The Doctor Is In
Protect your uterus.
Breast and ovarian cancers take center stage in the news, but uterine cancer is actually the most common gynecologic one. In fact, overall it’s the fourth most common cancer in women, resulting in hysterectomy and often radiation and chemotherapy. And alarmingly, over the last 15 years, while rates of colon, lung, and other cancers have decreased, uterine cancer rates have increased by 12%.
There are a number of reasons for this, but the biggest culprit is obesity (40% of women in the U.S. are now obese). Obese women are two to four times more likely to develop uterine cancer than those at a healthy weight. Fat cells make estrogen, and an overload of estrogen can result in an abnormal buildup in the lining of the uterus. That, in turn, can lead to the development of abnormal cells.
But it’s not just fat cells that can cause a hormonal imbalance.
Normally, ovulation triggers the production of progesterone, which prevents the uterine lining from getting too thick. If a woman isn’t ovulating (for example, if she is perimenopausal or has polycystic ovarian syndrome), the lining of the uterus gets blasted with estrogen, but there’s no progesterone to balance it out.
Uterine cancer is highly curable if detected early. Fiveyear survival rates for women diagnosed when the cancer is Stage I are over 90%. But Black women and those in other non-Caucasian racial/ethnic groups who have this cancer are approximately twice as likely to die from it, because it tends to be detected in them at a later, less treatable stage.
An important thing to watch for: any abnormal bleeding. Ninety percent of women with uterine cancer report that they’ve had that symptom. In a premenopausal or perimenopausal woman, this
means anything that varies from a normal monthly flow, whether it’s heavy bleeding, spotting, or irregular cycles. And any bleeding in a postmenopausal woman should be evaluated. The overwhelming majority of abnormal bleeding is not an indication of cancer, but it still needs to be checked out as soon as possible.
The number one thing you can do to reduce your risk: Get to a healthy weight. Exercise (any type of movement) also helps, as do these tactics:
CHOOSE AN IUD
Those that contain progestin significantly decrease the risk of uterine precancers and cancers.
USE HORMONAL BIRTH CONTROL
Using birth control pills and other hormonal contraceptives for at least one year decreases the risk of uterine cancer by a whopping 50% to 80%. This protection may last up to 30 years after you stop.
PICK YOUR PROGESTIN
If you’re taking oral or transdermal estrogen for relief of hot flashes (and you have a uterus), it’s crucial to take an appropriate progestin. (This isn’t necessary if you’re using a local vaginal estrogen.)
CONSIDER YOUR GENES
If you have multiple family members with colon cancer and/or uterine cancer, talk to your doctor about genetic testing. Your family may carry a Lynch mutation, with which there’s a 20% to 51% risk of developing uterine cancer.