How To Avoid Uterine Cancer

Not all cases of uterine cancer can be avoided, but the top ways to avoid uterine cancer are

• Take birth control pills, for each year additional protection is afforded against ovarian and uterine cancer
• Diagnose and Treat all precancerous conditions of the uterus such as polyps
• Prevent and Control Obesity and Insulin Resistance

The strategies to protect against uterine cancer are complex for many women, simple for others. Having a baby, using hormonal birth control, keeping your weight down, actually are all strategies to prevent the pre-cancerous and cancerous changes that can occur in the lining. We don’t know yet what other metabolic changes affect this, it may be that both diabetes and high blood pressure are also specific risk factors. And we do now know that the lining of the uterus changes long before it becomes cancerous.We do know with this long lag time, we can help many cases of uterine cancer be avoided, it has to be done through ongoing and individual evaluation, don't skip check ups even if it's not a pap smear year. The uterine wall is a muscle, and the lining tissue is very different stuff, it’s called the endometrium. Endometrium is shed monthly and it regenerates, this propensity to grow, develop and respond to estrogen, makes this vulnerable to factors that can created a malignancy. Other cancers of the uterus such as scarcomsas that form in uterine fibroids do exist, but most cancers of the uterus thus occur in the lining or endometrial cancers. So it’s important to keep that lining healthy.

 Gynos don't often miss precancerous changes, accuracy of transvaginal ultrasound and operative hysteroscopy (looking in the uterus) has enabled us to learn a lot about the changes of the lining to help you understand what could be done and what should be done. Lining changes that are specifically a thickened lining or accompanied by polyps of the lining are the changes that are most often seen. And when the thickening is formed in polyps is often what your gyno worries will become a lining cancer of the uterus. The old standard recommendation is that if are young, and if the polyps are small, meaning less than 1 cm, they may resolve on their own, and if the tissue that is polyp shaped on transvaginal ultrasound is greater than 1 cm it may be a precancerous or cancerous growth. Rarely is the growth cancerous.  Newest information from multiple studies does confirm that if you are older, particularly past menopause it is more likely the polyp growth is more serious. It is now calculated that if you do have a polyp your chance of having lining cancer is about 3.5%. We don’t know how to recalculate risks if you also have the factors mentioned above: obesity, diabetes, high blood pressure. Preventing cancer may mean surgically removing the polyp and treating with medication to prevent cancer.  If you have medical reasons you cannot take the hormones (usually progesterones) that are used to treat polyps then it is more likely you will benefit from a surgical solution. As I often gab about: accuracy in diagnosis is important and proper tests to determine the extent of the lining changes should be done before coming up with the plan of management.

As for controlling weight and obesity, we now know through animal studies that control of insulin for medicines like metformin which controls sugar counts for diabetetics can help control the growth factors that lead to uterine cancer.