How You Avoid Uterine Cancer

Not all cases, but we do believe we can help many cases of uterine cancer be avoided. 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.. Most cancers of the uterus thus occur in the lining or endometrial cancers. So it’s important to keep that limning. The strategies 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. Pre-cancerous changes in the lining do not often become cancerous. And the 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 thick lining or accompanied by polyps of the lining are the changes that are most often seen. And polyps are 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.