A new partnership between a Pennington Biomedical physician-researcher and an LSU School of Medicine oncologist has already saved several women’s lives in southeast Louisiana.
More than 60,000 women are diagnosed with endometrial cancer each year, a number that includes much younger women than just a decade ago. Endometrial cancer is the fastest growing cancer in young women in Louisiana, particularly among underserved and minority populations.
"Historically, endometrial cancer was pretty much limited to post-menopausal women," said Vance L. Albaugh, MD, PhD, a metabolic surgeon with Pennington Biomedical’s Metamor Institute. "But now it is being diagnosed in women who are much younger than before, even women in their teens in some cases."
While obesity is significantly associated with 13 unique types of cancer, endometrial cancer is the number one cancer associated with excess weight. Researchers believe the reason for the dramatic increase in this cancer is linked to the fact that fat tissue normally produces a small amount of estrogen. Typically, that amount of estrogen is negligible, but a much larger amount of estrogen is abnormally produced when someone has excess fat tissue. Even though estrogen levels rise and fall throughout the menstrual cycle normally, those levels remain persistently elevated in women with severe obesity. This estrogen elevation is a strong growth signal that drives the development of endometrial cancer.
As the Division Director of Gynecologic Oncology at the LSU School of Medicine in New Orleans, Amelia Jernigan, MD, was also witnessing this phenomenon of worsening obesity and increasing endometrial cancer in her daily work.
"We are already seeing and treating women with obesity at Metamor and at the metabolic surgery program at LSU Health in New Orleans. Both programs take multidisciplinary approaches to improve overall patient health, and it only made sense to ask a few additional questions as part of this novel screening tool to determine endometrial cancer risk in these women," Albaugh said.
Albaugh and Jernigan quickly realized it made sense to join forces to find solutions. Together, they have utilized their new screening tool for almost two years and have screened about 2,000 women pursuing metabolic surgery.
"We have been surprised by the number of women experiencing abnormal bleeding. Unfortunately, most don’t realize their cycles are abnormal and they don’t realize they are at increased risk for cancer. Identifying these women with cancer early can prevent the need for hysterectomy or other invasive treatments, obviously a tremendous benefit in women still wanting to bear children," he said.
Albaugh and Jernigan are advocating for all metabolic/bariatric clinics to start screening their female patients for endometrial cancer, sometimes called uterine cancer. The screening helps overcome the difficulties of diagnosing a cancer that masquerades as a normal menstrual cycle. Many of the symptoms are present for years in women before they begin to realize that something might be wrong.
"Our goal is to catch these cancers at very early stages and eliminate the cancer before the need for a major surgery," he said. "Our long-term goal is to determine if treating obesity will prevent a woman from developing endometrial cancer. Ultimately, we want to decrease cancer rates among the general public by treating obesity effectively."