Endometrial Cancer and Risk Factors

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  • 0:01 Female Reproductive Cancers
  • 1:01 Endometrial Cancers
  • 1:51 Risk Factors: Diseases…
  • 5:28 Risk Factors: Estrogen…
  • 7:38 Risk Factors: Lifestyle
  • 7:59 Lesson Summary
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Instructor: Heather Adewale

Heather has taught reproductive biology and has researched neuro, repro and endocrinology. She has a PhD in Zoology/Biology.

While it doesn't get the press that breast cancer does, or have a vaccine like cervical cancer, endometrial, or uterine, cancer is actually one of the more common cancers of the female reproductive tract. So how do you know if you or someone you know is at risk? Learn about the risk factors for endometrial cancer in this lesson.

Female Reproductive Cancers

Did you know there is a vaccine for cancer? The HPV vaccine for women helps prevent cancer of the cervix. That's this part of the reproductive tract. But, even though we have created a vaccine for cervical cancer, it's actually not even the most common form of cancer found in the reproductive tract.

The most common cancer of the female reproductive tract is endometrial cancer, a cancer that occurs in the endometrial lining of the uterus. The endometrium is the inner lining or layer of the uterine wall, the one that grows and sheds during menstruation. An estimated 50,000 women were diagnosed with endometrial, also called uterine, cancer in 2013 and, of these, about 8,000 had fatal cases of the disease. So what is endometrial cancer? And how do you get it?

Endometrial Cancer

While we don't know the exact cause of endometrial cancer, we do know that it involves a mutation in the cells of the endometrium. This mutation in their DNA causes normal, happy and healthy endometrial cells to become abnormal and unhealthy cells that overgrow and multiply. Kind of like Bruce Banner vs. the Incredible Hulk, or Dr. Jekyll and Mr. Hyde. The mutated cells are out of control compared to their normal counterparts.

These out-of-control cells keep on multiplying and don't die off when they are supposed to, creating a tumor in the epithelial tissue. In some cases, if the cancer isn't caught soon enough, the tumor cells can metastasize, or spread to other parts of the body.

Risk Factors: Diseases and Disorders

So who exactly is at risk for this type of cancer? Well, females obviously, but is there anything that makes one female more susceptible to endometrial cancer than another?

Well, one of the main risk factors is actually the hormone estrogen. I know, you may be thinking, 'But aren't females supposed to have estrogen?' And yes, they are. Normally, both estrogen and progesterone levels rise and fall naturally, but sometimes certain conditions or diseases can alter estrogen metabolism. This can prevent estrogen levels from decreasing naturally or can cause higher-than-normal estrogen levels.

Prolonged exposure to estrogen has been identified as a risk factor for many female reproductive cancers, including endometrial cancer. Some of the conditions that can alter estrogen levels include:

Obesity and diabetes in association with a high-fat diet. You may not think that fat and your reproductive tract are related but they are. Excess fat can increase estrogen levels and interfere with fertility. Body fat can actually produce estrogen, and at the same time that estrogen makes it harder to break down abdominal fat, making estrogen and obesity linked.

Anovulation is our next risk factor. Now sometimes this can also be associated with obesity, but what does it mean? Well, let's break down the keyword. 'An' means without, so without what? Well, the definition is right there in the word. An'ovulation' means without, or lack of, ovulation.

Anovulation usually indicates abnormal hormone levels. Think about it this way. When a woman takes birth control pills, she is taking estrogen, well, estrogen and progesterone, and what do birth control pills do? They stop her cycle, right? Similarly, naturally occurring anovulation can be caused by excess estrogen.

PCOS, or polycystic ovarian syndrome, is also a cause of anovulation. It's thought to be a result of abnormal hormone levels, specifically the male hormone androgen that interferes with or prevents normal egg growth and ovulation.

Usually androgens in females are really low, which is why we don't have all that excess hair growth! And, our androgens can be converted to estrogens. So when androgens increase, estrogens also increase, raising the estrogen levels in PCOS patients, making it another risk factor associated with endometrial cancer.

Tumors or other growths of tissue that secrete estrogen. Sometimes non-cancerous tissue growths can be found in the ovaries or the uterus, and, in some cases, even though the growth itself isn't dangerous with respect to cancer, the cells inside it can produce estrogen. This then increases the level of estrogen in the body, thus increasing one's chance of developing endometrial cancer.

Risk Factors: Estrogen Therapy and Genetics

And even estrogen therapy for breast cancer or menopause can cause prolonged exposure of the endometrium to higher-than-normal estrogen levels.

Now let's take a moment and look at that last one. Why would doctors prescribe something that could cause cancer? Well, in the case of breast cancer, the risk for developing endometrial cancer is lower than the risk of letting breast cancer spread. So for some women, this is worth the risk.

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