Carcinoma endometrial

Glucocorticoids have inhibitory (apoptotic) effects on lymphocyte proliferation and are used to treat leukemias and lymphomas. Estrogens (fosfestrol) are used to block the effect of androgens in prostate cancer. Progestogens (megestrol, medroxyprogesteroneacetate) have been useful for treating endometrial carcinoma, renal tumors, and breast cancer. 

Hipp S, Walch A, Schuster T, et al. Precise measurement of the E-cadherin repressor Snail in formalin-fixed endometrial carcinoma using protein lysate microarrays. Clin. Exp. Metastasis 2008 25 679-683. 

Tamoxifen -nonsteroidal antiestrogen -nausea and vomiting -bowel changes (diarrhea or constipation) -headache -peripheral edema -hot flashes -endometrial carcinoma -vaginal bleeding -venous thrombosis... 

The answer is e. (Hardman, p 12740 Medroxyprogesterone is used as a second-line hormone therapy for metastatic breast or endometrial carcinoma that was previously treated with surgery and radiation. 

When studied in a model of human endometrial carcinoma, such as EnCa 101 tumors in athymic mice, ICI 164384 not only showed no stimulatory activity on tumor progression but also blocked the tamoxifen-stimulated growth of the tumor (Gottardis et al. 1990). 

The overall uterine effects obtained in animals treated with the different compounds make it possible to assume that pure antiestrogens could be used in the treatment of endometrial disorders and endometrial carcinoma (Gradishar and Jordan 1997). 

Gottardis MM, Ricchio ME, Satyaswaroop PG, Jordan VC (1990) Effect of steroidal and nonsteroidal antiestrogens on the growth of a tamoxifen-stimulated human endometrial carcinoma (EnCalOl) in athymic mice. Cancer Res 50 3189-3192... 

In a case-control study (van Leeuwen et al. 1994) in which 98 cases of invasive endometrial carcinoma were diagnosed at least 3 months after diagnosis of primary breast cancer, it was observed that the use of tamoxifen was associated with a RR of 1.3. The risk appeared to have a tendency to increase during treatment, from 0.6 for less than a year to 3.0 for more than 5 years of treatment. It should be noted that the accumulated dose of tamoxifen was significantly associated with risk of endometrial cancer. However, the average daily dose used (20-40 mg/d) did not seem to influence risk. Other authors have also observed that the increase in risk is only detected when a determined accumulated dose is attained (van Leeuwen et al. 1994 De Muylder et al. 1991). 

Magriples U, Naftolin F, Schartz PC, Carcangiu ML (1993) High-grade endometrial carcinoma in tamoxifen-treated breast cancer patients. J Clin Oncol 11 485-490... 

Progestins are nsed for varions menstmal cycle disorders, for functional uterine bleeding of various origins, and as a contraceptive. Progestin therapy is also used to treat endometriosis and endometrial carcinomas. Progesterone is not effective when taken orally due to intensive metabolism, and therefore it is used by either parenteral or transvaginal introduction. 

Estrogens have been reported to increase the risk of endometrial carcinoma. 

Studies have reported an increased risk of endometrial carcinoma associated with the prolonged use of estrogen in postmenopausal women. The risk appears to be decreased in OC users because of the progestin component. Users appear about half as likely to develop ovarian and endometrial cancer as women who have never used OCs. The protective effect from endometrial cancer lasts up to 15 years after... 

Megestrol acetate Synthetic progestogen Treatment of endometrial carcinoma and some forms of breast cancer... 

Fleming GF, Brunetto VL, Celia D, Look KY, Reid GC, Munkarah AR et al. Phase III study of doxorubicin plus cisplatin with or without paclitaxel plus filgastrim in advanced endometrial carcinoma a Gynecologic Oncology Group study. J Clin Oncol 2004 22 2159-66. 

Thigpen JT, Blessing JA, Hatch K, Barrett M, Adelson M, DiSaia P. A randomized trial of medroxyprogesterone acetate (MPA) 200 mg versus 1000 mg daily in advanced or recurrent endometrial carcinoma a Gynecologic Oncology Group (GOG) study. Proc ASCO 1991 10 185. 

Wadler S, Levy DE, Lincoln ST, Soori GS, Schink JG, Goldberg G. Topotecan is an active agent in the first-line treatment of metastatic or recurrent endometrial carcinoma Eastern Cooperative Oncology Group smdy E3E93. J Clin Oncol 2003 21 2110-4. 

Palliative treatment of advanced endometrial carcinoma PO 40-320 mg/day in divided doses. Maximum 800 mg/day in 1-4 divided doses. 

Endometrial carcinoma (uterus) Hormonal and cytotoxic chemotherapy, surgery... 

It is indicated as contraceptive, in hormone replacement therapy, primary and secondary amenorrhoea, dysfunctional uterine bleeding, endometriosis, postponement of menstruation, premenstrual syndrome, uterine hypoplasia, threatened or habitual abortion and premenstrual tension. It is also useful in endometrial carcinoma. 

It is indicated in dysfunctional uterine bleeding, amenorrhoea, dysmenorrhoea, hypo and hypermenorrhoea, delay of menstrual period, oligo and polymenorrhoea, benign breast disease, endometriosis, metrorrhagia and endometrial carcinoma. 

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