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Estrogen and progestin in ovarian cancer treatment

Márcia Mendonça Carneiro, Rívia Mara Lamaita, Márcia Cristina França Ferreira, Agnaldo Lopes Silva-Filho
Almost 5% of women with endometrial cancer are under age 40, and they often have well-differentiated endometrioid estrogen-dependent tumors. Cancer survival rates have improved over the last decades so strategies to avoid or reduce the reproductive damage caused by oncologic treatment are needed. We reviewed the published literature to find evidence to answer the following questions: How should we manage women in reproductive age with endometrial cancer? How safe is fertility preservation in endometrial cancer? Can pregnancy influence endometrial cancer recurrence? What are the fertility sparing options available? Progestins may be prescribed after careful evaluation and counseling...
December 1, 2016: JBRA Assisted Reproduction
Christopher R McCartney, John C Marshall
No abstract text is available yet for this article.
July 7, 2016: New England Journal of Medicine
M Wijnen, M M van den Heuvel-Eibrink, M Medici, R P Peeters, A J van der Lely, S J C M M Neggers
Long-term adverse health conditions, including secondary malignant neoplasms, are common in childhood cancer survivors. Although mortality attributable to secondary malignancies declined over the past decades, the risk for developing a solid secondary malignant neoplasm did not. Endocrine-related malignancies are among the most common secondary malignant neoplasms observed in childhood cancer survivors. In this systematic review, we describe risk factors for secondary malignant neoplasms of the breast and thyroid, since these are the most common secondary endocrine-related malignancies in childhood cancer survivors...
June 2016: Endocrine-related Cancer
Ashley S Felix, Kristen Bunch, Hannah P Yang, Hannah Arem, Britton Trabert, Gretchen L Gierach, Yikyung Park, William J Lowery, Louise A Brinton
BACKGROUND: Although menopausal hormone therapy (MHT) use has been linked with an increased risk of ovarian cancer, whether pre-diagnosis MHT use affects ovarian cancer-specific mortality is unknown. METHODS: Our analysis included 395 incident epithelial ovarian cancer patients with data on pre-diagnosis MHT use from the National Institutes of Health-AARP (NIH-AARP) Diet and Health Study. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for MHT type and ovarian cancer-specific mortality, adjusted for tumor characteristics, treatment, and other risk factors...
August 2015: Gynecologic Oncology Reports
Jessica Finlay-Schultz, Carol A Sartorius
The ovarian hormones progesterone and estrogen play important roles in breast cancer etiology, proliferation, and treatment. Androgens may also contribute to breast cancer risk and progression. In recent years, significant advances have been made in defining the roles of these steroid hormones in stem cell homeostasis in the breast. Stem cells are potential origins of breast cancer and may dictate tumor phenotype. At least a portion of breast cancers are proposed to be driven by cancer stem cells (CSCs), cells that mimic the self-renewing and repopulating properties of normal stem cells, and can confer drug resistance...
June 2015: Journal of Mammary Gland Biology and Neoplasia
Hirotaka Iwase, Yutaka Yamamoto
Sequential use of endocrine agents is common in estrogen receptor (ER)-positive metastatic breast cancer (MBC). In premenopausal women with MBC, tamoxifen and/or a luteinizing hormone-releasing hormone (LH-RH) agonist are options for endocrine treatment. Meta-analysis showed that the combination of the two agents is superior to either monotherapy. Under ovarian ablation or function-suppression, an agent used to treat postmenopausal women, such as the aromatase inhibitor (AI), fulvestrant, becomes possible as a subsequent therapy...
April 2015: International Journal of Clinical Oncology
Hatem Abu Hashim
Endometriosis is an estrogen-dependent chronic inflammatory disease affecting 5%-10% of reproductive-age women, with a prevalence of 5%-50% in infertile women and >33% of women with chronic pelvic pain. Third-generation aromatase inhibitors (AIs) are approved adjuvants for the treatment of estrogen receptor-positive breast cancer. Molecular studies have revealed the presence of aromatase P450, the key enzyme in the biosynthesis of ovarian estradiol, inside the endometriotic tissue, indicating local synthesis of estradiol...
2014: International Journal of Women's Health
Paolo Vercellini, Paola Viganò, Edgardo Somigliana, Luigi Fedele
Endometriosis is defined as the presence of endometrial-type mucosa outside the uterine cavity. Of the proposed pathogenic theories (retrograde menstruation, coelomic metaplasia and Müllerian remnants), none explain all the different types of endometriosis. According to the most convincing model, the retrograde menstruation hypothesis, endometrial fragments reaching the pelvis via transtubal retrograde flow, implant onto the peritoneum and abdominal organs, proliferate and cause chronic inflammation with formation of adhesions...
May 2014: Nature Reviews. Endocrinology
Todd P Knutson, Carol A Lange
Ovarian steroid hormones contribute to breast cancer initiation and progression primarily through the actions of their nuclear transcription factors, the estrogen receptor alpha (ERα) and progesterone receptors (PRs). These receptors are important drivers of the luminal A and B subtypes of breast cancer, where estrogen-blocking drugs have been effective endocrine therapies for patients with these tumors. However, many patients do not respond, or become resistant to treatment. When endocrine therapies fail, the luminal subtypes of breast cancer are more difficult to treat because these subtypes are among the most heterogeneous in terms of mutation diversity and gene expression profiles...
April 2014: Pharmacology & Therapeutics
M Hallamaa, P Suvitie, K Huhtinen, J Matomäki, M Poutanen, A Perheentupa
OBJECTIVE: Human epididymal secretory protein E4 (HE4) is a new promising tumor marker developed for the diagnostics and follow up of ovarian cancer. It has yet to become widely accepted in clinical practice, and its biological properties have not been inclusively studied. The aim of this study was to investigate whether serum HE4 concentration varies within the normal menstrual cycle and whether common gynecological hormonal treatments have an effect on HE4 values. METHODS: Our study population consisted of 180 women, including 126 endometriosis patients and 54 healthy women...
June 2012: Gynecologic Oncology
Lindsey S Treviño, Elizabeth L Buckles, Patricia A Johnson
Ovarian cancer is the leading cause of reproductive cancer death in U.S. women. This high mortality rate is due to the lack of early detection methods and ineffectiveness of therapy for advanced disease. Until more effective screening methods and therapies are developed, chemoprevention strategies are warranted. The hen has a high spontaneous prevalence of ovarian cancer and has been used as a model for studying ovarian cancer chemoprevention. In this study, we used the hen to determine the effect of progestin alone, estrogen alone, or progestin and estrogen in combination (as found in oral contraceptives) on ovarian cancer prevalence...
February 2012: Cancer Prevention Research
Astrid Bellem, Soumia Meiyappan, Sarah Romans, Gillian Einstein
Estrogens and progestagens (ovarian steroids) not only play an important a role in sexual behavior and reproduction, but they are involved in the development, regulation, and function of all body systems, including aging, sleep, pain, pharmacodynamics, immune response, and cognition. They are essential to the maintenance of cardiovascular, renal, mental, and bone health. Often, their effects are positive and their absence, negative. However, in certain contexts they can promote the development of cancers and neurologic conditions...
October 2011: Gender Medicine
JoAnn V Pinkerton
Pharmacological therapies for the treatment of abnormal uterine bleeding are effective and generally well tolerated. This review presents an evidence-based approach to medical therapy. Selection depends on the etiology and amount of bleeding, need for contraception or preservation of fertility, perimenopause status, and medication efficacy and adverse effects.Available nonhormonal agents include nonsteroidal anti-inflammatory agents, which reduce bleeding by 25% to 35% and improve dysmenorrhea through reduced prostaglandin levels; tranexamic acid, which inhibits plasminogen activator with a 40% to 60% reduction in menstrual blood loss; and intranasal desmopressin, which is an antifibrinolytic for women with an underlying bleeding disorder (eg, von Willebrand disease)...
April 2011: Menopause: the Journal of the North American Menopause Society
Vanessa L Jacoby, Deborah Grady, Jean Wactawski-Wende, JoAnn E Manson, Matthew A Allison, Miriam Kuppermann, Gloria E Sarto, John Robbins, Lawrence Phillips, Lisa W Martin, Mary Jo O'Sullivan, Rebecca Jackson, Rebecca J Rodabough, Marcia L Stefanick
BACKGROUND: Elective bilateral salpingo-oophorectomy (BSO) is routinely performed with hysterectomy for benign conditions despite conflicting data on long-term outcomes. METHODS: This is a prospective cohort of 25 448 postmenopausal women aged 50 to 79 years enrolled in the Women's Health Initiative Observational Study who had a history of hysterectomy and BSO (n = 14 254 [56.0%]) or hysterectomy with ovarian conservation (n = 11 194 [44.0%]) and no family history of ovarian cancer...
April 25, 2011: Archives of Internal Medicine
Adolf E Schindler
Ovarian function and menstrual cycle disturbances, pregnancy, and reproductive medicine procedures can either increase gynecological cancer risk or prevent cancer development. For ovarian cancer development, there are two hypotheses, which are connected with ovulation and gonadotropin secretion. Most of the ovarian cancers seem to be derived from displaced ovarian surfice epithelial cells. One year of ovulatory cycles increases the ovarian cancer risk by 6%. Ovulation between 22 and 29 years of age causes the highest risk increase per year...
December 2011: Gynecological Endocrinology
Avner Hershlag, Mary E Rausch, Matthew Cohen
Teenage girls who have survived childhood and adolescent cancer are at risk of losing ovarian function as a result of treatment. This iatrogenic complication may compromise their ability to conceive in the future. In addition, the more immediate consequence is interference in the physical, sexual, and psychosocial development of the female adolescent and her ability to "graduate" into young adulthood. This paper lends strong support to meticulous, graduated hormone replacement, mimicking Tanner's stages of pubertal development, to allow smooth transition of adolescent cancer survivors into adulthood...
April 2011: Journal of Pediatric and Adolescent Gynecology
Kiyoshi Ito, Hiroki Utsunomiya, Hitoshi Niikura, Nobuo Yaegashi, Hironobu Sasano
Endometrial carcinoma and possibly ovarian carcinoma are considered "estrogen-dependent tumors" in human gynecological malignancies. In endometrial carcinoma, the enzymes responsible for intratumoral estrogen metabolism and biosynthesis are different from those in human breast carcinoma, although both of them are considered "estrogen-dependent malignancies". Specific and effective endocrine treatment of endometrial carcinoma should be explored, although progestin agents have been widely used for a long time...
July 4, 2011: Molecular and Cellular Endocrinology
Giuseppe Laurelli, Giovanni Di Vagno, Cono Scaffa, Simona Losito, Maurizio Del Giudice, Stefano Greggi
OBJECTIVE: This study evaluated the feasibility and efficacy of combined operative hysteroscopy (HSC) and hormone therapy as fertility-preserving treatment in a cohort of selected young women with early endometrial carcinoma (EC). METHODS: Fourteen patients (median age 38 years, range 26-40) with FIGO stage IA (intramucous) EC wishing to preserve fertility were enrolled with the following inclusion criteria: age ≤40 years; no evidence of Lynch II syndrome; well-differentiated estrogen/progesterone receptor positive (ER+/PR+) endometrioid EC; no evidence of myoinvasion, multifocal tumor, node metastasis, ovarian mass; normal serum CA 125...
January 2011: Gynecologic Oncology
J H Pickar
This article reviews publications dating back more than a century describing investigations of the endometrium, including those examining the relationship between endometrial hyperplasia and carcinoma, the influence of estrogens on the endometrium, and strategies for protecting the endometrium from unopposed estrogen stimulation. Endometrial hyperplasia and carcinoma studies date from before 1900. The influence of endogenous estrogens on the endometrium became evident with observations of endometrial hyperplasia and/or carcinoma in women with estrogen-secreting tumors or polycystic ovarian disease...
December 2009: Climacteric: the Journal of the International Menopause Society
Guillermo N Armaiz-Pena, Lingegowda S Mangala, Whitney A Spannuth, Yvonne G Lin, Nicholas B Jennings, Alpa M Nick, Robert R Langley, Rosemarie Schmandt, Susan K Lutgendorf, Steven W Cole, Anil K Sood
PURPOSE: The effects of reproductive hormones on ovarian cancer growth are not well understood. Here, we examined the effects of estrous cycle variation and specific reproductive hormones on ovarian cancer growth. EXPERIMENTAL DESIGN: We investigated the role of reproductive hormones in ovarian cancer growth using both in vivo and in vitro models of tumor growth. RESULTS: In vivo experiments using the HeyA8 and SKOV3ip1 ovarian cancer models showed that tumor cell inoculation during proestrus significantly increased tumor burden (251-273%) compared with injection during the estrus phase...
May 1, 2009: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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