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Uterine and Endometrial cancer

CISS relies strongly in its evaluations below on impartial analyses by the International Cochrane Collaboration and the British Medical Journal’s Clinical Evidence Group – two groups of researchers who specialise in Evidence Based Medicine.

Conventional medicine supports the paradigm that the tumour is the first stage of cancer, therefore, treating and removing the cancer should cure the cancer. Unfortunately statistics will show this is rarely the case. Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy. In fact evidence based medicine suggests that the only reliable evidence needs to come from properly run randomised controlled trials. Again, with conventional cancer treatment, this is generally not the case.

The following is based on the conventional cancer paradigm.

The uterus is a hollow, muscular organ where a foetus grows, uterine cancer can start in different parts of the uterus. Most uterine cancers start in the endometrium (the inner lining of the uterus). This is called endometrial cancer. Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make mucous and other fluids).

Uterine sarcoma is an uncommon form of uterine cancer that forms in the muscle and tissue that support the uterus.

Obesity, certain inherited conditions, and taking oestrogen alone (without progesterone) can increase the risk of endometrial cancer. Radiation therapy to the pelvis can increase the risk of uterine sarcoma. Taking tamoxifen for breast cancer can increase the risk of both endometrial cancer and uterine sarcoma.

The most common sign of endometrial cancer is unusual vaginal bleeding. Endometrial cancer can usually be cured. Uterine sarcoma is harder to cure (National Cancer Institute).

Risks:

 

About 2300 women in Australia are diagnosed with uterine cancer each year. The majority of uterine cancers are diagnosed in women aged 50 and over. Uterine cancer is the most commonly diagnosed gynaecological cancer in Australia (Cancer Council NSW).

 

As mentioned, taking tamoxifen or receiving pelvic radiation can increase your risk of endometrial / uterine cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean you will not get cancer. Regular exercise, a healthy diet and quitting smoking may prevent cancer.

Other risk factors include:

  • Oestrogen
    • Oestrogen only hormone replacement therapy in postmenopausal women or women who have had their ovaries removed
    • Early menstruation increases exposure to oestrogen over a women’s lifetime
    • Late menopause also increases number of years a woman is exposed to oestrogen
    • Never being pregnant as oestrogen levels are reduced during pregnancy
  • Hereditary nonpolyposis colon syndrome
  • Other inherited conditions
  • Family History
  • Body fat

The following are protective factors:

  • Combination oral contraceptives
  • Physical activity
  • Pregnancy and breast feeding
  • Diet (National Cancer Institute)

 

Signs and Symptoms:

The most common symptom of uterine/endometrial cancer is vaginal bleeding, particularly if the cancer occurs after menopause. Some women experience a watery discharge, which may have an offensive smell.

Abnormal bleeding or discharge can happen for other reasons, but it is best to check with your doctor if you have this symptom (NSW Cancer Council).

Treatment:

  1. Surgery – is the main treatment for uterine/endometrial cancer. Most women will have a hysterectomy and bilateral salpingo-oophorectomy. This is where women will not only have their uterus and cervix removed in a hysterectomy, but will also have their fallopian tubes and ovaries removed. The ovaries will usually be removed because they produce oestrogen, a hormone that may cause the cancer to grow. Removing the ovaries reduces the risk of the cancer coming back.

If the cancer has moved to the cervix the surgeon may also remove a small part of the upper vagina and the ligaments supporting the cervix. The lymph nodes in your pelvis may also be removed, depending on the size and type of cancer (NSW Cancer Council).

Please note: there is little evidence that surgery for cancer has any benefit on increased percentage 5 year survival except in cases where the tumour is in a life threatening position (The efficacy of surgical treatment of cancer, DJ Benjamin).

 

  1. Radiotherapy– uses high energy x-rays to kill cancer cells. It is commonly used as an additional treatment to reduce the chance of uterine cancer coming back. There are two ways it is given:

i – From inside the body (internal), also known as brachytherapy, radioactive material are placed in thin tubes on or near the cancer.

ii – From outside the body (external), a machine directs radiation at the cancer and surrounding tissue.

Radiation is recommended as the main treatment if you are not well enough for a major operation (NSW Cancer Council).

Please note: radiation has been shown to reduce recurrence with many types of cancer but this rarely results in increased survival. (The efficacy of radiotherapy, DJ Benjamin).

  1. Chemotherapy – the use of toxic drugs to kill the cancer cell or stop them from growing. Research by Morgan et al conclude that chemotherapy in uterine cancer may give a zero percent 5 year survival benefit and in ovarian cancer gives an 8.7% five year benefit.

 

  1. Hormone treatment – Hormones are substances that are produced naturally in the body. Some uterine cancers depend on hormones like oestrogen to grow. Hormone treatment works by helping the body to produce smaller amounts of the hormone that the cancer needs to grow.

 

Hormone treatment can be given if the cancer has spread or if the cancer has come back. It is also sometimes offered in the first instance if surgery is not an option. The main hormone treatment for women with uterine cancer is progesterone.

 

Progesterone occurs naturally in women, and it can also be produced artificially to help shrink some cancers and control symptoms. It can be given as a tablet or an injection. It can also be given in a device called a Mirena that is fitted into the uterus.

 

Common side effects of progesterone treatment include:

Breast tenderness

Tiredness

Nausea

Fluid retention

In high doses it may increase appetite and cause weight gain (NSW Cancer Council)

The above therapies all come with risks and side effects which should be discussed in detail by your treating physician.

Before deciding on one of these treatments you would benefit from asking your physician three questions:

Question 1: What are my treatment options? – these should include doing nothing.

Question 2: What are the possible outcomes of those options? – including benefits and side effects.

Question 3: How likely is each of the outcomes to occur?

If your doctor or other health practitioner cannot answer these questions, or shows that he or she is not comfortable with you asking these questions, it raises the question as to whether they are practising evidence based medicine and you should consider getting another opinion.

These three questions can be expanded.

For a complete comprehensive overview of conventional treatments used for endometrial/uterine cancer with up to date information on % effectiveness of each treatment on mortality and morbidity, please follow this link to The Ralph Moss Reports.

Alternative Cancer Therapies

 

As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer.

Another paradigm believes that cancer is a systemic disease and the tumour is in fact a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:

 

  1. Treatment should cause no harm
  2. Treatment should be Wholistic (ie consider the whole person – body, mind, emotions and spirit)
  3. The person with cancer needs to take control of their own health.

 

This latter paradigm is supported by CISS (See Introduction to CISS)

 

Alternative cancer therapies are generally consistent with the above principles. In fact those believed to be most effective in controlling cancer – psychotherapy and immunotherapy – also have strong evidence from randomised controlled trials.

 

There are approximately 200 other alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. What is important in any cancer treatment is to both understand and believe in your chosen therapy.

 

In Endometrial and Uterine cancer, Ralph Moss (Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention) reports the following alternative therapies have been shown to benefit.

 

  1. Fermented Wheat germ extract – is a medicinal food supplement. In the US it is marked under the names Avemar, AveUltra or Oncomar. It is used as a supplement. Proponent literature claims that Avemar helps regulate the process of cellular metabolism and support mechanisms of immune regulation.

 

In 2012, scientists at the H. Lee Moffit Cancer Centre in Tampa studied the activity of fermented wheat germ extract. In advanced stage epithelial ovarian cancer. They characterised the efficacy of fermented wheat germ extract against ovarian cancer and defined what they believe to be the “genomic basis of its activity”

 

References. Judson PL, Al Sawah E, Marchion DC, et al. Charaterising the efficacy of fermented wheat germ extract against ovarian cancer and defining the genomic basis of its activity. Int. J. Gynecol. Cancer. 2012;22:960-967.

 

  1. Metformin – Metformin is an oral anti-diabetic medication. It is used to decrease excessive blood glucose and to prevent the cardiovascular complications of type 2 diabetes mellitus. It is also being investigated as an anti-cancer medication.

 

The conclusion of a December 2012 study from the Mayo Clinic, Rochester, MN was that metformin may improve survival in women with ovarian cancer. In this study women with ovarian cancer who received metformin were compared with women with ovarian cancer who did not receive the drug. In its analysis patients who received metformin had a five year disease free survival of 67 percent, vs. 47 percent in those who did not get the drug, an absolute advantage of 20 percent.

 

References. Kumar S, Meuter A, Thapa P, et al. metformin intake is associated with better survival in ovarian cancer: A case control study. Cancer. 2012 December 9.

 

  1. Beta Carotene – a natural chemical found in many fruits and vegetables.

 

Scientists at Albert Einstein College of Medicine in the Bronx, New York, measured tissues of women with a kind of uterine growth called leiomyomas. They found that beta-carotene levels were significantly lower in fibroid tissue than in the normal tissue. Beta-carotene levels in cancers of the cervix, endometrium, ovary, breast, colon, lung, liver and rectum were also found to be lower than in the adjacent normal tissues. This suggests that beta-carotene deficiency might play a role in the origin of many kinds of cancer.

 

References. Palan PR. Decreased b-carotene tissue levels in uterine leiomyomas and cancers of the reproductive and non reproductive organs. American Journal of Obstetrics and Gynecology.1989;161:1649-1652.

 

  1. Heat therapy – also known as hyperthermia, is the scientific use of heat for the treatment of cancer and other diseases.

 

Duke University cancer Centre has treated women with ovarian cancer with a combination of chemotherapy and heat. The conventional drug Cisplatin was infused by catheter into the abdominal cavity. The woman is then given hyperthermia (to 41.5 degrees C) directly to the area where the drug is given. Overall body temp is maintained at 38 degrees C.

 

Women chosen for this study were no longer responding to conventional therapy. Duke scientists say they increased the effectiveness of cisplatin several-fold by combining it with heat therapy. The hyperthermia team at Duke is one of the largest in the US.

 

  1. Iscador – a fermented preparation of mistletoe. In one study 25 women with cancers of the ovary (including 20 with advanced cancer) received treatment with Iscador after surgery, Five year survival rates with this combined treatment were 100 percent in stages I and II, 23 percent in stage III and zero percent in stage IV. These results were compared to women who had received the standard drug Cytoval after surgery.

 

Iscador patients had more advanced disease than the Cytoval group. Yet they survived on average 16.2 months, compared to 5.2 months in the Cytoval-treated group. Iscador treated patients in stage III (with metastasis outside the pelvis) survived 4.2 times longer than the Cytoval patients.

 

The scientists concluded that Iscador is a useful and effective treatment of carcinoma of the ovary, particularly since it usually does not cause serious and undesired side effects.

 

References. Hassauer W, et al. What prospects of success does Iscador therapy offer in advanced ovarian cancer. Onkologie.1979;2:28-36.

 

  1. Vitamin C– a powerful antioxidant found in many foods. One study on the use of Vitamin C found impressive results. Of 11 women who did not take vitamin C who had cancers of the ovary, breast and fallopian tubes, all but one died, and the survivor was very ill. But after a comparable period of time, 21 of forty women who received the vitamin were alive and all but two of these were well.

 

References. Hoffer A and Pauling L. Hardin Jones biostatistical analysis of mortality data for cohorts of cancer patients with a large fraction surviving at the termination of the study and a comparison of survival times of cancer patients receiving large regular oral doses of vitamin C and other nutrients with similar patients not receiving those doses. Orthomolecular medicine.1990;5:143-154.

 

  1. Urea – other than water urea is the most abundant chemical found in urine.

Indian scientists found that urea could be used to successfully treat cancers of the cervix and the penis.

 

References. Gandhi G, et al. Urea management of advanced malignancies (preliminary report). Journal of Surgical oncology.1977;9:139.

 

If you or someone close to you has just been diagnosed with endometrial /uterine cancer, it is important you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical, mental, emotional/psychological and spiritual treatment.

 

For more information on some more common evidenced based alternative treatments please go to the alternative treatment tab. If you don’t know where to begin in your journey to wellness then we suggest you read where to start.

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