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

Osteoporosis is the most common bone disorder in the United States. Bone mass is decreased, and porosity and fragility are increased. Dual-beam photon absorptiometry is currently considered the best detection technique. Prevention involves increased calcium intake and avoidance of diets high in protein and phosphates, excessive alcohol consumption and smoking. Estrogen therapy is recommended for most oophorectomized or postmenopausal women, at least for a few years. The addition of progestins to the regimen reduces the risk of endometrial cancer.
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PMID:Osteoporosis. 406 Dec 40

Reduced estrogen content has significantly decreased the risks of oral contraceptive (OC) use. However, the systemic effects of OCs, but it is unclear if this change is physiologically significant. Estrogen-mediated inhibition of cortisol levels may contribute to the impairment of glucose tolerance by OCs. Women at high risk for diabetes, older than 35, obese, with family history of diabetes, or who have had glucose intolerance during previous pregnancies should either not take OCs or take pregestin-only pills. OCs raise plasma triglyceride levels 30-50 mg per dl in users of all ages. High density lipoprotein (HDL) cholesterol is also affected, and cholesterol and triglyceride levelshould be measured before and during OC use. The risk of hepatic adenoma rises with duration of OC use; however, most adenomas diagnosed before hemorrhage have regressed with discontinuation of the contraceptive regimen. The most significant adverse effects of OC use involve the arterial and venous vascular systems. OCs appear to raise the blood pressure in nearly all women. Change in systolic pressure is consistently greater than in diastolic, suggestingthat the primary hypertensive effect of OCs is on blood volume and cardiac output. Accumulated data indicate that if OCs are not used by women older than 35 or by women who smoke or who are hypertensive, then risk of subarachnoid hemorrhage or other cerebrovascular complication is very small. The relative risk of myocardial infarction in OC users has been from 0-6 times greater than in nonusers; this may depend on other confounding risk factors. Reduction in estrogen content of OCs decreases risk accordingly. The preponderance of evidence indicates that prolonged use of OCs does not increase risk of breast disease or ovarian and endometrial cancer, and, in fact, may protect users from malignant lesions by suppressing gonadotropins and ovulation.
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PMID:Systemic effects of oral contraceptives. 608 41

Of 860 women with endometrial cancer registered in a regional cancer treatment center, 259 (30%) gave a history of estrogen use for 6 or more months at some time before diagnosis, and 568 (66%) were nonusers. Estrogen use was associated with younger age, earlier stage, lower grade of tumor, less common myometrial invasion, and preferred treatment including radiation and hysterectomy. The 5-year survival of estrogen users was 92+ or - 2% compared with 68+ or - 2% for nonusers. Further analysis controlling for differences in the distribution of the variables associated with survival showed that for women who have endometrial cancer, the risk of any death for nonusers is approximately 2.7 times greater than for estrogen users, and the risk of death from endometrial cancer is 5.4 times greater for nonusers. A history of estrogen use is not associated with superior survival of women who have poorly differentiated tumors or myometrial invasion.
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PMID:Oestrogen use and survival in endometrial cancer. 610 99

Estrogen receptors and progesterone receptors were measured in tumors from patients with previously untreated endometrial carcinoma before and after a 5-day course of tamoxifen citrate. On initial biopsy, 13 of 25 tumors (52%) were progesterone receptor-positive, whereas 21 of 25 tumors (84%) were progesterone receptor-positive after tamoxifen. Grades 1 and 2 tumors were more likely to demonstrate this increased incidence of measurable progesterone receptors. Considering these results, and the work of others who have shown that progesterone receptor-positive metastatic endometrial cancer is more responsive to progestin therapy than are progesterone receptor-negative tumors, we instituted a phase II clinical trial of tamoxifen plus progestin for patients with recurrent endometrial carcinoma. Thus far, however, the 33% total response rate achieved with the combination therapy has not been superior to standard progestin therapy.
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PMID:Tamoxifen and endometrial carcinoma: alterations in estrogen and progesterone receptors in untreated patients and combination hormonal therapy in advanced neoplasia. 623 50

Twenty-four patients with endometrial carcinoma received tamoxifen (Nolvadex) for 7 days. Before and after administration, circulating hormones (estradiol, testosterone, progesterone, gonadotropins FSH and LH) were evaluated. Estrogen (ER) and progesterone receptors (PgR) in neoplastic tissue were also assayed. Our results show a net increase in PgR content and a significant decrease in gonadotropin levels after the treatment. The authors suggest that clinical trials be conducted using tamoxifen and progestins for adjuvant therapy after surgery of endometrial carcinoma and for the therapeutic approach of advanced carcinoma.
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PMID:Hormonal and receptor status in postmenopausal women with endometrial carcinoma before and after treatment with tamoxifen. 642 17

Cancer is the presumed complication of oral contraceptive (OC) use that is of greatest concern to the public, although with the exception of cancer of the endometrium, which was linked to 1 specific type of sequential preparation, Oracon, there is no convincing evidence linking OCs and cancer. Oracon was found in detailed study to be strongly associated with subsequent risk for cancer, while other sequentials and combination pills were found to reduce the risks. Oracon was different from other sequentials in that it contained a large amount of estrogen, 100 mcg of ethinyl estradiol, with only a weak progestin, 25 mg of dimethisterone, too little to reverse estrogen-induced endometrial hyperplasia. Proctection appears to increase with duration of use of combined OCs. The Centers for Disease Control (CDC) estimates that approximately 2000 cases of endometrial cancer are prevented each year in the US due to the present level of OC use. Evidence is strong that OCs are a means of preventing ovarian cancer, the 4th leading cause of cancer deaths among women in the US. Case-control studies show that women with ovarian cancer are less likely to have used OCs than are controls without cancer. Physiologically, the risk for cancer of the ovary seems to be related to what has been described as "incessant ovulation". Until recently, most women throughout history have been either pregnant or lactating for most of the time. Time spent pregnant or on OCs, with resulting blockage of ovulation, is now established as protective against ovarian cancer. The longer a women has been taking OCs, the greater the protection. Researchers at the CDC estimate that 1700 ovarian cancer deaths are prevented each year in the US by the use of OCs. Results of epidemiologic studies exploring the connection between OC use and cervical cancer are incolclusive because of methodological problems of preventing bias and controlling for confounding variables. Women taking OCs are more likely to have regular cervical cytology, giving rise to selection bias. Use of women emloying barrier contraception as a control group is another source of bias because barrier contraceptives reduce the rise of cervical neoplasia. Sexual behavior, especially age at onset of sexual activity and number of partners over time, is an important determinant of cervical cancer risk and therefore an inportant confounder that is difficult to control. On balance, there appears to be no or very little increased risk of cervical cancer from OC use; given the confounding factors, a final answer may never be obtained. The risk of developing hepatocellular adenoma is about 30 cases/million women per year.
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PMID:Oral contraceptives and neoplasia. 648 5

Estrogen sulfoconjugation previously was reported in normal endometrium and in RL95-2 cells, a cell line derived from a human endometrial cancer maintained in continuous in vitro culture. In the present study the estrogen sulfurylation activity in the cytosolic fraction of RL95-2 cells was characterized using [3H]estrone as substrate. Estrone sulfate was separated from unreacted estrone by thin layer chromatography. Activity was proportional to cytosol concentration, with a pH optimum at pH 8. There was marked temperature dependence between 24 and 40 C. The apparent Km for estrone conjugation was 3.6 nM, with a maximum velocity of 135 fmol/micrograms DNA . h. No complex kinetic behavior was found at estrone concentrations up to 1 microM. The apparent Km for the cosubstrate 3'-phosphoadenosine 5'-phosphosulfate was 0.6 microM. Inhibition experiments demonstrated that the sulfurylating activity studied under these conditions was specific for estrogens. Only estradiol and estriol, in addition to estrone itself, inhibited conjugation to any significant degree. Dehydroepiandrosterone had only 1% the inhibitory activity of estrone. Other androgens, corticoids, progestins, phenols, nonsteroidal estrogens and antiestrogens, and bile acids had no significant effects on the sulfurylation of estrone. An estrogen-sulfoconjugating activity with the characteristics of estrogen sulfotransferase (EST) was demonstrated in RL95-2 cells. The Km of EST for estrone in the RL95-2 cells closely approximated the value reported for the enzyme in normal endometrium. The affinity of EST for estrogens is within the range of the Kd of estrogen receptor and of the physiological concentrations of estrogens reported in the endometrium, suggesting that EST could serve as a regulator of intracellular estrogen levels.
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PMID:Characterization of cytosolic estrogen sulfotransferase from RL95-2 endometrial cancer cells. 659 68

A cohort of 23 233 women who had received estrogen prescriptions was recruited for a prospective study of estrogen therapy and the associated risk of endometrial cancer. For a detailed study, a comprehensive questionnaire was mailed to 735 randomly sampled cohort members, and 89 per cent of them responded. Estrogen exposure and its implications were described in a preceding paper (part I). The present paper reports the distribution in the cohort sample of personal features known to be risk factors for endometrial cancer. A comparison with results from various materials derived from population-based surveys and case-control studies implied that the cohort members might have a lower proportion of nulliparity (infertility) and a somewhat higher prevalence of hypertension. Differences in the distributions of age at menarche or menopause, weight, height and prevalence of diabetes were according to these comparisons slight and probably without clinical significance. It was concluded that the prevalence of risk factors for endometrial cancer other than estrogen exposure was not higher in the cohort than in the background population. Moreover, approximately one-fifth of the estrogen takers had been freed of their risk through hysterectomies.
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PMID:Characteristics of estrogen-treated women. A descriptive epidemiological study of a Swedish population. Part II. 663 3

Estrogen metabolism was studied in a newly established cell line (RL95-2) derived from a human endometrial carcinoma. Estradiol and estrone were metabolized to water-soluble derivatives by cells under in vitro culture conditions. Between 80-90% of the added steroids were metabolized, with nearly quantitative recovery of the products from the incubation medium. Arylsulfatase treatment converted the metabolites to ether-soluble forms, whereas beta-glucuronidase had no effect on the aqueous solubility of these compounds. Butanol extracts of the water-soluble estradiol metabolites cochromatographed on high performance liquid chromatography with 17 beta-estradiol-3-sulfate (93.6%) or estrone-3-sulfate (3.5%). No more than 6% of the estradiol added to the incubation medium was recovered in the form of estrone, either as estrone or estrone sulfate. After arylsulfatase treatment of the estradiol conjugates, 92% of the ether-soluble radioactivity cochromatographed with estradiol, and 3.8% cochromatographed with estrone. Estrogen-sulfurylating activity was localized in the cytosol of subcellular fractions of RL95-2 cells. The sulfoconjugation of estrogens by RL95-2 cells may prove useful as a model for the investigation of estrogen metabolism in endometrial carcinoma cells.
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PMID:Estrogen sulfoconjugation by human endometrial cancer cells (RL95-2) in culture. 669 41

The three primary indications for estrogen replacement therapy in postmenopausal women are severe vasomotor symptoms (hot flashes), prevention or treatment of osteoporosis, and atrophy of the genital tract. Estrogen replacement therapy is well established as reducing the morbidity and mortality associated with osteoporosis. The increased incidence of endometrial cancer associated with estrogen use (from 1/1,000 to 4/1,000 per year) must be accepted and viewed in perspective. Many of these estrogen-related cancers are stage I lesions, with a cure rate of 95%. In addition, the risk associated with estrogen replacement therapy can be reduced by coadministration of a progestogen during the last ten days of the cycle.
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PMID:Estrogen replacement therapy--boon or bane? Current status of the controversy. 670 Nov 32


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