Hormone Therapy

Estrogen and Uterine Cancer

Uterine cancer is a general term that refers to several different types of cancers that affect the uterus. These cancers include:

  • Endometrial cancer: Endometrial cancer forms in the lining of the uterus. It is the most common type of cancer of the uterus.
  • Cervical cancer: Cervical cancer forms at the tip of the uterus, which opens into the vagina. Forty years ago, cervical cancer was very common. A screening technique called the pap smear has significantly decreased the incidence of cervical cancer.
  • Uterine sarcoma: Uterine sarcomas form in the uterine smooth muscle or connective tissue.

Uterine cancer is the fourth most prevalent cancer among women in the United States. In 2008, over 43,000 women were diagnosed with cancer of the uterus, and over 7,500 women died from the disease. Most women diagnosed with the disease are between the ages of 60 and 70.

Cancer of the uterus most frequently occurs among postmenopausal women. The risk of developing the disease is highest among women who are significantly overweight and who use estrogen hormone replacement therapy to mitigate menopausal symptoms. Diabetic women have twice the risk of developing cancer of the uterus than women who do not have diabetes. There also appears to be a connection between hypertension and this type of cancer.

Signs and symptoms of cancer of the uterus include:

  • Pelvic pain, particularly with sexual intercourse.
  • Vaginal bleeding. It is important to remember that any type of vaginal bleeding among postmenopausal women is abnormal.
  • Difficulty with urination.

The standard treatment for cancer of the uterus is a hysterectomy, a surgical procedure that removes the uterus, fallopian tubes, and ovaries. Adjuvant therapies frequently include radiation treatments and hormone therapy.

Radiation therapy involves bombarding target areas with high-energy beams such as X-rays. External radiation involves the use of a machine to direct the radiation at target areas, while internal radiation, or brachytherapy, involves the insertion of a radiation device into the vagina.

Hormone therapies for uterine cancer involve taking pharmaceuticals that regulate the body's own levels of progesterone and estrogen. Increased estrogen levels appear to play a significant role in the development of uterine cancer. Progesterone functions as an estrogen antagonist, while lowering the body's estrogen levels will interfere with the growth of estrogen dependent cancer cells.

Estrogen was once widely prescribed for postmenopausal women, since it alleviates many of the unpleasant symptoms associated with menopause. In the interests of the prevention of uterine cancer, however, estrogen replacement therapy is typically used these days only with women who've undergone hysterectomies.