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Endometriosis and cancer

Endometriosis and Ovarian Cancer Risk

Women with endometriosis have a higher ovarian cancer risk, though doctors aren’t sure why.

By Kristen Stewart (Medically reviewed by Cynthia Haines)

Endometriosis, a condition in which the tissue that normally lines the uterus (the endometrium) grows elsewhere in the body, may put women at higher risk of ovarian cancer.

While the exact link is still under investigation, there is growing evidence to suggest it’s the inflammatory process associated with endometriosis that promotes a cancer transformation, says Dr. Munkarah. However, that’s not a reason for those with endometriosis to panic or presume that every pain is a growing tumor.

“There are data to suggest that endometriosis is associated with increased risk of ovarian cancer,” says Adnan R. Munkarah, MD, chair of the department of women’s health services for the Henry Ford Health System in Detroit. “The existing statistics suggest the risk for ovarian cancer is four to five times higher in women with endometriosis.”

Endometriosis and Ovarian Cancer: Connections

Endometriosis and cancer

There are some similarities as well as distinct differences between ovarian cancer and endometriosis. Both can share symptoms such as:

Also, endometriosis can cause cysts on the ovaries that may appear to be pelvic masses similar to ovarian cancer.

But the two conditions are distinctly different. With endometriosis, the most common symptom is pelvic pain, often (but not always) related to the menstrual cycle. Infertility is another common symptom, affecting 30 to 40 percent of women with endometriosis.

Ovarian cancer also involves the abnormal growth of tissue that can affect the ovaries and other parts of the reproductive tract, but the growths are cancerous rather than the benign growths of endometriosis. Ovarian cancer symptoms are less likely to be associated with the menstrual cycle and more likely to be generalized throughout the month. Symptoms are not always present, but when they are, can include:

  • Abdominal discomfort or feeling of abdominal heaviness
  • Weight gain or loss
  • Unexplained back pain
  • Nausea, vomiting, gas
  • Loss of appetite

Its reach is also far less than that of endometriosis: The National Cancer Institute predicted that ovarian cancer would be diagnosed in 21,550 women in 2009.

Perhaps the biggest difference usually relates to a woman’s age. “Endometriosis is a disease affecting women in their reproductive years, while ovarian cancer is generally a disease of postmenopausal women,” says Munkarah.

However, one recent 10-year study found that ovarian cancer shows up in women with endometriosis about 5 1/2 years earlier than it does in women without endometriosis.

Endometriosis and Ovarian Cancer Prevention

Given that a link between the two conditions has been determined and that there is no cure for endometriosis, it is important for women with endometriosis to see their gynecologists on a regular basis. If for any reason ovarian cancer is suspected, a woman should make sure she gets the appropriate tests to rule it out. Tests for ovarian cancer prevention include:

  • Gynecologic exam
  • Pelvic ultrasound
  • Computed tomography (CT) scan

“We need to remember, however, that the risk for ovarian cancer in the general population is relatively low,” says Munkarah, which means that most women with endometriosis will not end up with ovarian cancer. However, ovarian cancer has symptoms that can be vague and easily confused with other health issues ranging from irritable bowel syndrome to diverticulosis to urinary tract infections. So women should always listen to their bodies and see their doctor if anything feels amiss.

Research links endometriosis and ovarian cancer

September 9, 2010 – Sheryl Ubelacker – THE CANADIAN PRESS

Canadian researchers have isolated a genetic mutation that appears to link two types of ovarian cancer with endometriosis, a common gynecological condition in women.

In a study published in this week’s New England Journal of Medicine, researchers at the Ovarian Cancer Research Program of B.C. found that a mutation that turns off the ARID1A gene may be a preliminary event in the transformation of endometriosis into one of two types of ovarian cancer.

Those cancers — called clear-cell carcinoma and endometrioid carcinoma — represent the second and third most common types of ovarian tumor, said principal researcher Dr. David Huntsman, a genetic pathologist at the B.C. Cancer Agency.

Together, they account for one-quarter of all ovarian cancer cases in North America and an even higher proportion of ovarian tumors among Asian women. The genetic mutations were found in 46 per cent of ovarian clear-cell carcinomas and in 30 per cent of endometrioid carcinomas.

But Huntsman stressed that having endometriosis does not mean a woman will develop ovarian cancer.

“Endometriosis is a very common condition and there have been (research) papers over the years suggesting that women with endometriosis are at a slightly higher risk of developing clear-cell carcinoma and endometrioid carcinoma,” he said from Vancouver. “However, the risk is low for any individual woman with an endometriosis.”

Dr. Andrew Berchuck, director of gynecologic oncology at Duke University Medical Center in Durham, N.C., called the research “a major scientific breakthrough.”

“This discovery also sheds light on how endometriosis predisposes to the development of these cancers,” he said in a statement. “The novel insights provided by this work have the exciting potential to facilitate advances in early diagnosis, treatment and prevention of endometrioid and clear-cell cancers, which account for over 20 per cent of ovarian cancer cases.”

According to Ovarian-cancer – When considering the relationship between endometriosis and ovarian cancer, it is important to note that not every case of this health issue will develop into a cancerous tumor. The mass may be self-contained and benign in many cases. However, there is a mounting body of evidence that supports the idea that women who do develop endometriosis are at a higher risk for eventually experiencing ovarian cancer, especially if the mass developed in one of the ovaries.

For decades, healthcare experts have speculated on whether the link between endometriosis and ovarian cancer was not a situation of one condition leading to the other. Conventional wisdom states that there is no direct link to the two, but do acknowledge the possibility of an indirect link. One theory supported the idea that both health issues could develop from the same triggers, creating what appeared to be a link. This idea seemed to be supported by the fact that not every woman who has ovarian cancer has experienced endometriosis and vice versa.

In recent years, this theory has been challenged. While still acknowledging that ovarian cancer can occur without the presence of endometriosis, a number of researchers point to studies where this development of an organ within an organ did seem to increase the chances of ovarian cancer in many women. However, these results are not universally accepted at this time, and more research into the connection between endometriosis and ovarian cancer is taking place.

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