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Wednesday, 17 October 2012


IUDs effective in treating early stage uterine cancer

Georgia Health Sciences University Cancer Center researchers find common birth control device is effective for treating endometrial (uterine) cancer and could result in a cost effective treatment for all women with this type of cancer.

View slideshow: Reducing endometrail cancer

Endometrial cancer forms in the tissue lining the uterus and is the third most common gynecologic cancer and will affect 47,130 women this year, particularly the obese.

Dr. Sharad Ghamande, MBBS, MD, a gynecologic surgeon and oncologist,Director; Developmental Therapeutics; Gynecologic Oncologist at GHSU Cancer Center and principal investigator of study stated "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.”

For this study Dr. Ghamande and research team followed a small group of high-risk patients with early-stage endometrioid adenocarcinoma, the most common type of endometrial cancer and those with atypical endometrial hyperplasia, or thickening of the uterine lining, which can lead to cancer,. The patients were followed for two years.

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 (a safe and painless procedure that uses sound waves to "see" inside your body and create detailed images which the physician can study) before the study and at three and six month intervals. The stripe's progressive thinning at each stage demonstrated the effectiveness of the treatment. Afterward a endometrial biopsy found reversal of abnormal cell growth, known as neoplastic changes, in all patients.

The research team also examined 13 published studies and found a complete pathological response in 91.3 percent of cases, with no progression of disease, in which confirmed their findings. The study also provided validation for transvaginal ultrasound, generally used in the diagnosis of endometrial cancer and as a follow-up tool in determining 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," stated Dr. Ghamande in a public release. He adds "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."

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

This study was presented Tuesday during the International Gynecological Cancer Society's 14th biennial meeting.

Researchers from Hospital Universitario Madrid Sanchinarro in Spainconducted the first prospective clinical trial to see whether an intrauterine device (IUD) releasing the progestin hormone levonorgestrel.

Dr. Lucas Minig and associates found may successfully treat a precancerous condition known as endometrial hyperplasia, as well as early stage endometrial cancer, in young women while preserving their fertility.

This small study included 34 women with almost all with atypical endometrial hyperplasia (AEH). All of the women had the IUD device planted in the womb which released a steady stream of levonorgestrel to the affected area. In addition the women also received month injections f gonadotropin-releasing hormone for a period of six months to bring an end to production of oestrogen in their body. The women had the IUD for a period of one year.

After the year the women were cured and 57.1 percent of women with well-differentiated endometrial cancer limited to the endometrium had a complete response the therapy, 27 women who had a complete response to the treatment, nine went on to have a total of 11 spontaneous pregnancies.

Researchers reported 95 % had a complete response to the treatment at the end of the year, although four had later relapses and required further therapy. Nine participants succeeded in having a baby. All the participants are alive at date of the report.

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