Endometrial Cancer

What you do, what you eat, and how you handle stress impact your overall state of well-being.

About 2.7 percent of women will be diagnosed with endometrial cancer at some point during their lifetime, based on the SEER 2008-2010 data.

Endometrial cancer is the most common malignancy of women in developed countries, and its incidence is 10 times higher than in developing countries.

81.1% of women with endometrial cancer have a 5 year survival rate.[1]

Endometrial cancer is heavily influenced by estrogen exposure, therefore it is found in higher amounts in women with early start of menstrual cycle, no children and late menopause.

WATCH YOUR WEIGHT
Maintain a healthy weight as obesity is related to an increased risk of estrogen dependent cancers.

Causes/Contributing Factors

A number of risk factors are known to be associated with endometrial cancer occurrence, with different risk factors among different age groups. Endometrial cancer occurs much more frequently in post- menopausal women.[2] Among the most well-established risk factors include:

  1. A history of cancer in the family, particularly a first degree relative.
  2. Tamoxifen use for breast cancer. Women with breast cancer who take the hormone therapy drug tamoxifen have an increased risk of developing endometrial cancer.
  3. Starting menses prior to age 12 and having no pregnancies significantly increases the risk.
  4. Hereditary nonpolyposis colorectal cancer (HNPCC) is a syndrome that increases the risk of endometrial cancer. HNPCC occurs because of a gene mutation from parents to their offspring.

Risk factors for older women:

  1. Taking hormones after menopause that contain estrogen but not progesterone increases the risk of endometrial cancer. Unopposed estrogen is associated with increased risk of endometrial hyperplasia at all doses, and durations of therapy between one and three years.[3]

Other known risk factors include:

  1. Alcohol intake
  2. Higher amounts of dietary fat
  3. Elevated blood sugar – overweight women with an elevated blood glucose had over a 2.5 fold increase (260%) in risk for female reproductive cancers, while overweight women with a normal glucose had only a 70% increase in risk.[4]
  4. High percentage of body fat
REDUCE STRESS
Practice mindfulness-based stress reduction, like breathing techniques, yoga, Pilates and meditation.

Relevant Diagnostic Testing

Physical symptoms There is not one lab test to diagnose endometrial cancer, rather it is most often suspected from initial physical exam and history. It is estimated that 90% of women with endometrial cancer experience changes in their menses, vaginal bleeding, or experience post-menopausal vaginal bleeding and 10% of endometrial cancers present as a non-blood discharge. Later stages of the cancer may show up as pain in the pelvis, feeling a mass in the abdomen or pelvis, and losing weight without trying.

Noninvasive methods: Ultrasound of the pelvic region and endometrial cytology (cell study).

Invasive methods: Dilatation and curettage (D&C); endometrial biopsy and hysteroscopy with biopsy of the endometrium (uterine lining).

STAY ACTIVE
Exercise often. It has been established that exercise reduces endometrial cancer risk.[5]

Dietary Action Plan

Emphasize:

  1. 4 or more daily servings of fruits and vegetables that are orange or yellow, which provide beta carotene (peppers, squashes and carrots for example). Tomatoes and watermelon are rich sources of lycopene.
  2. Whole foods (foods that are as close to their natural form as possible)
  3. Low sugar/low glycemic diet: (Glycemic index (GI) and glycemic load (GL) are measures of the effect on blood glucose level after a food containing carbohydrates is consumed)
  4. Omega-3 fatty acids, found in cold water fish such as sardines, wild-caught salmon, cod, mackerel, tuna
  5. High fiber, from whole grains, beans, vegetables and fruits
  6. Healthy fats, from avocados, nuts, seeds, olive oil, coconut oil, cold water fish
  7. For animal protein, choose lean poultry and fish over red meat, and aim to view meat as a condiment rather than a staple. Try to choose grass fed and organic meats and eggs whenever possible. Eat no fish larger than a salmon to minimize environmental contaminants, including mercury.[6]
  8. Having one to two servings of whole soy foods each day may prove beneficial (as long as the soy is GMO free). Try non GMO soymilk as a beverage as well as edamame, tempeh, tofu, roasted soy nuts and soy nut butter. Traditional fermented soy foods, such as miso, tempeh, and natto, are particularly beneficial.

Avoid:

  1. Processed and grilled meats. Also, try to limit intake of red meat to avoid excess estrogens.
  2. Insulin plays a role in a women’s estrogen balance so eliminate refined sugar, processed flours, artificial sweeteners and sugary beverages to keep blood sugar under control.
  3. Fast foods, fried foods, baked goods and packaged, processed foods
  4. Limit or avoid alcohol. In most studies that have looked at alcohol consumption and risk of most cancer, regular consumption is linked with increased cancer risk.
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Endometrial Cancer Supplement Program

Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Supplement Info

 

Includes:

  • Vitamin D
  • Scutellaria Baicalensis
  • Agaricus Blazei
  • Lycopene
  • Beta Carotene
  • Green Tea Extract
  • Omega-3 Fatty Acids
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[1] Matsuo K, Cahoon SS, Gualtieri M, Scannell CA, Jung CE, Takano T, Paulson RJ,  Muderspach LI, Roman LD. Significance of Adenomyosis on Tumor Progression and Survival Outcome of Endometrial Cancer. Ann Surg Oncol. 2014 Jul 8.

[2] Ali AT. Reproductive factors and the risk of endometrial cancer. Int J Gynecol Cancer. 2014 Mar;24(3):384-93.

[3] Furness S, Roberts H, Marjoribanks J, Lethaby A. Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. Cochrane Database Syst Rev. 2012 Aug 15;8:CD000402.

[4] Moore LL1, Chadid S2, Singer MR2, et al. Metabolic Health Reduces Risk of Obesity-Related Cancer in Framingham Study Adults. Cancer Epidemiol Biomarkers Prev. 2014 Jul 10. pii: cebp.0240.2014. [Epub ahead of print]

[5] Keum N, Ju W, Lee DH, Ding EL, Hsieh CC, Goodman JE, Giovannucci EL. Leisure-time physical activity and endometrial cancer risk: dose-response meta-analysis of epidemiological studies. Int J Cancer. 2014 Aug 1;135(3):682-94.

[6] Arem H, Neuhouser ML, Irwin ML, Cartmel B, Lu L, Risch H, Mayne ST, Yu H. Omega-3 and omega-6 fatty acid intakes and endometrial cancer risk in a population-based case-control study. Eur J Nutr. 2013 Apr;52(3):1251-60.

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