Cancer endometrial

Meg estrolAceta.te. This compound is used outside the United States as an oral contraceptive. In the United States, it is used for the paUiative treatment of breast cancer and endometrial cancer, or as an adjunct to other therapies. Its use has been associated with an increased appetite and food intake and has been evaluated in the treatment of anorexia and cachexia (107). 

Pentoxifylline is stmcturaHy related to other methylxanthine derivatives such as caffeine [58-02-2] (1,3,7-trimethylxanthine), theobromine [83-67-0] (3,7-dimethylxanthine), and theophylline [58-55-9] (3,7-dihydro-1,3-dimethyl-1 H-piirine-2,6-dione or 1,3-dimethylxanthine), which also show radioprotective activity in some instances, suggesting that methylxanthines as a dmg class may radioprotect through a common mechanism (see Alkaloids). In a retrospective analysis of cervical and endometrial cancer patients receiving primary or adjuvant XRT, no association between caffeine consumption and incidence of acute radiation effects has been found. However, there was a decreased incidence of severe late radiation injury in cervical cancer patients who consumed higher levels of caffeine at the time of thek XRT (121). The observed lack of correlation between caffeine consumption and acute radiation effects is consistent with laboratory investigations using pentoxifylline. 

Thus, our attention should shift from the concern of potential adverse effects to the health benefits imparted by hormonal contraceptives. The use of oral contraceptives for at least 12 months reduces the risk of developing endometrial cancer by 50%. Furthermore, the risk of epithelial ovarian cancer in users of oral contraceptives is reduced by 40% compared with that on nonusers. This kind of protection is already seen after as little as 3-6 months of use. Oral contraceptives also decrease the incidence of ovarian cysts and fibrocystic breast disease. They reduce menstrual blood loss and thus the incidence of iron-deficiency anemia. A decreased incidence of pelvic inflammatory disease and ectopic pregnancies has been reported as well as an ameliorating effect on the clinical course of endometriosis. 

Future efforts should be directed at optimizing current formulations to finally come up with an ideal oral contraceptive which would reduce the risk of breast, ovarian and endometrial cancer without any cardiovascular complications. 

Taking the contraceptive hormones provides health benefits not related to contraception, such as regulating the menstrual cycle and decreased blood loss, and incidence of iron deficiency anemia, and dysmenorrhea Health benefits related to the inhibition of ovulation include a decrease in ovarian cysts and ectopic pregnancies. hi addition, there is a decrease in fibrocyctic breast disease, acute pelvic inflammatory disease endometrial cancer, ovarian cancer, maintenance of bone density, and symptoms related to endometriosis in women taking contraceptive hormones. Newer combination contraceptives such as norgestimate and ethinyl estradiol... 

Warning associated with the administration of estrogen include an increased risk of endometrial cancer, gallbladder disease, hypertension, hepatic adenoma (a benign tumor of the liver), cardiovascular disease, increased risk of thromboembolic disease and hypercalcemia in those with breast cancer and bone metastases. 

Breast cancer 160 mg/d PO endometrial cancer 40-320 mg/d in divided doses PO... 

The pattern of hormonal risk factors involved in the development of endometrial cancer is similar to those associated with the development of breast cancer. In addition, there is substantial evidence to suggest that HRT can increase the risk (Beral et al, 1999 Bingham et al, 1998). Compared to the UK, the incidence of endometrial cancer in countries such as Japan is relatively low (Bingham et al, 1998). It has been suggested that dietary factors may be responsible for the reduced incidence, and there is indirect evidence from epidemiology studies which suggests that increased consumption of soy products may lower the risk of endometrial cancer. However, these data are not conclusive. To date, no studies have demonstrated a link between consumption of phytoestrogens and an increased risk of endometrial cancer. 

The risk of endometrial cancer among women who have used oral contraceptives for at least 1 year is approximately 40% less than the risk in women who have never used oral contraceptives.9 There is additional evidence to suggest that the benefit of reduced risk for endometrial cancer is detectable within 1 year of use10-12 and that the benefit may persist for years following discontinuation of oral contraceptives.9... 

Women who have an intact uterus should be prescribed a progestin in addition to estrogen in order to decrease the risk of endometrial hyperplasia and endometrial cancer. 

SUI. Systemic estrogen therapy also carries numerous short- and long-term side effect risks (mastodynia, uterine bleeding, nausea, thromboembolism, cardiac and cerebrovascular ischemic events, and enhanced breast and endometrial cancer risks). If estrogens are to be used in SUI management, only locally-administered products should be used (Table 50-4). 

Contraindications/ Contraindications include known or suspected breast or Precautions endometrial cancer... 

Long-term use of hormone-replacement therapy and concurrent use of progestins appear to contribute to breast cancer risk.7 The use of postmenopausal estrogen-replacement therapy in women with a history of breast cancer generally is considered contraindicated. However, most experts believe that the safety and benefits of low-dose oral contraceptives currently outweigh the potential risks and that changes in the prescribing practice for the use of oral contraceptives are not warranted. Oral contraceptives are known to reduce the risk of ovarian cancer by about 40% and the risk of endometrial cancer by about 60%. 

SERMs Tamoxifen Toremifene 20 mg orally daily 60 mg orally daily Hot flashes, vaginal discharge, mild nausea, thromboembolism, endometrial cancer... 

Tamoxifen 20 mg PO twice a day continuously until progressive disease 10% Thrombocytopenia, anemia, thromboembolism, hot flashes, decreased libido, nausea/ vomiting 1. Protective effect on bone and lipids. 2. Increased risk for endometrial cancer. 

Karas, M., M. Danilenko, D. Fishman et al. 1997. Membrane-associated insulin-like growth factor-binding protein-3 inhibits insulin-like growth factor-I-induced insulin-like growth factor-I receptor signaling in ishikawa endometrial cancer cells. J Biol Chem 272(26) 16514—16520. 

Nahum, A., K. Hirsch, M. Danilenko et al. 2001. Lycopene inhibition of cell cycle progression in breast and endometrial cancer cells is associated with reduction in cyclin D levels and retention of p27(Kipl) in the cyclin E-cdk2 complexes. Oncogene 20(26) 3428-3436. 

Interestingly, while it has been reported that the inhibition of cell growth by carotenoids in colon (Palozza et al., 2001b, 2007a) as well as in prostate (Williams et al., 2000) adenocarcinoma cancer cells was independent of p53 and p21 status, HL-60 cells increased their p21 expression as a consequence of the treatment with p-carotene (Palozza et al., 2002b). In addition, the antiproliferative effects of P-carotene required p21 expression in human fibroblasts (Stivala et al., 2000). In contrast, mammary and endometrial cancer cells decreased p21 levels, following lycopene treatment (Nahum et al., 2001). 

A 41-year-old female is treated for endometrial cancer with tamoxifen. Of the following, how is tamoxifen classified ... 

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