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| Uterine Cancer and Menopause |
You've been through "the change," which was rough enough, but now you are faced with an increased risk of a variety of health conditions, including uterine cancer. The most common reproductive cancer in women, uterine cancer generally occurs in women older than 50.
"Just as all cancers increase with age," so does uterine cancer, says Karen Lu, MD, a professor of gynecologic oncology at the University of Texas M. D. Anderson Cancer Center in Houston. However, she says, "it's counterintuitive, because at menopause there is a drop in estrogen, a hormone we know is related to uterine cancer."
Why Is Uterine Cancer More Likely After Menopause?
It is not clear why post-menopausal women are at increased risk for uterine cancer. However, research indicates that hormone treatments, once taken by many menopausal women, may be partially to blame.
Hormone replacement therapy (HRT) used to be the first line of treatment to relieve menopausal symptoms such as hot flashes and prevent bone loss and heart disease. Today, fewer women take HRT since researchers found that HRT can actually increase a woman's risk for a number of health problems, including breast cancer, heart disease, stroke, and blood clots. While combined HRT, with both estrogen and a progestin, has not been shown to raise the risk for uterine cancer, taking estrogen alone does increase the risk of uterine cancer.
Likewise, women who have been treated for breast cancer may take the drug tamoxifen (Nolvadex) to prevent the return of the cancer. But tamoxifen increases the effect of estrogen in your body — and may increase the risk of uterine cancer.
Preventing Uterine Cancer in Menopause
There are several steps you can take to help prevent uterine cancer following menopause:
Maintain a healthy weight. One of the strongest risk factors linked to uterine cancer is obesity. Obese women are two to five times more likely to get uterine cancer than normal-weight women. Eating a healthy diet and getting enough physical activity to maintain a normal weight for your age can help prevent uterine cancer.
Control diabetes. If you have type 2 diabetes, work with the doctors, nurses, and others on your medical team to keep your blood sugar under control. Women who have diabetes and are diagnosed with uterine cancer are 76 percent more likely to die than their non-diabetic peers, according to one recent study. While controlling your blood sugar may not prevent uterine cancer, it may make the cancer less likely to be fatal.
Control high blood pressure. Dr. Lu notes that there is a link between having high blood pressure (hypertension) and the risk of uterine cancer, "probably because [hypertension] is related to obesity as well," she says.
Catch Uterine Cancer Early
One of the benefits of menopause is that it may help you catch uterine cancer early. The most significant early warning sign of uterine cancer is unusually heavy or prolonged bleeding, or bleeding between menstrual cycles. As you go through menopause, your periods become lighter and less frequent until they stop. This means that any bleeding that does not follow that pattern requires a call to your doctor, says Lu.
"The lifetime risk for each woman is about 3 percent," says Lu. "If the bleeding is different from your baseline, I would rather err on the side of caution. Uterine cancer is very treatable with surgery alone — [there is an] 85 to 95 percent cure rate when confined to the uterus."
If you are experiencing unusual bleeding before menopause or any bleeding after menopause, or if you have pain in your pelvic area or pain during intercourse, talk to your doctor about the possibility of uterine cancer.
Your doctor will do a pelvic exam and may want to analyze a sample of your endometrial tissue, which lines the uterus. This procedure, called an endometrial biopsy, is quick and nearly painless, and can be done in your gynecologist's office. Occasionally, a larger sample is obtained by doing a dilation and curettage (D&C). Both tests can tell your doctor if there are abnormal or cancerous cells present in the lining of your uterus.
Article source: http://www.everydayhealth.com/uterine-cancer/basics.aspx
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