Ovarian and Endometrial Cancer

A comparative study of malignant and normal endometrial tissues yielded a panel of proteins displaying differential expression in malignant tissues. A prominent putative marker was identified as chaperonin 10 by both MALDI-Qq-TOF and ESI-Qq-TOF-MS, confirmed by Western blot and immunohistochemistry [73], A comparison of sera of patients with endometrial cancer with those of healthy females using SELDI-TOF-MS (weak cation exchange chips) yielded a number of putative biomarkers upon evaluations with three data mining tools (a tree classifier, Biomarker Wizard, and Biomarker Patterns System). The diagnostic pattern combined with 13 putative markers made it possible to differentiate patients with endometrial cancer from healthy subjects with specificity of 100% and sensitivity of 92.5% [74]. 

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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. 

Noncontraceptive benefits of OCs include decreased menstrual cramps and ovulatory pain decreased menstrual blood loss improved menstrual regularity increased hemoglobin concentration improvement in acne reduced risk of ovarian and endometrial cancer and reduced risk of ovarian cysts, ectopic pregnancy, pelvic inflammatory disease, and benign breast disease. 

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... 

It has become apparent that reduction in the dose of the constituents of oral contraceptives has markedly reduced mild and severe adverse effects, providing a relatively safe and convenient method of contraception for many young women. Treatment with oral contraceptives has also been shown to be associated with many benefits unrelated to contraception. These include a reduced risk of ovarian cysts, ovarian and endometrial cancer, and benign breast disease. There is a lower incidence of ectopic pregnancy. Iron deficiency and rheumatoid arthritis are less common, and premenstrual symptoms, dysmenorrhea, endometriosis, acne, and hirsutism may be ameliorated with their use. 

The overall incidence of reproductive cancers attributable to oral contraceptive use has been estimated in a modeling analysis (72). The authors assumed a 50% reduction in ovarian and endometrial cancers associated with 5 years or more of tablet use, and used two alternative scenarios for breast and cervical cancer effects. If oral contraceptive use produces a 20% increase in breast cancer before age 50 and the same increase in cervical cancer, then for every 100 000 tablet users there would be 44 fewer reproductive cancers and these users would gain one more day free of cancer. If instead the increase in risk of early breast cancer and of cervical cancer is 50%, oral contraceptive users would have 11 fewer cancer-free days. 

Tumor-inducing effects are discussed in the monograph on estrogens. The risks of epithelial ovarian and endometrial cancer are reduced by combined oral contraceptives. Effects on other cancers are slight. 

Correct choice = E. Oral contraceptive agents decrease the incidence of ovarian and endometrial cancers. 

Q17 There are some major problems associated with oestrogen-replacement therapy. These include pulmonary embolism, thromboembolism, seizures, hepatic adenoma and risk of stroke. There is also now evidence of an increased incidence of breast, ovarian and endometrial cancer, which is related to the duration of HRT use. Approximately 14 in every 1000 women aged 50-64 years not using HRT develop breast cancer. Use of oestrogen-only HRT for five years in this age group increases the incidence of breast cancer to about 15.5 in every 1000 women this represents a relatively small increase in risk. 

I Cancer. The risk for ovarian and endometrial cancer decreases by 40% to 50% with OC use, and the beneficial effect is believed to persist for at least 15 years after the use ceases. The relationship between OCs and other cancers is controversial. OCs increase cervical ectopy, but the association with cervical cancer is unclear. 

The health benefits of oral contraceptives go beyond contraception and outlast the reproductive years.41 These include reduced incidence of ovarian and endometrial cancers. Oral contraceptives do not increase the risk of breast cancer, heart disease, or blood clots.42... 

Combination oral contraceptives have substantial health benefits unrelated to their contraceptive use. They significantly reduce the incidence of ovarian and endometrial cancer within 6 months of use, a protective effect that persists for up to 15 years after oral contraceptives are discontinued. Depot MPA injections also reduce substantially the incidence of uterine cancer. These agents also decrease the incidence of ovarian cysts and benign fibrocystic breast disease. 

Many reports indicate that malignant cancer cells express carbohydrate antigens other than sLe and sLe antigens. These reports show a correlation between expression of particular cell surface carbohydrate antigens and poor prognosis in cancer patients (104,105). Examples of these are seen in Lewis B (Le ) and Lewis Y (Le ) antigens overexpressed by breast, lung, ovarian, and endometrial cancers (104,106-110). 

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