A very frequent question I am asked from my patients when diagnosed with uterine cancer is how did this happen or why did this happen to me. There is really two answers to that question. One is there is a genetic syndrome called Lynch syndrome or HNPCC that puts certain families at risk for uterine cancer and so if you have a patient or you come from a family where you see many cancers on one side of the family and those cancers that we worry about being linked to Lynch syndrome are colon cancer, uterus cancer, ovary cancer, kidney cancer, and some other more rare instances of certain brain cancers, you may actually be in a family that has a genetic mutation that puts a woman at risk for uterus and ovary cancer. The most important risk factor for a woman developing uterine cancer is really one thing. 90% of all the uterine cancers or endometrial cancers that we take care of are associated with obesity. Women that are overweight and this is actually goes up literarily depending upon how heavy a woman is meaning a 200 pound patient versus a 300 pound patient actually will have different degrees of estrogen in her body. So the heavier woman is will have a higher concentration of estrogen in her bloodstream and what estrogen does is actually continually drives the lining of the uterus to grow and so the estrogen hormone on the lining of the uterus otherwise known as the endometrium is commonly similar to like fertilizer for your lawn. It stimulates the endometrium to continually grow but to keep the endometrium safe, a woman should have regular monthly cycles for their periods and that has caused by a change in the estrogen and progesterone concentration in her bloodstream and that triggers a monthly sloughing of the endometrium which is protective of the endometrium meaning protective at preventing that woman from developing uterine cancer. Commonly what we see in our overweight patients is that they stop having regular monthly cycles and the reason for that is that interplay between estrogen and progesterone gets distorted and there is too much estrogen in that patient's bloodstream leading to a constant driving of the growth of the endometrium and that month after month after month stimulatory growth pattern of the endometrium leads to abnormalities, leads to cancer. We will do a much better job at preventing uterine cancer if we can do something about the epidemic obesity in this country. So the most important thing a woman can do in this country to help prevent uterine cancer is maintain a good body image and body size. It is a lot more difficult to do and easier said than done, but it is incredibly important for patients that are overweight to understand that if you are 50 pounds overweight, and that depends on your height, but if you are 50 pounds overweight your risk is 10 times the regular normal population of developing uterine cancer and that number actually goes up, the heavier you are. If you are 100 pounds overweight, it is a higher risk. So it is very important for our patients to know the risk of obesity for other medical symptoms and medical problems. It is alarming to me how many women that develop endometrial or uterine cancer do not know the association of obesity to that cancer.
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