Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case is presented of a healthy, 36-year-old woman with leiomyomas of the uterus to illustrate the broad dimensions of choosing an appropriate contraceptive method. Additionally, this woman had a history of pregnancy-induced hypertension, gestational diabetes, and a family history of breast and endometrial cancer. The woman presented for contraceptive advice 5 days after a regular, normal menstruation. She reported that she generally had been healthy, with no current medical problems and had used several barrier methods of contraception. The woman found the barrier methods to be unreliable as well as somewhat difficult to use. The clinical problem was how best to provide this woman with contraception. The patient was divorced and sexually active, and she wanted to remarry and to have more children. As this patient was parous and had not experienced previous problems with excessive menstrual blood loss or dysmenorrhea, she might have tolerated an IUD well. However, women with leiomyomas, especially the kind that produce an irregular cavity, should not use an IUD. Additionally, IUDs have been linked to an increased incidence of pelvic inflammatory disease, particularly in women with multiple partners. Consideration was given to steroid contraceptives -- oral (OCs), injectable, and implantable -- for this patient. The last 2 modalities were potential options as the patient had no immediate plans for conception. Various aspects of the patient's family history as well as the physical findings needed to be evaluated in relation to the use of hormones. In this context, the familial predisposition to breast cancer was considered. As the results of the Centers for Disease Control and the National Institute of Child Health and Human Development Cancer and Steroid Hormone Study showed no change in risk of breast cancer in OC users, regardless of age at 1st use or subsequent duration of use and other large epidemiologic studies have confirmed these findings, the patient's family history of breast cancer was not a contradindication to OC use. The somewhat remote family history of endometrial carcinoma was not epidemiologically significant. The fact that no adverse effect of high dose contraceptives on existing tumors has surfaced in 2 decades of OC use by millions of women is reassuring. A large body of clinical information concludes that there is no contraindication to prescribing OCs for women with gestational diabetes. Concerns about the cardiovascular effects of OCs stemming from reports in the 1960s and 1970s remain questionable and are not likely to be relevant to contemporary OCs. Injectable medroxyprogesterone, which is remarkably free of adverse reactions, proved or suspected, after 2 decades of use, was chosen as an appropriate contraception option for the patient described.
 ...
PMID:Medical aspects of contraception. 310 32

HMFG antigen is a tumour associated glycoprotein that has been immunohistochemically shown to be expressed by malignant cells in breast and ovarian and to a lesser degree in gastro-intestinal carcinomas. We have developed a non-isotopic sandwich ELISA for secretory HMFG antigen utilizing a polyclonal catcher and a tracer monoclonal antibody (MAb). 52/52 of healthy medical students (controls) had a serum value under 400 U/ml whereas 15/30 patients (50%) with evident ovarian cancer and 13/37 (35%) with advanced breast cancer had a value exceeding 400 U/ml. From other patients with malignant tumours 2/14 (14%) with endometrial carcinoma, 0/5 with cervical carcinoma, 0/5 with vulvar carcinoma, 1/33 with gastro-intestinal carcinoma, 0/4 with oesophageal carcinoma and 2/45 of patients with leukemia or lymphoma had an elevated serum HMFG value. Four cases of Crohn disease, 3 cases of ulcerative colitis and 2 cases of pelvic inflammatory disease all showed a serum value below 400 U/ml. Progression of ovarian cancer was accompanied by increasing serum HMFG antigen levels. The antigen detected by our assay is different from CA 125 but may be related with the tumour associated antigen CA 15-3.
 ...
PMID:Elevated serum HMFG antigen levels in breast and ovarian cancer patients measured with a sandwich ELISA. 316 44

Circulating CA 125 levels were studied in patients with gynecologic cancer and pelvic inflammatory disease, and in pregnant women. The CA 125 level was elevated (greater than 35 U/ml) in 69% (9/13) of patients with active ovarian cancer, in 32% (7/22) of patients with active cervical or endometrial cancer, in 24% (11/46) of pregnant women, and in 33% (10/30) of patients with acute pelvic inflammatory disease. Sixty-three other patients with nonmalignant gynecologic disorders, including 15 patients with ectopic pregnancy, had normal CA 125 levels. The occurrence of elevated CA 125 levels in patients with pelvic inflammatory disease can limit the use of the assay for diagnosis of cancer in young women. Gynecologic tumors may be associated with inflammatory reactions that may contribute to elevated CA 125 levels in some cancer patients.
 ...
PMID:Ovarian cancer antigen CA 125 levels in pelvic inflammatory disease and pregnancy. 345 53

For healthy women under 25 years of age, the benefits of oral contraceptive (OC) use far outweigh the risks. Because the agents protect against such life-threatening conditions as ovarian and endometrial cancer, pelvic inflammatory disease, and ectopic pregnancy, the number of deaths they prevent is larger than the number they cause. For nonsmokers up to age 40, OCs may offer more benefits than other available fertility-control methods, although for smokers 35 years of age or older, the risks of OC use outweigh the benefits. When risk factors for cardiovascular disease are taken into account in selecting OC users and when an appropriate agent is chosen, the likelihood of a cardiovascular accident is greatly reduced. The formulations containing low-dose estrogen and low-dose, low-potency progestins appear to be safest, as they have fewer adverse effects on serum lipids and lipoproteins.
 ...
PMID:Oral contraceptives. The benefits and the cardiovascular risks. 354 7

Prescription of oral contraceptives is reviewed by giving practical tips on the absolute contraindications, timing of the first dose, dose of estrogen, choice of type of progestin, reasons for changing the combination, and a list of benefits of oral contraceptives. The major risk in taking orals is cardiovascular disease, but actual risks are clustered in subsets of women. Those at high risk are women over 45, smokers over 35, and smokers of any age with cardiovascular risk factors. Generally women should start with a 30 or 35 mcg estrogen combined pill, and perhaps consider taking a higher estrogen dose if they experience breakthrough bleeding or amenorrhea. The 1st cycle can be started at any time up to 6 days after Cycle Day 1 or after spontaneous or induced abortion. Women taking bromocriptine should also begin contraception soon after delivery. Signs of potential major complications are abdominal pain, chest pain or dyspnea, headache or neurologic symptoms, visual or speech problems, or leg pain or weakness. Benefits of oral contraception include menstrual regulation, decreased menstrual flow, prevention of functional ovarian cysts, protection against ovarian and endometrial cancer by half, against benign breast disease, and possibly against pelvic inflammatory disease.
 ...
PMID:Oral contraceptives. Who, which, when, and why? 362 38

Use of oral contraceptives has been shown to reduce the risk of gynecologic conditions that cause significant mortality, including ovarian cancer, endometrial cancer and ectopic pregnancy. Additionally, its use has been linked to quality-of-life issues, such as the prevention of pelvic inflammatory disease, benign breast disease and functional ovarian cysts, as well as to dysmenorrhea, premenstrual syndrome and iron deficiency anemia. Such information should be conveyed to women of reproductive age during their contraceptive counseling session.
 ...
PMID:Oral contraceptives. Assessment of benefits. 377 7

The new generation of oral contraceptives (OCs) contains less than 50 mcg of estrogen compared to previous levels of 100-150 mcg, and as a result have fewer undesirable side effects. In addition, it appears that the newer OCs decrease the susceptibility to many diseases. For example, the pill decreases by 40% the risk that a woman under 55 years of age will develop ovarian cancer. The risk of endometrial cancer is reduced by 50% in OC users. The pill also significantly lowers the risk of pelvic inflammatory disease--a condition that is involved in almost 20% of all gynecologic problems and is a leading cause of infertility. OC use reduces the risk of ectopic pregnancy. Further, by decreasing menstrual blood flow, the pill protects against iron-deficiency anemia. The pill is claimed to decrease premenstrual tension, menstrual cramps, and even acne. It has a protective effect against ovarian cysts and benign breast cancer. Finally, there is the possibility that OCs protect against the development of rheumatoid arthritis and duodenal ulcers.
 ...
PMID:Oral contraceptives come of age. 385 23

Although the adverse effects of oral contraceptives (OCs) should be given serious consideration, the many beneficial effects of OC use should also receive recognition. The main advantage of the pill is its effectiveness as a method of reversible fertility control, enabling women to be free of the fear of unwanted pregnancy and its psychological, social, and physical implications. In addition, however, there are numerous noncontraceptive advantages. Many symptoms related to ovulation and menstruation, such as dysmenorrhea, premenstrual syndrome, irregular menses, menorrhagia, and ovulation pain, disappear or are greatly reduced through OC use, especially in young women. Endometriosis and functional ovarian cysts are less common in OC users, and the risk of pelvic inflammatory disease in OC users is about half that in nonusers of contraception. The reduced menstrual blood loss resulting from OC use cuts the risk of iron deficiency anemia by 50%. In addition, the pill has a protective effect against benign breast disease and appears to reduce the risk of ovarian and endometrial cancer. Other beneficial effects include a reduction in the rate of thyroid disease, rheumatoid arthritis, and possibly duodenal ulcers.
 ...
PMID:The benefits of oral contraceptives. 392 18

This article summarizes the major risks and benefits of oral contraceptive (OC) use for specific categories of users. Major risks associated with OC use include vascular and circulatory disorders, hypertension, cancer, and other conditions such as gallbladder disease. There are also numerous minor side effects, e.g., breast tenderness, weight changes, yeast infections. Most of these side effects are attributed either to estrogen or progestin, which mimic excesses or deficiencies in the natural hormonal balance. These symptoms can often be reversed through alterations in the hormonal content of the OC. There have been numerous recent reports regarding the protective effect of OC use against conditions such as benign breast disease, ovarian and endometrial cancer, pelvic inflammatory disease, ectopic pregnancy, and rheumatoid disease. The risks and benefits for potential users can only be evaluated through reference to data from the relevant population group, taking into account factors such as age, race, heredity, potential predisposition for disease, and social habits. Information about the risk of medical problems in specific population groups must be weighed against the risk for those problems in the same population when combined with OC treatment. The benefits of the drug must also be weighed against the number and degree of risks found for the specific user. The convenience and efficacy associated with OCs can far outweigh the risks, inconveniences, and less impressive efficacy of other contraceptive methods in many cases. However, women over age 35 years, especially smokers, should use alternative methods of contraception. New hormonal contraceptive formulations and different modes of drug delivery are currently under development. However, several years of scientific investigation will be required to evaluate the longterm advantages or disadvantages of the newer experimental drugs compared with present OCs.
 ...
PMID:The pill: a closer look. 655 6

The present level of understanding of the known risks of oral contraceptive (OC) use are summarized. The findings of many investigations in the late 1960s and early 1970s may no longer be totally appropriate because OCs available then had higher dosages than today. Also, early studies enrolled predominantly women in their 20s, who are now almost all more than 35 years old. Thus, the risks observed in these studies may not be applicable to younger women using OCs today. Another consideration has been underscored by the results of the Walnut Creek Study. Behavioral characteristics such as smoking, drinking, and sexual activity are factors which can strongly confound risks of OC use and must be considered when assessing current and future investigations. Many studies have clearly shown that the most serious life threatening danger associated with OC use is that of cardiovascular complications arising from the interaction of OC use and smoking. The increased risks attributable to smoking while using OCs account for a substantial number of the deaths recorded. The Walnut Creek Study showed a somewhat different outcome. Its data suggest no significant risk of myocardial infarction (MI), ischemic heart disease, cerebral thrombosis, or ischemic cerebrovascular disease associated with OC use, but there were nonsignificant increases noted in some cardiovascular diseases which appeared to be explained by a synergism between current use and heavy smoking. Age also has a strong influence on risk for cardiovascular disease. The results of earlier studies seem to indicate that OC use is associated with a risk of subarachnoid hemorrhage. The Walnut Creek Study also noted an increased risk of subarachnoid hemorrhage associated with OC use and found that risk increased with use. Several studies have shown that the incidence of venous thrombosis seems dependent on the dosage of the OC used. An overwhelming majority of studies on the carcinogenicity of OCs have found no increased incidence of cancer of the ovaries, uterus, or breast among users. In regard to both ovaries and endometrium, there is some evidence that OCs may be protective. Several studies have concluded that OC users have a slightly increased risk of developing malignant melanoma. The results of the Oxford/Family Planning Study show that although previous use of OC by nulliparous women may delay future childbearing by several months, it does not impair longterm potential for pregnancy. No increase in risk of clinically apparent diabetes mellitus has been reported in users. In addition to their possible protection against ovarian and endometrial cancer, OCs may reduce the risk of at least 5 other diseases: benign breast disease; deficiency anemia; arthritis, pelvic inflammatory disease; and ovarian cysts.
 ...
PMID:The pill: an evaluation of recent studies. 704 36


<< Previous 1 2 3 4 5 6 7 Next >>