About 8 thousand new diagnoses every year in our country, especially after menopause. Obese women and those with a higher concentration of abdominal adipose tissue are more in danger
Overweight and hormonal imbalances increase the risk of endometrial cancer, the fifth most common among Italian women and the third if we consider only the age group 50-69 years. To highlight new possible mechanisms of interaction between neoplasms affecting the mucosa that covers the internal cavity of the uterus and high levels of the body mass index is a new study published by British researchers from the University of Bristol University of Bristolwith the support of Cancer Research UK, which analyzed data on 122,000 women, nearly 13,000 of whom had endometrial cancer.
Symptoms not to be overlooked
It is the most common gynecological cancer after breast cancer. In Italy they are registered about 8 thousand new diagnoses every year. “The incidence is higher in menopausal women,” he says Giovanni Swaps, director of the Department for the protection of women’s health and oncological gynecology at the Gemelli Hospital in Rome -. It presents itself above all around the age of 55-65 (average age 61 years) and only in 20% of cases before menopause has begun: it is in fact rare before the age of 40 ». The metrorrhagia, or the abnormal uterine bleeding regardless of the menstrual cycle or postmenopausal, it is the first alarm bell: for this reason, blood loss, especially in postmenopausal women, should be a reason for rapid and thorough investigation. White-yellowish vaginal discharge (leucoxantorrhoea), abdominal pain and swelling (edema) in the lower limbs are more characteristic of an advanced stage of cancer.
Who is most at risk of getting sick
“Obesity, diabetes, hypertension, late menopause, intake of estrogens not balanced by progestogens increase the chances of getting sick – he continues Sunday Lorusso, associate professor of oncological gynecology at the Catholic University of the Sacred Heart of Rome -. The risk is also higher for women who take it tamoxifendrug used in breast cancer therapy and in those who have received it previous radiotherapy to the pelvis. The reason behind the increased danger for these categories of people lies in the increased share of estrogen which, in all these cases, stimulates the endometrium in an improper way “. Several studies, then, have clearly highlighted that excessive weight not only increases the chances of developing a neoplasm, but also of dying from it: the International Agency for Research on Cancer of Lyon, in fact, has officially linked 13 different types of cancer to obesity, including endometrium, colorectal rectum, esophagus, kidney, pancreas and breast. “To be accused in particular is the type of body fat distribution in addition to its absolute quantity – adds Lorusso -: visceral and abdominal fat, located deep around the central organs of the body and therefore not palpable, it is much more dangerous than the subcutaneous fat that accumulates on the surface, between the skin and muscles. In particular of the four subtypes of endometrial cancer known today, it seems more associated with this problem that one that presents the expression of hormone receptors and that is, consequently, “super-stimulated” by excess estrogen ».
The new study
The results of the new survey indicate that having a body mass index (BMI, body mass index) higher can interfere with different hormones and explain some mechanisms that lead to the onset of endometrial cancer. The body mass index is obtained by dividing the weight (expressed in kilograms) by the square of the height: a BMI value of less than 25 indicates a person of normal weight; 25 to 30 are overweight; 30 to 40 indicates obesity and over 40 a severe form of obesity. The BMI represents an approximate index since it does not take into account the type of physical constitution, the location of fat and muscle mass. Another value to consider is the waist circumference (measured at the navel), which is an index of the abdominal adipose tissue. «The British researchers – explains Lorusso – have discovered that an increase in BMI of even just 5 points is associated with an 88% increase in the risk of developing endometrial cancer. In fact, obese patients often present problems in sugar metabolism and insulin resistance which would determine a greater availability in the circulation of the male hormone (testosterone) in a free form, which is transformed in the adipose tissue into estrogen. And these, in turn, go to stimulate the growth of the tumor ».
The extra pounds also interfere with therapies
Scientific research in recent years has made it clear that excessive weight not only increases the chances of getting sick, but also of dying from cancer. If diagnosed and treated at an early stage, the prognosis for endometrial cancer is good: approximately 90-95% of patients are alive 5 years after diagnosis. “Those who are obese, however, are more likely to face complications, both medical and surgical, during treatment – concludes Scambia -. In the obese patient, the treatment is likely to be reduced or excessive due to the different distribution of the drug that occurs in body fat. Fortunately we also know that Losing weight concretely contributes to improving the situation. Finally, since the imbalance of estrogen and progesterone plays an important role in the development of endometrial cancer, it is important that the intake of these hormones is always balanced under strict control of the specialist “.
May 16, 2022 (change May 16, 2022 | 15:50)
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