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Common Birth Control Device Proves to be Cost-effective Treatment for Early Endometrial Cancer

by Thilaka Ravi on  October 17, 2012 at 4:28 PM Cancer News   - G J E 4
A common birth control device has been found effective in treating early-stage endometrial cancer in morbidly obese and high-risk surgery patients, said Georgia Health Sciences University Cancer Center researchers, and this could lead to a cost-effective treatment for all women with this cancer type.
Common Birth Control Device Proves to be Cost-effective Treatment for Early Endometrial Cancer

Endometrial cancer, which starts in the lining of the uterus, is the third most common gynecologic cancer, striking more than 47,000 American women every year, particularly the obese. "Total hysterectomy, sometimes with removal of lymph nodes, is the most common treatment for this type of cancer. But women who are morbidly obese or who have cardiac risk factors are not good candidates for surgery," said Dr. Sharad Ghamande, a gynecologic surgeon and oncologist at the GHSU Cancer Center, Chief of the Section of Gynecologic Oncology at the Medical College of Georgia, and principal investigator on the study.

For two years, Ghamande and his team followed a small group of high-risk patients with early-stage endometrioid adenocarcinoma, a common subtype of endometrial cancer, and those with atypical endometrial hyperplasia, or thickening of the uterine lining, which can lead to cancer. Patients were treated with an intrauterine device that releases the progestin levonorgestrel, successfully used for the past decade as a contraceptive.

The endometrial stripe, or thickness of the endometrium, was measured with transvaginal ultrasound before the study and at the three- and six-month marks. The stripe's progressive thinning at each stage demonstrated the effectiveness of the treatment. Subsequent endometrial biopsy found reversal of abnormal cell growth, known as neoplastic changes, in all patients.

Ghamande's group also analyzed 13 published studies and found a complete pathological response in 91.3 percent of cases, with no progression of disease, confirming their findings. The study also validated use of transvaginal ultrasound, commonly used to diagnose endometrial cancer, as a useful follow-up tool in assessing endometrial cancer treatment.

"Thirty to 35 percent of women with hyperplasia will go on to develop endometrial cancer, and in 30 percent of these cases, women will present with a co-existing cancer," said Ghamande. "Traditional treatments can result in postoperative complications and morbidity, not only in patients at high risk. But we may succeed in establishing a lower-risk and more cost-effective way of managing this cancer in all women."

"Identifying better treatments for cancer is the most important goal of our cancer research center," said Dr. Samir N. Khleif, Director of the GHSU Cancer Center. "Studies such as Dr. Ghamande's are changing the landscape of cancer care today, both here in Georgia and around the world."

Ghamande and Dr. Cinar Aksu, a GHSU Cancer Center fellow, presented the study results on Tuesday during the International Gynecological Cancer Society's 14th biennial meeting. Dr. Michael Mcfee, a gynecologic oncologist, and fellow Dr. Steve Bush, both of the GHSU Cancer Center, co-authored the study.

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"But women who are morbidly obese or who have cardiac risk factors are not good candidates for surgery," said Dr. Sharad Ghamande, a gynecologic surgeon and oncologist." This really pissed me off!! I was diagnosed with endometrial cancer a year ago and was successfully treated with surgery, DESPITE the fact that I am morbidly obese. When I was given the news that I had cancer by my gynecologist [over the phone no less], I asked whether surgery would be the next step. He stated that he didn't think that they would be able to do surgery because I was too fat. So, I spent the following month (until my appointment with my gynecologic oncologist), upset and terrified that they would be unable to treat my cancer because of my size and that I was therefore doomed. When I saw my surgeon, she took no issue with my weight and scheduled me for surgery by the DaVinci method. My surgery (which was considered curative) went fine and my recovery was uneventful. While I understand that there may be some risks in regards to weight, these are very often times manageable. I think that a poor attitude towards operating on the obese has a LOT to do with size prejudice and the skill set (or lack thereof) of the surgeon in question. When someone is facing a cancer diagnosis, they have enough stress to deal with, without the fear mongering about obesity.
Chrysalis Tuesday, March 18, 2014

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