Intrauterine device may deliver hormones and halt endometrial cancer

Intrauterine device may deliver hormones and halt endometrial cancer

An intrauterine device (IUD) - the coil contraceptive device - may be used to delay endometrial cancer, European researchers reveal in an article published in Annals of Oncology. Endometrial cancer is also known as cancer of the uterus or cancer of the womb. Preliminary findings in a trial show that the IUD can deliver hormones to the lining of the uterus to halt, and possibly even reverse the development of cancer.

A woman with endometrial cancer will usually have to undergo a total hysterectomy - her womb and ovaries are removed - resulting in infertility. Surgical removal of the uterus is a very effective treatment for this type of cancer during its early stages. In some cases the woman can be administered oral hormone therapy which slows down the cancer's development; however, there are often undesirable side effects, including nausea, vomiting and skin rashes.

Researchers say this new procedure can buy patients time so that they can have children before having to have a hysterectomy. As the IUD delivers the hormones straight to the target area, there is a much lower risk of undesirable side effects.

The researchers studied 39 females aged between 20 and 40. Twenty of them had a precursor condition known as AEH (atypical endometrial hyperplasia), they had not yet developed endometrial cancer. The other fourteen had early stage cancer - it had not spread beyond the inner lining of the uterus. They were implanted with an IUD that slowly released a progesterone-like hormone (levonorgestrel) designed to stop the cancer from growing. They also received six monthly injections of gonadotropin-releasing hormone (GnRH) - this injection stops them from producing estrogen. Estrogen, a hormone, encourages the development of endometrial cancer.

The women had the IUD inside them for 12 months. The IUD was removed if the tumor had not continued to grow or had shrunk, allowing them to try to become pregnant. After having the number of children they had planned for, the patients then underwent hysterectomies.

The female patients were monitored closely during and after treatment.

19 of the 20 AEH patients had an initial complete response to therapy. Four of them relapsed later. Of the 14 patients with early stage endometrial cancer at the start of the trial, 8 of them had an initial complete response to therapy; two of them relapsed.

The women who relapsed either underwent a hysterectomy or were received the IUD plus GnRH therapy again.

The authors report that nine of the patients have subsequently had children. They are all alive and disease free.

The researchers concluded:

The combined treatment showed effectiveness in a substantial proportion of patients with AEH and EC. Close follow-up during and after treatment is crucial.

Endometrial cancer is more likely to affect women aged 55 to 70 years, but may also affect individuals of reproductive age - about 5% of all cases are diagnosed in women aged between 20 and 40. It accounts for approximately 6% of female cancers. Risk factors associated with endometrial cancer include obesity, having no children, starting menstruation at a young age, and reaching the menopause late. Experts believe the risk factors are linked to high estrogen levels, or exposure to estrogen for long periods.

Almost 300,000 new cases of endometrial cancer are diagnosed globally each year. Approximately 75,000 patients die each year.

"Progestin intrauterine device and GnRH analogue for uterus-sparing treatment of endometrial precancers and well-differentiated early endometrial carcinoma in young women"

L. Minig, D. Franchi, S. Boveri, C. Casadio, L. Bocciolone and M. Sideri

Ann Oncol doi: 10.1093/annonc/mdq463

How Intrauterine Device Prevent Pregnancy? - Manipal Hospital (Video Medical And Professional 2020).

Section Issues On Medicine: Disease