Endometrial cancer recurrence risk: Predicting and preventing

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A collaborative study performed out of Yale University, the University of Hawaii, and The International Agency for Research on Cancer (IARC) found that endocrine-targeted therapies and an assessment of biomarkers in sex hormone and insulin signaling pathways may be useful in the prevention and treatment of endometrial cancer recurrence.

This is hugely important because we now have another way to predict who might be at higher risk of recurrence and employ proactive lifestyle changes and add therapies that may help retard recurrence.

It is well known that the sex hormone estrogen and insulin growth factors are associated with endometrial cancer recurrence risk of endometrial cancer.

“Women who are diagnosed with more advanced stages of endometrial cancer have a substantially higher risk of recurrence and death,” Huang added.

The study team analysed blood serum and stored endometrial tumor samples from several hundred women who participated in the study. These women were all observed for up to 10 years following their initial surgical treatment for endometrial cancer.

The technical factors are as follows: ER-positivity (HR 0.67, 95% CI 0.47-0.95), IR-positivity (HR 0.53, 95% CI 0.29-0.98), and circulating IGF-I (highest versus lowest quartile, HR 0.66, 95% CI 0.47-0.92) were inversely associated with recurrence risk. Circulating estradiol (highest versus lowest tertile, HR 1.55, 95% CI 1.02-2.36) and pIGF1R/pIR positivity (HR 1.40, 95% CI 1.02-1.92) were associated with increased recurrence risk.

Circulating estradiol hormone and positivity for phosphorylated IGF1R/IR (pIGF1R/pIR), the activated form of cellular receptors for insulin-like growth factors and insulin were associated with increased recurrence risk.

While the study did not address nor prove what can be done about these markers it supports the notion that adopting a healthier lifestyle with weight loss may help reduce both circulating estrogen and insulin-like growth factors.

The study was published in the journal Cancer Epidemiology Biomarkers and Prevention.

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“I help and guide women to beat endometriosis and gynecologic cancers that are associated with endo, like ovarian cancer, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician triple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic master surgeon, and is internationally vetted by iCareBetter (https://icarebetter.com/doctor/dr-steven-vasilev/). He serves as Professor at the world-renowned Saint John's Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope and was the founding Medical Director of Integrative Medicine at Providence Saint John's Health Center. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for over 20 years.