A certain class of drugs known as?bisphosphonates?is extremely helpful in boosting bone density. They are commonly prescribed to treat osteoporosis. An ongoing trial suggest these medications may offer additional benefits.
Bone density medications such as, Actonel (risedronate), Boniva?(ibandronate) and Fosamax (alendronate), may lower a woman's risk of developing endometrial (uterine) cancer.?
Talk to your oncologist about bone density tests.
Henry Ford Hospital researchers are conducting a trial which is currently in its fifth year. A total of 29,254 women, aged 55-79, were asked to complete questionnaires that inquired about their history of using medicines that treat thinning bones - bisphosphonates.
The participants were divided into two groups - those who had "ever used" bisphosphonates and those who never had.
Since completing the questionnaires, 115 women have been diagnosed with endometrial cancers.
Investigators found that the incidence of uterine cancer among women taking?bisphosphonates was about half the rate seen in women who have never taken any of these medications. The protective effect was even greater against other less aggressive cancers.
"The results of the study suggest that use of low bone density medications may have a protective effect on endometrial cancer, or that women who take them get a less-aggressive cancer," said Sharon Hensley Alford, Ph.D., lead author of the study and a public health researcher at Henry Ford Hospital.
dailyRx?Contributing Expert, Adam Brufsky, M.D., Ph.D. is not surprised by these findings. "There are emerging indications that bisphosphonates may prevent breast cancer and perhaps other cancers. This study appears to add to this growing evidence," said Dr. Brufsky?who is?professor of medicine at the University of Pittsburgh School of Medicine.
Data for this retrospective study was gathered from?the National Cancer Institute's Prostate, Lung, Colorectal, and Ovarian Screening Trial. That trial collected information on cancer outcomes of participants. ?
Alford cautions that there were limitations to this study. It reviewed past, self-reported information. She says that a clinical trial "with closely monitored data, needs to be done for definitive results."
Results of this study were presented March 24 at the Society of Gynecologic Oncology's 2012 Annual Meeting on Women's Cancer in Austin, Texas.
Until published in a peer-reviewed journal, study findings are considered preliminary.
Endometrial Cancer
Recent estimates from the American Cancer Society show that each year in the United States, over 45,000 women will be diagnosed with some form cancer of the uterus, the most common of which is cancer of the endometrium (the lining of the inside of the uterus). Over 8,000 of these women will die from the disease. It is the third most common gynecologic cancer behind cervical and ovarian cancers.
Endometrial cancers are usually carcinomas that originate from the endometrial cells that line the inside of the uterus, the function of which is to provide the optimal environment of a fertilized egg to implant in the uterus after conception. During a woman's menstrual cycle, this layer of endometrial cells is expelled from the uterus during menstruation.
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Most endometrial cancers occur in post-menopausal women between the ages of 60 to 70, although there are certain types that can occur in younger women around age 40. The most common type is associated with increased estrogen exposure over a woman's lifetime as well as endometrial hyperplasia (an overgrowth of the endometrium which can occur with obesity, polycystic ovarian syndrome (PCOS), and some forms of hormone replacement therapy).
While there is no known single cause of endometrial cancer, several risk factors have been identified, including estrogen replacement therapy without progesterone, a history of endometrial polyps (benign growths), diabetes, infertility as well as never being pregnant, obesity, PCOS, a late start to menopause (after age 50) and an early menarche (first menstrual period before age 12), and exposure to the anti-breast cancer drug Tamoxifen. Additional risk factors are believed to be a high intake of animal fats in the diet, hypertension, and heavy daily intake of alcohol. Women who have had breast or ovarian cancer are also at an increased risk.
Symptoms of endometrial cancer usually begin with abnormal vaginal bleeding in women who have already gone through menopause, and abnormal or heavy menstrual bleeding in pre-menopausal women, usually between menstrual periods. Postmenopausal women may also experience a clear, thin white vaginal discharge as well. Lower abdominal pain and pelvic cramping are also common.
Usually, women are not routinely screened specifically for endometrial cancer, as the disease is highly curable in the early stages. As the disease advances, some women may notice a change in the size or shape of her uterus, along with the above mentioned symptoms. Diagnosis is typically started with endometrial curettage, which provides a sample of the endometrium for pathologic diagnosis. Visualization of the inside of the uterus can be done through hysteroscopy, which can aid in biopsy and identifying lesions. A newer method called TruTest can sample the entire lining of the uterus and is less painful than biopsy.
Treatment is usually started with a total abdominal hysterectomy, where the surgeon will remove the entire uterus, the ovaries and fallopian tubes, and take a look inside the abdomen to take samples of abdominal fluid and inspect the lymph nodes for signs of metastasis. Radiation therapy is usually given to women whose disease has a high likelihood of returning or has spread into the abdomen. Chemotherapy is usually not given unless a woman has very advanced disease.
For women whose disease has not spread beyond the uterus, the survival rate is very high, up to 95% in some instances. Unfortunately the survival rate drops considerably as the disease moves to other organs. The best way to reduce the risk of endometrial cancer is to live a healthy lifestyle (avoid obesity, heavy alcohol intake, high fat diets) and to have regular Pap smears and pelvic examinations as recommended by a gynecologist. ?
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Dr. Brufsky is professor of medicine at the University of Pittsburgh School of Medicine. He also serves as the associate director of clinical investigation for the University of Pittsburgh Cancer Institute.
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