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

An adequate calcium intake is important to attain peak bone mass and to oppose that component of age-related bone loss due to insufficient intestinal calcium absorption. Calcium and appropriate vitamin D supplements are particularly important for preventing cortical bone loss and associated hip fractures in the elderly (Type II osteoporosis). Within the initial 5 years following menopause, there is an accelerated loss of trabecular bone from the spine and distal radius (Type I osteoporosis). At that time, estrogen replacement is most effective for preventing the rapid trabecular bone loss that could otherwise result in vertebral or Colles' fractures. During this early period of estrogen deficiency when excessive bone turnover is releasing large amounts of calcium into the circulation, supplemental calcium is ineffective. Progesterone, often given with estrogen to prevent endometrial carcinoma, may itself have a trophic influence on bone.
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PMID:Calcium, estrogen, and progestin in the treatment of osteoporosis. 798 85

We reviewed 94 cases of complex endometrial hyperplasia (CH) with and without atypia to assess some of the clinical and pathologic changes observed on curettage and in hysterectomy specimens. Age, parity, height, weight and nomograms did not differ between CH with or without atypia, and CH associated with endometrial carcinoma. CH without atypia, however, predicted lesser degrees of malignancy as compared to CH with atypia. Progesterone or progestinlike treatment is indicated for CH without atypia along with endometrial monitoring, but CH with atypia necessitates diagnostic and therapeutic hysterectomy whenever fertility is not a priority.
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PMID:Complex hyperplasia of the endometrium. Predictive value of curettage vs. hysterectomy specimens. 799 30

An attempt was made to examine the efficiency of the progesterone test and uterus sonography for ten-years period. The progesterone test was used for 621 patients, most of them from the University Obstetrics and Gynaecological Hospital in the town of Varna. Department of Obstetrics and Gynaecology as well as at the National Oncological Centre, Gynaecological Clinic--Sofia during the last few years. There have been found out deep knowledge in epidemiology, etiology and the present possibilities for early diagnostics of the endometrial cancer. All patients of a total number of 621 were in the postmenopausal period and received Progesterone as one-time medical administration. In 44 women bleeding occurred, and 31 of them agreed to undergo abrasio probatoria. 354 out of these 621 patients were examined by ultrasound B-picture after about 6 months to 1 year. 31 cases needed to be cleared-out additionally. The abrasio probatoria done later showed full correspondence to the ultrasound images with the exception of 6 cases. In 15 cases was found polyps endometrial, in 9 cases--atypical glandular hyperplasia, in one case--carcinoma in situ and in 6 cases--early endometrial cancer.
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PMID:[The early detection and screening of endometrial carcinoma by the progesterone test and uterine sonography]. 801 Mar 94

Hormonal agents have been used to treat endometrial cancer since the early 1960s. The response rate for patients with advanced or recurrent endometrial cancer subjected to gestagen therapy has been reported to be about 30%. However, the analysis of the action mechanism of gestagen on endometrial cancer is not complete. Since oral administration of high dose MPA has begun, thrombosis has been reported as an uncommon but severe side effect. The risk factors for thrombosis in patients having gestagen therapy were clarified in the report published by the Ministry of Welfare in 1992. This report emphasized the importance of patient selection for gestagen therapy and cautious management. Besides gestagen therapy, antiestrogen therapy has been tried for the treatment of endometrial cancer. However, tamoxifen therapy was not so effective compared with gestagen. Moreover, antiestrogen-gestagen combination therapy and chemo-endocrine therapy are on trial recently. These trials are attempts to find a more effective regimen for the treatment of endometrial cancer. A recent theme in the study of hormonal therapy is basic investigation concerning the effect of MPA upon the action of growth factor and oncogene expression in endometrial cancer cells. These studies may lead to a molecular biological explanation of the action mechanism of gestagen therapy in future.
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PMID:[Hormonal therapy in endometrial cancer]. 825 43

Currently, more than 50% of married women of childbearing age are using a form of contraception. Between 1960-65 and 1985-90, the number of contraceptive users in all developing countries increased from 31 to 381 million, in East Asia from 18 to 217 million, in Latin America from 4 to 44 million, in South Asia from 8 to 94 million, and in Africa from 2 to 18 million. WHO has recently estimated that over 500,000 women die each year from causes related to pregnancy and childbirth. With a worldwide estimate of 36-53 million induced abortions performed each year, between 125,000 and 170,000 women die each year because of unsafe abortions. According to data from the World Fertility Survey, short spacing between births raises the average chances of offspring dying in infancy by 60-70% and the chances of dying before the age of 5 years by about 50%. WHO's minimal estimate for yearly incidence of bacterial and viral STDs (excluding HIV infection) is 130 million. Most STDs have more serious sequelae in women than in men and lead to pelvic inflammatory disease (PID), permanent infertility, and the risk of ectopic pregnancy. African countries with high incidence of STDs have the lowest prevalences of contraceptive use. A recent examination of the WHO international data base of 22,908 IUD insertions and 51,399 woman-years of follow-up indicates that the occurrence of PID in IUD users is most strongly related to the insertion process and to background STD risk and suggests that PID is an infrequent occurrence after the insertion period. A WHO Scientific Working Group review confirmed the beneficial effects of oral contraceptives in reducing the risk of ovarian cancer, endometrial cancer, and biopsy-proven benign breast diseases. A WHO collaborative study in 5 centers in Kenya, Mexico, and Thailand provided assurance that women who used DMPA for a long time and who initiated use many years previously are not at increased risk of breast cancer.
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PMID:Contraception and women's health. 832 13

Paraffin-embedded materials obtained from 117 cases of endometrial hyperplasia and 84 cases of carcinoma were used for measurement of both ki-ras and p53 gene mutation and aromatase (ARO) and TGF-alpha immunostaining. The overall incidence of ki-ras mutations in the hyperplasia specimens (16%) was similar to the incidence detected in carcinomas (18%). None of 117 endometrial hyperplasias were found to have mutations in the p53 gene, whereas mutations were seen in 3 (13.3%) endometrial carcinomas. The intensity of both ARO and TGF-alpha immunostaining was increased in glands of both hyperplasia and carcinoma, and also in the interstitium of carcinoma. The positive sites of both ARO and TGF-alpha were almost the same, with an incidence below 40% in both hyperplasias and carcinomas. The cultured cells of endometrial carcinoma showed aromatase activity below MCF-7 cells, because testosterone was converted to estradiol (E2). TGF-alpha induced cell growth with at an optimal concentration. In HEC-59 cells, TGF-alpha increased both ARO-activity and mRNA. Some promoters on ARO-exon 1 in HEC-59 cells were different from those in BeWo cells. Progesterone inhibited the E2-induced excretion of pre TGF-alpha in endometrial carcinoma cells. These findings suggest that endometrial hyperplasia can be a premalignant condition of carcinoma, and can be initiated by both ki-ras codon 12 mutation and abnormal activity of ARO induced by TGF-alpha. In addition, HEC-59 cells may possess autocrine/paracrine properties involving ARO, E2 and TGF-alpha.
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PMID:[Aromatase activities of endometrial carcinomas and both basic and clinical analyses of endometrial hyperplasia as a premalignant disease]. 837 Oct 7

Combination oral contraceptive (COC) users have reduced risks of ovarian and endometrial cancer, but COCs have not reduced breast cancer risk. We have previously argued that a hormonal contraceptive with substantially lower doses of sex-steroids should reduce breast cancer risk by decreasing the breast epithelial cell proliferation below usual premenopausal levels. We report here the preliminary results of a pilot trial with such a prototype contraceptive consisting of an agonist of gonadotropin releasing hormone (GnRHA) administered with low doses of an oral estrogen (0.625 mg of conjugated estrogen, CE, for 6 days every week) and intermittent oral progestogen (10 mg of medroxyprogesterone acetate, MPA, for 13 days every 4 months). Eighteen subjects at five-fold or greater increased breast cancer risk were entered and randomized -12 to the contraceptive arm and 6 to a control arm. The principal endpoints included tolerance of the regimen, vaginal bleeding patterns, and the regimen's effect on the endometrium, bone metabolism, and lipids. A symptom questionnaire was used to assess tolerance; the contraceptive subjects had fewer symptoms following initiation of the regimen. This results from the elimination of symptoms associated with the luteal phase of the menstrual cycle, commonly referred to collectively as premenstrual syndrome, PMS. The few occurrences of hot flushes or vaginal dryness that did occur were eliminated by small increases in estrogen dose (0.9 mg CE). Scheduled vaginal bleeding occurred associated with most periods of progestogen administration. Unscheduled bleeding or spotting was infrequent and decreased with time on the regimen. A beneficial rise in high-density lipoprotein cholesterol was evident in the contraceptive subjects. Despite the use of an estrogen dose which is known to prevent loss of bone mineral density in normal postmenopausal women, an annualized loss of 1.9% was seen in contraceptive subjects. It is hypothesized that this is secondary to inhibition of ovarian androgen production by the GnRHA, which may additionally account for changes in libido occasionally reported with GnRHA. The study continues with the addition of a small dose of androgen to replace that lost by the action of the GnRHA.
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PMID:Pilot trial of a gonadotropin hormone agonist with replacement hormones as a prototype contraceptive to prevent breast cancer. 839 Mar 40

To study the early effects of steroid hormones on cells we investigated the influence of the sex steroids and tamoxifen on phospholipid turnover in endometrial carcinoma and breast cancer cells. Studies were performed on 19 human uterine adenocarcinomas and 29 breast cancer tumors. Progesterone in a final concentration of 10(-7) mol/l caused a twofold decrease of 32P incorporation into phospholipids (phosphatidylcholine and phosphoinositides) in 85% of the uterine adenocarcinomas where the progesterone receptor (PR) content was more than 100 nmol/kg and only in 30% of the tumors where the PR content was less than 100 nmol/kg. Treatment of the cells with 10(-8) mol/l 17 beta-estradiol or 10(-8) mol/l epidermal growth factor led to an increase in 32P incorporation into phospholipids. Analysis of the hormonal responsiveness of 29 human breast cancers showed that 17 beta-estradiol increased 32P incorporation into phospholipids in 47% of the tumors where the estradiol receptor (ER) content was more than 10 nmol/kg and in 21% of the receptor-negative tumors (ER < 10 nmol/kg) The results show that phospholipid turnover in uterine and breast cells can be regulated by sex steroids. Treatment of the breast cancer cells with the antiestrogen tamoxifen (10(-6) mol/l) led to an increase of 32P incorporation into phosphoinositides and a decrease of 32P incorporation into phosphatidylcholine. Addition of an activator of protein kinase C, i.e. 2 x 10(-7) mol/l 12-0-tetradecanoylphorbol-13-acetate, weakened the inhibitory effect of tamoxifen on phosphatidylcholine turnover. These findings suggest that tamoxifen action can be mediated via an alteration of the growth signal transducing system.
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PMID:Regulation of phospholipid turnover by steroid hormones in endometrial carcinoma and breast cancer cells. 839 60

The major complaint about injectable hormonal contraceptives, e.g., Depo-Provera (DMPA), is changes in menstrual patterns. In fact, menstrual alterations are the leading reasons women opt to discontinue their use. Injectables' ability to suppress ovulation over a long period and to cause extended endometrial atrophy can delay a return to fertility. Prior to 1967, clinicians used DMPA to treat endometrial cancer. In 1967, its manufacture, Upjohn, requested the Food and Drug Administration's (FDA) permission to expand its use as a contraceptive. FDA wanted more clinical data because it was concerned about its effect on future fertility. It also requested animal studies on DMPA's effect on bone deposition and cancer risk. By 1978, there was so much evidence of increase risk of cervical and breast cancer in animal models and of birth defects that FDA decided not to approve DMPA. Upjohn had exhausted all options by 1986. WHO clinical research (conducted in Kenya, Mexico, and Thailand) revealed in 1991 that DMPA was not a carcinogen. In fact, DMPA users had a significantly lower risk of endometrial cancer than women who did not use DMPA. Clinical research in Thailand suggested that DMPA causes an increased risk of low birth weight and neonatal mortality. A case-control study in New Zealand indicated that DMPA users experienced more bond density loss than non-DMPA users. Nevertheless, FDA approved DMPA as a contraceptive in October 1992. It did order Upjohn to do a postmarket study of DMPA's effect on bone density and risk of osteoporosis, however. Despite its approval, the controversies would continue until further research provided more details about cancer and other risks. Before January 1993, Upjohn sold vials of DMPA to clinicians at $11 to $12 per injection. After January 1993, it began selling it in single-dose disposable syringes at a cost of $29.50. When the cost of a clinic visit is added, the cost per DMPA injection increases to about $50 ($200/year).
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PMID:Injectable hormones and regulatory controversy: an end to the long-running story? 843 75

A prospective study was devised in 1980 to assess the effect on survival of neoadjuvant Provera as part of the primary treatment of endometrial carcinoma in conjunction with surgery and radiotherapy. Between June 1980 and June 1985, 218 patients with Stage I adenocarcinoma of the corpus uteri were allocated on the basis of hospital of presentation to receive either neoadjuvant treatment with medroxyprogesterone acetate (MPA) 100 mg t.i.d. p.o. from diagnosis for 90 days, or no adjuvant treatment (the control group). The minimum follow-up was 5 years. There was no significant difference between the overall actuarial survival in the treatment group (123 cases) and that in the control group (95 cases). This was 83.7% and 69.2% at 5 and 10 years respectively in the treatment group and 78.9% and 70.7% in the control group (P > 0.1).
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PMID:Stage I endometrial carcinoma: the role of neoadjuvant progesterone therapy. 848 58


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