective. Tamoxifen treatment was ineffective at a weekly dose of 20 mg after a prior dose of 20 mg/day 29. One study compared prophylactic administration of 10 mg of tamoxifen for one year vs. therapeutic administration of 20 mg with better symptom outcomes in previously treated patients. Treatment with 10 or 20 mg had no significant effect on the course of prostate disease 30. Overall, despite concerns 31 about the overall quality of the studies being very modest (lack of data from randomized and controlled trials, small number of samples studied), the effectiveness of therapy with tamoxifen, appears to derive from the results of all the studies. Several reviews support its use in all types of GM for 3 to 6 months 32 – 34. Given the mechanism of action, it is still important to take a cautious stance in patients still in the growth phase, as the drug may affect long bone maturation.

There is no indication for gynecomastia for any of the treatments described, which is therefore an off-label condition to be prescribed and treated according to the procedures set forth in the Legislative Decree of February 17, 1998, n. 23 when prescribed in group C, except in cases documented and submitted to individual local boards (if any) that may determine grantless dispensing of the drug.

Endometrial cancer: treatment depending on stage

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Endometrial cancer is a disease characterized by the presence of tumor cells in the endometrial tissue, which is then distinguished from the tumor form that affects the muscular portion of the hollow organ that receives the fetus during pregnancy. The risk of developing endometrial cancer seems to be increased in women who are treated with ovarian hormones that act on the development of female character and menstruation.

Diagnosis

If these symptoms are present, the gynecologist proceeds to visit the. Given the fact that endometrial cancer develops inside the uterus and for this reason is usually undetectable in a Pap test, the gynecologist needs to take a sample of endometrial tissue and analyze it under a microscope to determine the presence of cancer cells. The gynecologist can choose between different procedures: an endometrial biopsy consists of inserting a flexible instrument inside the uterine cavity to gently scratch the uterine wall to extract a small amount of tissue to be analyzed under the microscope.

Dilation and curettage (D C) after cervical dilation, t.е. The lower part of this organ. Cervix, the gynecologist inserts a spoon-shaped surgical instrument into the uterine cavity through which he can take large tissue samples; hysteroscopy, using a thin instrument equipped with a small camera at the tip and a small loop, the gynecologist can visualize the uterine cavity and select a tissue sample for targeted analysis. It is currently the most correct and most commonly used method of. These procedures may sometimes require anesthesia. ” The stage of the tumor (if it is limited to the endometrium, if it affects the entire uterus or has spread to other organs), as well as from general health.

Stage of the disease

After confirming the presence of the tumor, further tests must be performed to check whether the cancer cells have spread to other parts of the body (a process that establishes the extent and spread of the tumor, therefore, its aggressiveness). Staging is important for choosing the most appropriate treatment.

Endometrial cancer is classified into the following stages: – Stage I: The tumor is limited to the uterine body, but has not invaded the cervix. Divided into stages IA and IB depending on the depth of infiltration of the muscular part of the uterus; – Stage II: the tumor has spread from the endometrium to the cervix, but not beyond the uterus; – Stage III: the tumor extends beyond the uterus into the lower part of the large abdomen, vagina, and lymph nodes. Recurrence: the tumor recurs after treatment, recurrence may develop in the pelvic area, lymph nodes and/or other organs at a distance.

How to care

The current treatment options for endometrial cancer are as follows:

  • surgery;
  • chemotherapy;
  • therapy;
  • administration of hormones for therapeutic purposes.

Surgery is the most common method of treatment. The surgeon may decide to remove the tumor by performing one of the following types of surgery: ” Bilateral: is an operation in which the surgeon removes the uterus, salpingitis (or fallopian tubes), and ovaries.To check the condition of the lymph nodes, the surgeon may proceed at the same site to excise the lymph nodes by removing the pelvic and/or aortic lymph nodes, with the role of examining the sentinel lymph node (the first lymph node that drains clear, clear, colorless fluid circulating in the vessels) still considered experimental-mphatic and which contains lymphocytes. ” Lymph from the tumor area; even if the surgeon removes the entire tumor during surgery, in some cases, based on certain risk factors identified by microscopic analysis of a tissue sample taken during biopsy. ” The oncologist may recommend radiotherapy or postoperative chemotherapy to induce death of any remaining tumor cells and prevent recurrence. Chemotherapy is a treatment that destroys cancer cells by administering drugs that can be taken by mouth in pill form or injected intravenously or intramuscularly. Chemotherapy is defined as a systemic treatment because the drug enters the bloodstream, spreads through the body, and thus can reach and destroy cancer cells that have spread away. Radiotherapy (also called radiation therapy) uses high-frequency radiation to kill neoplastic cells. Radiation can be delivered by a device outside the body (external radiotherapy) or by a radioactive substance ((or radionuclide) A substance capable of emitting radiation. ” The radioisotope) can be placed directly into the area affected by the tumor using plastic tubes (internal radiotherapy or intracavitary). Endometrial cancer radiotherapy can be done alone or in combination with surgery, chemotherapy, or both. Hormone therapy (or hormone therapy) consists of taking hormones to block the growth of cancer cells. Estrogens and progestagens are hormones that can somehow affect the growth of some cancer cells. If tests show that the tumor cells have proteins that recognize and selectively bind certain substances (e.g., hormones, antigens, sugars) or even microorganisms (e.g., viruses, bacteria). Receptors located on the surface or inside cells. Receptors for estrogen and/or progestagens, hormone therapy may be considered a therapeutic option.

Treatment depending on stage

The specialist may suggest standard treatment because of its proven efficacy, confirmed by previous experience, or participation in a clinical trial. Standard therapy is not always appropriate for all patients and sometimes comes with more side effects than you think. For this reason, clinical trials are being conducted to identify more effective therapies based on the most current information available.

Stage I

Treatment options are as follows: – in selected cases, in very initial very early stage tumors and in young patients who wish to become pregnant, conservative uterine therapy with hormone therapy and possible hysteroscopic removal of only a small portion of the endometrium affected by the cancer may be offered; – hysterectomy and bilateral adnexectomy; – hysterectomy and bilateral adnexectomy with excision of pelvic and/or abdominal lymph nodes, followed by internal or external pelvic radiotherapy. After surgery, a plastic tube can be inserted into the vagina, inside which a radioactive source is placed in order to destroy any residual tumor cells; – Radiotherapy only for inoperable patients.

Stage II

The treatment options are as follows: – Hysterectomy and bilateral adnexectomy with or without excision of pelvic and abdominal lymph nodes, followed by radiotherapy; – Hysterectomy and bilateral adnexectomy with or without excision of pelvic and abdominal lymph nodes, followed by internal or external pelvic radiotherapy. Internal radiotherapy may be recommended after surgery; – Radiotherapy alone for inoperable patients.

Stage III

Treatment options are as follows: – Radical hysterectomy with excision of the pelvic lymph nodes followed by internal and external radiotherapy; – Radiotherapy alone for inoperable patients; – Chemotherapy plus radiotherapy.

Stage IV

Treatment options are as follows: – Radiotherapy, aimed at relieving symptoms; – Palliative surgery, aimed at relieving symptoms.

Recurrent endometrial carcinoma

In this case, the therapeutic options are as follows: – Palliative radiotherapy, t.е. Directed dilatationTo reduce symptoms and improve quality of life.

 

Thanks to Prof. G Scambia and Dr. R. De Vincenzo (Women’s and Child Health Center – A. Gemelli University Polytechnic Foundation, Catholic University of the Sacred Heart – Rome) for critical revision of the text.

What is endometrial cancer, what are the symptoms, life expectancy and treatments?

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Endometrial cancer is a disease that causes tumor cells to appear in the endometrial tissue. This is the difference with the tumor affecting the muscular component of the uterus, which is called uterine sarcoma. Since the causes of the disease are not known, there are several recognized risk factors. Other important risk factors include first menstruation at a very young age (premature menarche), menopause at an older age (also called late menopause), diabetes, obesity, and tamoxifen treatment in women with breast cancer. The risk of developing an endometrial tumor seems to increase in all those women who are forced to follow a therapy based only on estrogen hormones, which can cause and contribute to the development of certain tumors. However, when estrogen administration is combined with other progestagens, this risk does not appear to increase further.

What are the symptoms of endometrial cancer

With this tumor, diagnosis is always particularly difficult because the symptoms are quite often late. Among the most common symptoms are bloody vaginal discharge (called metrorrhagia), which may be of various types (for example, pink, dark red and bright red). In particular, we should try to deepen the issue if such losses begin to occur after menopause, since this is the ideal age at which the tumor develops. Among the various symptoms are also vaginal discharge, usually whitish in color (they are called leucorrhea), in some cases accompanied by an unpleasant odor. Pain, in most cases, is delayed when the neoplasm affects organs inside the abdomen or in the pelvis. In the early stages, in some cases, patients may feel mild pain due to uterine distension caused by the proliferation of tumor vegetations, and the uterine contractions that this distension can reactivate.

Endometrium in menopause

Regarding endometrial cancer, it should be noted that age is the most important risk factor for developing endometrial cancer. In fact, this disease is very rarely diagnosed in people who are less than 50 years old. Quite often during menopause, a gynecologist or doctor may suggest an endometrial test. With this particular test, the actual collection of cells in the uterus is carried out in such a way that potentially dangerous situations (such as hyperplasia) or, in the case, also tumors detected at the stage of. initial stage. Cell sampling is a test that is performed without any anesthesia and, moreover, causes very little pain: in most cases, it is performed in the clinic in a few minutes. This examination is recommended when the patient suffers from persistent but irregular bleeding, both during menopause and menopause, as well as during substitution therapy. Among other tests that can be helpful in detecting ovarian cancer when it is at a particularly early stage, we of course find the following transvaginal ultrasound. This is an examination that involves inserting a probe inside the vagina, and it is certainly important to keep an eye on the condition of the genital apparatus around and, in particular, the endometrium and ovaries. This examination cannot be considered unequivocally painful, but at the same time it allows us to evaluate several important aspects, such as measuring the thickness of the endometrium, which is usually very thin during the menopause, as it is about 5 millimeters.

Endometrial adenocarcinoma g2

Endometrial cancer is also often referred to as adenocarcinoma because it originates from the glandular part. At each stage, there are different degrees of tumor severity based on the cells that make up the tumor mass. The degree of differentiation is a fundamental factor in making the right prognosis to be able to understand what treatment is most appropriate. According to the most common classification, which is called FIGO, there are essentially three grades of endometrial cancer, namely G1, G2 and G3. As is easy to understand, G1 tumors have the best prognosis. Grade G1 is an adenocarcinoma composed of a portion of glands that share many features with normal glands, but have an extremely complex structure. This degree of cancer should be distinguished from endometrial polyps, as well as from chronic inflammatory processes affecting the endometrium, but also from endometrial hyperplasia. In the grade that is defined by G2, we find a less important distinction between the tumor and healthy glands, and for this reason they are defined as atypical. In the degree, which is defined as G3, glandular tumor masses are particularly bizarre, and in some cases they cannot even be defined as such. In these cases, both hemorrhages and areas of cell death are more common: the tumor is called undifferentiated adenocarcinoma.

What are the chances of survival for endometrial cancer

The five-year survival rate of endometrial cancer patients depends strongly on several factors: among others, the involvement of the lymph nodes, the degree characterizing the tumor and its severity, the achievement or absence of myometrium, the more or less aggressive type of tumor mass, whether or not the peritoneal fluid is positive for malignant cells, the cancer size and the patient’s age should be emphasized. Generally, the five-year survival rate for patients who have undergone surgery varies depending on the stage at which the tumor is. The five-year survival rate for endometrial cancer for those at stage zero is 100%, those at stage one between 72 and 98%. Patients in the second stage have a five-year survival probability of 30-75%, while in the third stage it drops to 15-60%, to drop to 3-10% when the cancer has reached terminal stage, or the fourth.