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Dr. Magtibay explains how a woman can prevent endometrial cancer and describes why her family history of cancer is important. Additionally, he explains why obese women are most likely to develop endometrial cancer. Dr. Paul Magtibay is a gynecologic cancer specialist at Mayo Clinic in Phoenix, Arizona.
Dr. Magtibay:
Like ovarian cancer, endometrial cancer can actually be prevented by taking birth control pills. Birth control pills are what we consider progesterone dominant, meaning there are two types of hormones in most birth control pills – there’s estrogens and progesterones. The progesterones counteract the effects of the estrogen on the uterus, meaning it prevents that uterine lining from overgrowing and getting thick and potentially developing a cancer.
The progesterones have the opposite effect. It thins out that lining in the uterus and makes it very thin and that’s why women who take birth control pills for a long period of time will stop having their period because that lining has gotten so thin that they don’t really have anything to bleed from anymore. And by thinning out that lining we are actually preventing endometrial cancer from developing.
Second prevention is pregnancy. Pregnancy, too, is a high progesterone state, meaning women who have had multiple births, because they have had nine months of exposure to estrogen they are at a reduced risk of endometrial cancer.
Family history for endometrial cancer is very important and it’s important that the physician examine your family history at least on a superficial basis to determine are you at risk for one of the hereditary endometrial cancer type syndromes such as Lynch 2 syndrome.
Patients with Lynch-2 are at an increased risk of colon cancer but also have up to a 40 percent chance of developing cancer of the uterus, and we may consider doing a prophylactic or preventative hysterectomy on that patient to prevent endometrial cancer in the future.
There is an increased risk of endometrial cancer in obese patients, again because of the higher levels of circulating estrogen as those adrenal hormones that everybody produces get converted by the fat cells into estrogens, which are active estrogens and can stimulate the uterus and ultimately lead to a cancer.