Endometrial Cancer Can Develop After Radiation for Cervical Carcinoma
By Megan Rauscher
NEW YORK May 13, 2003 (Reuters Health) - It is widely assumed that radiation therapy for cervical carcinoma destroys the endometrium, but a study now finds that viable endometrial tissue may remain and that a small percentage of women may subsequently develop endometrial cancer.
Dr. Richard R. Barakat of Memorial Sloan-Kettering Cancer Center in New York and colleagues took a look-back at 23 patients treated with radiation for invasive cervical carcinoma who later developed endometrial cancer.
The mean age at diagnosis of endometrial cancer was 64.4 years and the average latency period from prior radiotherapy to the development of endometrial cancer was 14 years. The long latency period observed is "consistent with the hypothesis that radiation contributes to the genesis of these cancers," the authors write in the May issue of Obstetrics and Gynecology.
"Endometrial cancers that develop after radiation treatment for cervical cancer tend to be more high-risk cancers, based on the types of histology we see," Dr. Barakat told Reuters Health. In the series, 73% were diagnosed with stage II-IV disease, 35% had carcinosarcomas, and 30% had papillary serous or clear cell carcinomas.
As a result, prognosis was poor, with 2- and 5-year survival rates of only 50% and 21%, respectively.
"Since cervical cancer is generally a disease of younger women, many will experience menopausal symptoms after radiation therapy and clinicians will often place these women on estrogen replacement therapy," Dr. Barakat noted. "These women should receive estrogen plus progesterone. The addition of progesterone can help prevent endometrial cancer."
Dr. Barakat also said that any woman who has received radiation therapy for cervical cancer who subsequently develops vaginal bleeding should undergo an evaluation of the cervix as well as the endometrium to be certain that an endometrial cancer is not missed.
Obstetrics and Gynecology 2003;101:941-945.
Thanks to Reuters Health
Abstract #194 from
American Assoc for Cancer Res, 2003
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