Endometrial cancer is the most common type of gynecological cancer in developed countries. In Spain, it is the fourth most common, after breast, lung and colorectal cancer. Although the majority of women diagnosed are over 55 years old, there are more and more cases in young women. The cause? The growing increase in obesity in this population group. This risk factor, which affects various diseases, has a particularly relevant role in the development of endometrial cancer.
This type of cancer originates when the cells that line the internal cavity of the uterus grow uncontrollably. The cells that the ovaries produce—estrogens and progestogens—are very sensitive to hormonal changes. Dr. Berta Díaz, gynecologist-oncologist at Hospital Clinic Barcelonaexplains: “When there is an imbalance between estrogens and progestogens, an overgrowth of the internal cells of the uterus occurs, and this is the origin of cancer.” For this reason, most risk factors are related to hormonal factors.
Obesity is a risk factor because fat produces a hormone very similar to estrogen, and this hormonal incident can cause cancer.
The main risk factors include polycystic ovary syndrome, having had early menstruation or late menopause, not having had pregnancies, and having undergone estrogen hormone therapy after menopause. Additionally, those who have had radiation therapy to the pelvis to treat another cancer, or taken tamoxifen to treat breast cancer, are more likely to develop endometrial cancer. Being of Caucasian ethnicity or having a family history of colorectal, endometrial, breast or ovarian cancer also increases the risk.
What role does the obesity in the development of endometrial cancer? Dr. Díaz explains that “obesity is a risk factor because fat produces a hormone very similar to estrogen, and this hormonal element can cause cancer.” Thus, excess fat translates into excess hormones. Additionally, people with obesity have elevated levels of certain proteins and inflammatory factors in their blood, which also increases the risk of developing the disease.
According to a study that confirmed this relationship, an overweight woman is approximately 1.5 times more likely to develop endometrial cancer than a woman with a healthy weight, while an obese woman has between two and ten times the risk. The increase in cases in young women affects the clinical management of the disease, since the main treatment consists of removal of the uterus, ovaries and fallopian tubes, a procedure known as hysterectomy with bilateral adnexectomy.
If the cancer is caught early and has not spread to other parts of the body, in most cases, the five-year survival rate is 90% thanks to this intervention. However, in young women, preserving the ovaries and using fertility-preserving treatments should be considered in order to maintain hormonal function and quality of life after treatment. This should be done taking into account the patient’s reproductive expectations and seeking a balance with the most effective cancer treatment.
More than 90% of people who have endometrial cancer have abnormal uterine bleeding
In some cases, the disease can spread to the lymph nodes. For this reason, during surgery a biopsy of the lymph nodes near the tumor is performed and, if necessary, they are removed. Radiation therapy may be given as adjunctive treatment, depending on the risk of relapse. Chemotherapy may also be necessary after surgery. It can be administered simultaneously with radiotherapy and has an important role in the treatment of recurrent or metastatic disease. In other cases, especially low-grade tumors, hormone therapy is usually chosen.
What ensures a favorable outcome is early detection of the disease. Know the symptoms most common facilitates their identification. Dr. Ariel Glickman, gynecologist-oncologist at Hospital Clínic Barcelona, highlights the clearest warning sign: “More than 90% of people who have endometrial cancer present abnormal uterine bleeding.” Purulent vaginal discharge, abdominal pain or distension, breathing problems, extreme fatigue, or suspicious findings during vaginal cytology should also be of concern. Therefore, it is essential to perform regular gynecological check-ups.
#Obesity #increases #risk #endometrial #cancer
