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Query: UMLS:C0476089 (
endometrial cancer
)
11,379
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
At the Wilford Hall U.S. Air Force Base Medical Center, Texas, about 4000 postmenopausal women received estrogen replacement therapy during 1975. Of these, 2700 took estrogens only and 1240 were given a progestogen along with estrogen. Hysterectomy had been done previously on 1700 patients (42%), leaving 2300 with intact uteri and a risk of
endometrial cancer
. Adenocarcinoma of the endometrium was diagnosed in 7 patients. Of these, 6 had received estrogen therapy. There was 1 endometrial malignancy in a patient also receiving a progestogen. Among 510 untreated postmenopausal women with intact uteri, 1 adenocarcinoma of the endometrium was found. Type and dosage of estrogen were unrelated to endometrial malignancy. In addition to the 7 endometrial cancers from the clinic, 22 cases were diagnosed elsewhere and referred for treatment, 11 of these had received no hormones. 10 were taking estrogens and 1 was receiving Oracon for birth control. The incidence of endometrial malignancy in the U.S. is reported to be 21/100,000 women/year. There is a 3-fold to 9-fold increased risk of
endometrial cancer
associated with obesity alone. The probability that untreated postmenopausal women with intact uteri will develop
carcinoma of the endometrium
is 1/1000/year. With estrogen users, it is reported to be increased -7.6/1000 women/year. In the author's clinic during 1975, the incidence among those receiving only estrogen was 4.7/1000. Among those also receiving a progestogen the incidence was .8/1000. Unopposed estrogens apparently have a role in the etiology of endometria hyperplasia and neoplasia through incomplete shedding of the endometrium.
Progesterone
produces more complete sloughing of the endometrium and also converts all degrees of hyperplasia into secretory endometrium. Nulliparity, infertility, and anovulation are predisoposing factors to
endometrial carcinoma
. Progestogens are palliative therapy for
endometrial cancer
.
...
PMID:Estrogens, progestogens and endometrial cancer. 19 79
An overview of the sex hormones is presented. Testosterone is a natural androgen produced in the testes, adrenal glands, and ovaries. It has anabolic as well as androgenic effects. Testosterone is used to treat inoperable breast cancer and osteoporosis, and to stimulate erythropoesis. Androgens are absolutely counterindicated in cases of prostate cancer. Estrone, estradiol, and estriol are natural estrogens produced in the ovaries, placenta, testes, and adrenal glands. These hormones also influence the production of gonadotropins by the pituitary gland. Estrogens are used to treat menopausal disorders, ovarial insufficiency, estrogen-independent breast cancer, prostate cancer, and in some cases pregnancy disorders. Estrogens and progestagens are 2 components used in oral contraceptives.
Progesterone
, a natural progestagen, is produced by the corpus luteum. It promotes the proliferation phase of the endometrium, fertilization, and nidation, and it works to maintain pregnancy.
Progesterone
is used to treat spontaneous abortion, corpus luteum insufficiency, and
endometrial cancer
.
...
PMID:[Sex hormones]. 24 26
Proliferating tumor cells obtained from ovarian, mammary, and endometrial tumors in tissue culture were tested for the influence of proteohormones and steroid hormones on cellular DNA synthesis and cell growth. The gonadotropic hormones stimulated DNA synthesis of ovarian tumor cells by single administration, or in combination with cortisol, up to the 11-fold of the comparable controls. The hormone sensitivity of the cell lines was variable, resulting in individual reaction patterns. There was no correlation to the histological diagnosis of the primary tumors with respect to the grade of differentiation. The results suggest that ovarian tumor cells in tissue culture can maintain sensitivity to organotropic hormones. Compared to the ovarian carcinoma lines, mammary or endometrial tumor cells did not respond to a similar extent.
Progesterone
decreased DNA synthesis of
endometrial carcinoma
cells.
...
PMID:Hormone sensitivity of gynecological tumor cells in tissue culture. 47 69
The spectrum of progestin therapy has changed and expanded during the last few years. 1. The drug-therapy of choice in endometriosis is the medication of progestins for at least six months, for instance ethinyl-testosterone. If a patient wants additional children the "more gentle" dydrogesterone should be considered. 2. In the treatment of dysmenorrhea combination pills should be given, sequentials should be avoided. In the case of incompatibility of estrogens or in danger of oversuppression syndrome dydrogesterone should be applicated. 3. Dysfunctional bleedings should lead to an intense search for their cause. The treatment consists in an estrogen-progestin combination for 9 days and in cyclic continuation of this therapy for at least a further three months. In the case of hemorrhagic diathesis progestin treatment should be continued. 4. Cyclic adequate progestins have proofed to be successful in handling of hirsutism. The choice of the preparation depends on the patient's wish for children. 5. The progestin test is still the first step in diagnosis of amenorrhea. 6.
Progestin
therapy is indicated in progressive
endometrial carcinoma
. Some medical centres treat carcinoma of the mamma successfully with progestins. 7. Nowadays fast and early hormonal pregnancy tests are available. The progestin-pregnancy-test is limited to cases of premenopause. 8. The so-called short luteum phase has received considerable attention as a possible cause of infertility. In these cases a substitutional therapy of progestins should follow. Clomiphene or HCG-therapy is advisable. In short luteum phase and premenstrual spottings potent progestins should be given. 9. High dosage of progestins are in common use in the treatment of abortus imminens. 10. Combination pills and sequentials are widely used, the possible methods of a pure progestin contraception are: minipills, three-month-injections, implanted silastic capsules with progestional compounds, progestin impregnated intrauterine devices, vaginal silastic rings impregnated with progestional compounds. 11. Carcinogenesis of progestins was not detectable. 12. Some progestins are teratogenic.
...
PMID:[Current status of gestagen administration. 2. Gestagen therapy in the area of reproduction]. 55 11
Horones as a therapeutic agent are practically not used in gynecologic oncology, because gynecological malignomas are hormonally independent. Therapeutically succesful in only the use of
Progesterone
in metastases and relapses of
endometrial cancer
and of Estrogen in the palliative treatment of cervical cancer relapses. However, significant results are obtained by cytostatic therapy, particularly in carcinomas of the ovary and in choriocarcinomas; the therapy is somewhat less successful in the cancer of the oviduct and vulva, while in the cancer of the cervix and vagina it is not successful at all. Polychemotherapy is recommended because it results in better remissions and is less aggressive.
...
PMID:[Cytostatic and hormonal therapy on oncologic gynecology (author's transl)]. 75 24
Neoplastic tissue was obtained from 30 patients with
endometrial carcinoma
and the response of this tissue to various hormones was studied in vitro by histological methods and by measuring the incorporation of 3-H thymidine into DNA.
Progesterone
and synthetic progestogens had a consistently adverse effect on tissue survival in vitro while pregneolone had a beneficial effect.
...
PMID:Effect of protein hormones and steroids on tissue cultures of endometrial carcinoma. 113 39
The effectiveness of monophasic and multiphasic oral contraceptives (OCs) depends on their ability to suppress ovulation, change endometrial growth and ovum receptivity, and reduce cervical mucus receptivity to sperm. They are all more than 99% effective, but, depending on the type and dose of hormone components, they have different side effects. The estrogen component (ethinyl estradiol) of most new OCs is between 30 and 35 mcg, which reduces the risk of estrogen side effects, especially thromboembolism and hypertension. The Food and Drug Administration does not recommend use of an OC with an estrogen component for lactating mothers, while the American College of Obstetrics and Gynecology and the American Academy of Pediatrics believe it is fine. Estrogen may protect against coronary artery disease, yet the estrogen component of today's OCs is so low that the progestin component may cancels this beneficial effect. It also prevents breakthrough bleeding. The most frequently used progestins in OCs are norethindrone and norgestrel. They prevent ovum implantation, sperm penetration through the cervical mucus, and ovulation. Progestins, especially norgestrel, increase the risk of coronary artery disease. Other side effects include acne and weight gain.
Progestin
benefits are reduced menstrual blood loss, pain during menstruation, premenstrual tension, and
endometrial cancer
risk. The ideal estrogen-progestin balance depends on the individual, but the estrogen component should be between 30 and 35 mcg, and the progestin component should be the lowest possible dose to reduce metabolic side effects. If an OC user with a well stabilized cycle who takes another recently prescribed drug experiences unexpected breakthrough bleeding or spotting, this change may indicate a drug interaction. Absolute and/or possible contraindications of OC use are smoking after age 35, history of breast or
endometrial cancer
, liver disease or impaired liver function, cardiovascular risk factors, and diabetes mellitus.
...
PMID:Benefits and risks of oral contraceptive use. 143 13
For women beyond the desire for childbearing, the contraceptive options are discussed as appropriate for the age and in light of risks and benefits. Reeducation and careful history taking are important. A pregnancy for a woman 40 years places a woman at greater risk for an elective abortion and greater risk of maternal mortality from abortion; low dose contraceptive use can have beneficial effects for menopausal women. Methods are grouped as contraceptive steroids (combination pills, progestin-only pills, oral preparations, implants, and injections), IUDs, barrier methods (diaphragms, cervical caps, vaginal sponges, spermicides, and contraceptive film), condoms, sterilization, and natural family planning. Empowering women means providing current scientific information and urging women to examine their lives, and to review how and why contraceptive choices were made, and the consequences of the choices. Sexually transmitted disease counseling is appropriate for women in new relationships. A positive attitude toward menopause needs to be conveyed. Combination pills at the lowest dose possible are recommended for women 35 years who are healthy, nonsmoking (or smoking 15 cigarettes/day), blood group O, and able to derive benefits from the pill. Benefits include a 30% reduction in uterine fibroids and protection against
endometrial cancer
, and decreased risk of ectopic pregnancy, pelvic inflammatory disease (PID), and iron deficiency anemia. Multivitamin use with the pill is recommended due to reduced liver stores of vitamin A. Women 40 years with a parent dying of cardiac disease 50 years or with a history of hypertension, diabetes, or hyperlipidemia are not suitable candidates. 35 mcg preparations are recommended for women 35-45 years, and 20 mcg for women over 45 years.
Progestin
-only pills are recommended for those with contraindication to estrogen, but have a higher pregnancy rate. IUD use among older women may be difficult due to cervical or pelvic surgery; there is a higher incidence of PID and ectopic pregnancy with IUD use. Barrier methods are more successful for older women due to the changing vaginal anatomy. Vasectomy is the safest sterilization procedure.
...
PMID:Contraception for midlife women. 159 31
Well over 100,000,000 women have used the combined oral contraceptive (OC) pill. As a result of the population explosion in the 1970s and 1980s, there will be almost one third more women in fertile age in the year 2000 than in 1991. In the developing world outside China, the total number of contraceptive users could double in roughly 10 years. China, the total number of contraceptive users could double in roughly 10 years. The pill has a low failure rate, but one study in Egypt found that 90% of women made errors in moving from one packet to the next. Similarly, a 60% error rate was found among users in Colombia. The vaginal ring delivers combined progestogen and estrogen through a silastic wall. The device can be left in place for 21 days out of 28, and such delivery would virtually eliminate the low risk of hepatocellular carcinoma among OC users. A vaginal progestogen ring is being tested. Over 700,000 women have used Norplant, the subdermal implant method with an effectiveness rate of 99%. Depo-provera and norethindrone enanthate injections last 2 to 3 months. The
Progestasert
IUD, containing 38 mg progesterone released at a rate of 65 mcg per day, is effective.
Progesterone
-releasing IUDs lasting from 3 to 5 years could complement subdermal implants. Ethinyl estradiol (205 mg) and diethylstilbestrol (25-50 mg) have both been used as postcoital agents taken within 36 hours for 5 consecutive days after unprotected intercourse. In more than 3000 cases there were 17 pregnancies (.05%). These regimens are replaced by giving combined oral contraceptive tables (e.g., .25 mg d-norgestrel and 50 mg ethinyl estradiol), taken 2 at a time and repeated 12 hours later, within 72 hours of unprotected intercourse. Epidemiological studies have confirmed that the use of the combined oral contraceptive for 3 to 5 years halves a woman's risk of ovarian or
endometrial cancer
, and the protection persists for 10 to 18 years after cessation of use.
...
PMID:The future of hormonal contraception. 168 5
Investigations of estrogen and progesterone receptors content in 28 women with
endometrial cancer
in the cancer tissue. During treatment with large doses of
MPA
(Depo-Provera) a significant decrease of progesterone receptors was observed.
...
PMID:[Response of estrogen and progesterone receptors to treatment with large doses of progestogen (depo-provera) in endometrial cancer]. 214 45
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