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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adjuvant tamoxifen therapy is associated with modest improvement in disease-free and overall survival in women with invasive axillary node-negative breast cancer. The preponderance of data supporting these general conclusions are from trials in postmenopausal women; in premenopausal women data appear convincing regarding disease-free, but not overall, survival. Firm conclusions regarding magnitude of benefit related to presence of different prognostic factors cannot be drawn at present. In postmenopausal women tamoxifen appears to alter favorably some risk factors for cardiovascular diseases and osteoporosis, which are the most common causes of mortality or morbidity in older American women. Adjuvant tamoxifen is associated with a significantly reduced risk of second primary breast cancer. Major serious risks of tamoxifen therapy include depression, and possibly thrombophlebitis and uterine endometrial cancer. Symptomatic vasomotor and gynecological side effects are frequent. Decision making with women should include assessment of these multisystem benefits and risks.
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PMID:Tamoxifen in axillary node--negative breast cancer: multisystem benefits and risks. 142 94

Mechanism of action, indications, side effects and contraindications of oral contraceptive agents (OCA) are reviewed. OCA can be divided into two groups: consecutive and combined agents. Combined OCA contain both estrogens and gestagens and are taken for 3 weeks, while consecutive OCA contain only estrogens and are taken for 2 weeks followed by 1 week of combined OCA until the onset of menstruation. Biological activity of synthetic gestagens is estimated by a dosage which results in a delay of menstruation by 2 weeks. Gestagens norethindrone and norethynodrel were shown to be equally effective, while ethinodiol diacetate and norgestrel were 15-30 times more effective. Estrogen component of OCA is represented by ethinyl estradiol or mestranol. Combined OCA are more effective than consecutive OCA; probability of undesirable pregnancy during administration of combined OCA does not exceed 0.2%. The most frequent side-effects of OCA include nausea, headache, uterine hemorrhage, and changes in libido. OCA can affect the endocrine and reproductive systems. Major endocrine effects of OCA include changes in the cortisol metabolism in the adrenal glands, increase in the level of thyroid-binding globulin in the thyroid gland, changes in the glucose metabolism in the pancreas, inhibition of the luteinizing hormone releasing hormone in the hypothalamus with simultaneous decrease in the production of pituitary gonadotropins and inhibition of the ovulation. The most serious side-effects of OCA include cholelithiasis, thrombophlebitis, thromboembolism, liver adenoma, and myocardial infarction. Absolute contraindications to the use of OCA include hypertension, hyperlipidemia, breast or endometrial cancer, pregnancy, cardio-vascular diseases, liver diseases, and kidney insufficiency.
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PMID:[Principles of the use of oral contraceptive preparations]. 307 80

The purpose of this study was to evaluate therapy with melphalan, 5-fluorouracil (5-FU), and medroxyprogesterone acetate combination (MFP) in women with metastatic or recurrent endometrial carcinoma not amenable to surgery or radiation therapy, as compared to progesterone therapy alone. Previously, the authors have treated 114 women with progesterone therapy and achieved a 15.8% objective response rate; 7.0% were complete responders. Thirteen women with documented recurrent or metastatic endometrial carcinoma were entered into the MFP study. Thirteen were evaluable for toxicity and 11 for response (2 had no measureable parameter). Treatment consisted of melphalan 0.2 mg/kg/day for 4 days every 4 weeks; 5-FU 15 mg/kg/day for 4 days every 4 weeks; and medroxyprogesterone acetate 1.0 g intramuscularly weekly. Two of the first 3 patients who were treated with this regimen developed severe thrombocytopenia (platelets, 25,000 and 17,000/mm3). Therefore, the remaining 10 patients received 5-FU at a dose of 10 mg/kg/day for 4 days every 4 weeks. Except for 1 patient who devloped thrombophlebitis, there was no other significant toxicity in the 90 courses of therapy received by the 13 women. Of the 11 women evaluable for respone, 6 (54.5%) responded (2 complete responders, 4 partial responders), 2 for stationary disease, and 3 progressed after having had stationary disease for 3, 6, and 9 months, respectively. Of special interest was that the 2 women with adenosquamous carcinoma responded and 1 additional patient with adenocarcinoma maintained a complete response with 5-FU therapy alone.
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PMID:Melphalan, 5-fluorouracil, and medroxyprogesterone acetate in metastatic or recurrent endometrial carcinoma. Preliminary report. 742 77

Oral contraceptives are discussed with respect to: 1) the relationship between orals and thrombophlebitis and pulmonary embolism, cerbrovascular accidents, and hypertension; 2) effects of contraceptives on subsequent pregnancy; 3) postpartum use of oral contraceptives; 4) effects of orals on menopause; 5) the growth of uterine leiomyomas; 6) breast and ovarian changes; 7) relation of oral contraceptives to secondary amenorrhea and infertility; 8) relationship between orals and cancer of the breast and cervix, and endometrial carcinoma; and 9) contraindications and cautions in the use of oral contraceptives.
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PMID:Present status of oral contraceptives: 2. Complications, special considerations, relationship to cancer, cautions. 1222 84

The problems of oral contraception considered are: possible carcinogenesis, thrombophlebitis or thromboembolism, and possible effect on the reproductive or genetic potential of the ova. Estrogen-progestogen combinations produce characteristic effects of estrogen, indicating that the estrogen given exceeds normal endogenous estrogen production. In humans all known carcinogenic agents involve a latent period, many for a decade or more. Both endogenous and exogenous estrogens have been shown to modify the activity of established breast cancer in humans. The effect on the preclinical phases is unknown. Effects of prolonged use of estrogens on breast cancer will require more extensive studies. Endometrial cancer has been reported to undergo regression under intensive progesterone therapy. Other known carcinolytic agents such as X-rays and alkylating substances are known to be carcinogenic under some conditions. One may, therefore, question the advisability of derangement of such endocrinological relationships. Distinctive histological changes in the endometrium after use of estrogen-progestogen mixtures have been described. Such atrophic changes represent drug-induced pathology. Although these changes disappear when therapy is discontinued, the latent effect is unknown. Since the pathogenic period for cancer of the cervix is estimated to be 7-10 years, studies of this possible effect should exceed this time span and be carefully devised so that data can be compared. Data reported so far do not provide a sound statistical basis. Immediate effects on cervical dysplasia have not been shown to be unfavorable. Thrombophlebitis and thromboembolic phenomena have been reported but on the basis of available data no significant increase in risk has been demonstrated. Studies of carcinogenesis in animals are readily reproduced. However, the human population is so heterogenous that the genetic factor is uncertain. The ultimate effect of oral contraceptives on the ova is unknown. So far observations have shown none. Each physician prescribing these drugs should evaluate the risks involved with due regard for the results of alternate methods of contraception available.
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PMID:An appraisal of certain problems involved in the use of steroid compounds for contraception. 1225 50

Outlined is a protocol for the administration of emergency contraceptive pills. The indication for such treatment is unprotected intercourse within the past 72 hours. Absolute contraindications include the possibility of an existing pregnancy and a family history of stroke, heart attack, thrombophlebitis, breast or endometrial cancer, or liver tumor. Possibly excluded, depending on evaluation by a physician, are women with abnormal vaginal bleeding, active hepatitis, active gallbladder disease, high blood pressure, acute focal migraine, breastfeeding women, and those unable to understand instructions. The recommended regimen consists of six tablets of Ovral (two taken immediately, two more in 12 hours) or 12 tablets of Lo/Ovral, Nordette, or Levlen (four taken immediately, repeat dosage in 12 hours). The extra pills are to be used in cases of vomiting within three hours of pill ingestion. Women with a history of oral contraceptive-related nausea and vomiting should be provided with Compazine. Women should be informed that this method is effective in only about 92% of cases. All women who receive emergency contraception should be counseled that this is strictly a back-up method and helped to formulate a long-term birth control strategy.
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PMID:Emergency contraceptive pills (ECP) protocol. 1228 80