Understanding Endometrial Cancer Risk: Factors Influencing Incidence and Mortality

Understanding Endometrial Cancer Risk: Factors Influencing Incidence and Mortality from Patient Empowerment Network on Vimeo.

What are endometrial cancer risk factors for patients should know about? Expert Dr. Emily Hinchcliff from Northwestern Medicine discusses endometrial cancer risk factors, incidence and mortality rates, and patient advice to help guard against endometrial cancer.

[ACT]IVATION TIP

“…lifestyle modification is really important here. Obesity is a known risk factor for endometrial cancer. So working with your primary care physician to try to improve your health more generally, especially as it surrounds weight, is really important in terms of endometrial cancer prevention. I also think it’s important to know…that obesity and changing your obesity can impact your cancer’s response to certain therapies, especially with hormonal therapy.”

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Transcript:

Lisa:

Dr. Hinchcliff, for patients wondering about their risk, what are risk factors for endometrial cancer, and what should patients be aware of?

Dr. Emily Hinchcliff:  

So I think that it’s really important to highlight that endometrial cancer is one of the few cancers that is actually increasing in both number and also mortality. The numbers from the American Cancer Society for 2024 are over 70,000 women, or around 70,000 women will be diagnosed, and around 13,000 women will die of their disease. And I think that unlike many cancers where we’re actually making progress, endometrial cancer, the incidence, how many people are getting it is rising. And it’s rising faster in non-white ethnicities and groups.

So as I think about risk factors, I think the important ones to highlight are certainly obesity. This I think is a large driver of why there is increasing incidence of endometrial cancer. This relates to kind of the hormonal regulation. Obesity results in increasing levels of estrogen that disproportionately affect the endometrium. And then similar to that, certain hormonal syndromes where women have irregular or infrequent periods like polycystic ovarian syndrome can also put them at higher risk. More globally, I think age, family history are also risk factors. And then as I mentioned, unfortunately, women who are non-white have a higher risk of endometrial cancer mortality, especially as relates to some of the higher risk endometrial cancer subtypes.

Lisa:

Do you have an activation tip for patients for that question?

Dr. Emily Hinchcliff: 

Yeah, so I think that lifestyle modification is really important here. Obesity is a known risk factor for endometrial cancer. So working with your primary care physician to try to improve your health more generally, especially as it surrounds weight, is really important in terms of endometrial cancer prevention. I also think it’s important to know, given that this is often a patient audience that I’m speaking to, that obesity and changing your obesity can impact your cancer’s response to certain therapies, especially with hormonal therapy. So for women who are diagnosed with early stage endometrial cancer, for example, who may desire fertility preservation or may want to know what they can do to impact their own cancer care, I think that’s a really important point.

I guess I can also just bring up a quick one-liner regarding the recent publication of studies surrounding hair product use. So this is a question that we have been getting asked a lot after the publication of both the study and then the big New York Times article, but there was an NIH study that showed a potential association between hair product chemical straightener use and uterine cancer, especially for those who identify as frequent users. I think that the important key point here is that around 60 percent of the women who reported using hair products self-identified as Black and tend to initiate use earlier, so this is another risk factor that may be important.

Yeah, we’re still learning a lot more about that. Right now, there’s an unclear association in terms of what we should be doing about it.


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How Is Endometrial Cancer Staged?

 

How Is Endometrial Cancer Staged? from Patient Empowerment Network on Vimeo.

What are the stages of endometrial cancer? Expert Dr. Emily Ko explains factors involved in analysis for staging and what occurs in the body during each stage.

Dr. Emily Ko is a gynecologic oncologist and Associate Professor of Obstetrics and Gynecology at the University of Pennsylvania. Learn more about Dr. Ko.

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Transcript:

Katherine:

How is endometrial cancer staged? 

Dr. Ko:

So, the most classic, rigorous way to stage endometrial cancer is through a surgical procedure. So, what that usually involves is it does include a hysterectomy, removing the uterus and the cervix, usually also includes removing the fallopian tubes and the ovaries.  

And, at the same time, the surgeon will do a very thorough assessment of the abdominal pelvic cavity, basically looking around all those areas to see if there’s any signs of visible disease, anything they can see that looks like it could be tumor deposits in the abdominal cavity. If anything is seen, those deposits will be removed and biopsied, so that’s part of the staging procedure. 

And additionally, it’s important to try to assess the lymph nodes, typically. So, there are lymph nodes in the pelvic area, and then, higher up along the aortic area, and so, there are different surgical techniques that we can use to basically test or sample some of those lymph nodes, be able to remove them, send them to the pathologist, look under the microscope to see if there are any microscopic cancer cells that have traveled to those lymph nodes. 

So, that is all part of a surgical procedure, and with all the information collected from those tissue samples that are removed from the body and sent to the pathologist, but the pathologist then reviews all of that under a microscope, and then can issue a very thorough report describing where the cancer cells are located, and by definition, where the cancer cells are located then defines what the stage is of the cancer. 

Katherine:

Can you give me an example?  

Dr. Ko:

Of course. So, for example, if the cancer cells are located only in the uterus, and they’re not found anywhere else, then that is a stage I. If the cancer cells have traveled to the cervix area specifically, this we call a cervical stroma, that becomes a stage II. If the cancer cells have, for example, traveled to the fallopian tubes, or the ovaries, or the lymph nodes, then that becomes a stage III, and there are sort of substages within those categories as well. 

Katherine:

But stage III would be the highest or most severe? 

Dr. Ko:

So, there’s stage III, and then there’s actually stage IV. So, if the cancer cells have traveled outside of the pelvis into the abdominal area, then we consider that a stage IV. 

Katherine:

And that would be considered advanced endometrial cancer? 

Dr. Ko:

Right. So, by definition, “advanced” typically refers to stage III or IV. 

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What Disparities Exist in Treating Patients With Endometrial Cancer?

What Disparities Exist in Treating Patients with Endometrial Cancer? from Patient Empowerment Network on Vimeo.

What do endometrial cancer patients and advocates need to know about disparities? Expert Dr. Ebony Hoskins shares noted endometrial cancer disparities in care and how patients can take action to ensure their best care.

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

[ACT]IVATION TIP

“…I always think it’s important that patients feel that they’re heard by their providers or doctors, feel free to ask any questions and so having that or talking about…we are not going to be able to change the biology, right? But we can change our voice, and we can change making sure the patient is heard, making sure they have a comfortable relationship with their provider.”

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Transcript:

Mikki: 

Dr. Hoskins, what are the noted disparities seen in endometrial cancer treatment, and what are some of the actions being taken to combat them?

Dr. Ebony Hoskins: 

Well, I mean, first off, we know that Black women are diagnosed pretty much at the same rate as white women, but have a two times higher risk of death. And so that alone is a big disparity. We also see increased, I shouldn’t say increased, but more aggressive tumor types in Black women, and so we know that part. I think in terms of what we’re doing to combat it from a clinical trial standpoint, they, I think some of the clinical trials, have recognized that there is a low number of patients in these trials advancing and so there has been an increased effort in recruiting patients into these trials. I think there is more work being done, to understand the biology and why there’s a difference. Me as a provider I will always think, “Oh, it’s because women went to the doctor late or access to care.”

Dr. Ebony Hoskins:  

And then I’m like, “Well, no, no, no these women have access to care. They have access to insurance. They went to the doctor right away.” And so I think it’s very complex and deserves more study into it. In terms of my activation tips, in terms of disparity, I always think it’s important that patients feel that they’re heard by their providers or doctors, feel free to ask any questions and so having that or talking about…we are not going to be able to change the biology, right? But we can change our voice, and we can change making sure the patient is heard, making sure they have a comfortable relationship with their provider. I think that is important.


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How to Explain Endometrial Cancer to Newly Diagnosed Patients

How to Explain Endometrial Cancer to Newly Diagnosed Patients from Patient Empowerment Network on Vimeo.

How can experts explain endometrial cancer diagnosis to patients? Dr. Ebony Hoskins shares how she explains the diagnosis to newly diagnosed patients and provides advice for questions to ask your doctor.

Dr. Ebony Hoskins is a board-certified gynecologic oncologist at MedStar Washington Hospital Center and assistant professor of Clinical Obstetrics and Gynecology at Georgetown University Medical Center.

Download Guide  |  Descargar Guía en Español

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What Disparities Exist in Treating Patients with Endometrial Cancer

What Disparities Exist in Treating Patients with Endometrial Cancer?

What Role Does Hormone Therapy Play in Endometrial Cancer

What Role Does Hormone Therapy Play in Endometrial Cancer?

What Is the Role of Surgery in Treating Endometrial Cancer

What Is the Role of Surgery in Treating Endometrial Cancer?

Transcript:

Mikki:

What is endometrial cancer? How do you explain endometrial cancer to newly diagnosed patients?

Dr. Ebony Hoskins:

Great question. So endometrial cancer is a cancer of the lining of the uterus, and the way I typically describe it is the same location where a woman would have menses, and it’s abnormal growth of the same lining. That’s the reason why there is typically abnormal bleeding, either in a postmenopausal woman or a woman who may have not gone through menopause, could have abnormal bleeding.

Mikki:

Awesome. And with that, I know when I had endometrial cancer, and that was just totally new to me. I really didn’t know a lot of people with cancer, I had never heard of endometrial cancer. What are some of the things that I should have asked?

Dr. Ebony Hoskins:

I think asking what is endometrial cancer? Where is the endometrium? I think those are very good questions to ask, especially if you’ve never heard of it, I think anytime there’s something you don’t understand that you should feel free to ask a question and feel comfortable with asking what you may not know.


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