Episode summary
Welcome to a new episode of Inline - decodeMR's podcast!
In this episode, we discuss one of the critical aspects of women's health – uterine cancer presenting an interview with Dr. Sarita Sharma, an assistant professor of gynecologic oncology at the National Cancer Institute, AIIMS New Delhi.
Despite its more prevalent occurrence in menopausal women, Dr Sharma highlights the rising instances of uterine cancer in adolescents due to various factors like obesity, irregular menstrual cycles, and early exposure to estrogen. What are the challenges healthcare professionals face when dealing with uterine cancer in adolescents? How does the interplay of hormonal factors influence this disease? Dr. Sharma, with her wealth of expertise, provides insightful answers to these pressing questions.
Dr. Sharma also discusses recent advancements such as sentinel node mapping, a less invasive alternative to complete lymphadenectomy, providing insights into its effectiveness and the associated benefits for patients.
What should uterine cancer survivors keep in mind to ensure a good quality of life? Dr Sharma explains the importance of understanding their tumor type and maintaining long-term follow-up care. The episode encapsulates crucial information for both healthcare professionals and those seeking an understanding of uterine cancer, covering its diagnosis, treatment, and ongoing care.
Episode notes
Factors Contributing to Uterine Cancer in Adolescents: (1:13)
Uterine cancer, typically associated with menopausal women, can also occur in adolescents.
Factors that contribute to the development of uterine cancer in adolescence include obesity, irregular menstrual cycles (associated with PCOS), and early menarche, prolonged and unopposed estrogen exposure on the endometrium, leading to hyperplasia.
2. Clinical Challenges and Considerations: (3:12)
Balancing cancer survival outcomes with fertility preservation poses a significant challenge
Dr. Sharma highlights the need for a comprehensive, multidisciplinary approach in specialized cancer centers.
3. Risk Factors and Preventive Measures: (4:08)
Besides obesity, factors that increase the risk of uterine cancer include polycystic ovarian syndrome, estrogen-producing tumors, nulliparity, and other conditions linked to elevated estrogen levels.
Individuals with Lynch syndrome and those who have had breast cancer face an increased likelihood of developing uterine cancer. Additionally, there is an association between uterine cancer and type two diabetes, hypertension, gallstone disease, or thyroid disorders.
Lifestyle modifications, such as maintaining a normal BMI and controlling associated conditions, can reduce the risk.
4. Surgical Staging and Lymphadenectomy Procedures:(6:04)
Surgical pathology remains crucial in staging uterine carcinoma.
Dr. Sharma discusses the benefits and risks associated with lymphadenectomy.
In cases where the risk of lymph node metastasis is notably low, she refrains from recommending lymphadenectomy.
5. Advancements in Treatment:(8:13)
Sentinel node mapping replaces complete lymphadenectomy, showing promising outcomes. It is recommended as the first-line option for all risk categories of endometrial carcinoma, including high-risk cases, based on compelling evidence.
Integration of molecular classification offers personalized treatment plans and improves survival outcomes.
6. Long-Term Care for Uterine Cancer Survivors: (11:06)
Dr. Sharma emphasizes the importance of understanding tumor type, stage, and prognosis for survivors.
Long-term follow-up and lifestyle factors contribute to maintaining a good quality of life.
Take home messages:
Uterine cancer can occur in adolescents, necessitating careful consideration of fertility preservation and a multidisciplinary approach to management.
Lifestyle modifications, including maintaining a healthy weight and controlling related medical conditions, can help reduce the risk of uterine cancer.
Advances in surgical staging, such as sentinel node mapping, offer effective alternatives to complete lymphadenectomy, balancing accurate staging with reduced complications.
Molecular classification is shaping the future of uterine cancer treatment, allowing for personalized and targeted therapies.
Uterine cancer survivors should focus on understanding their specific condition, undergoing regular follow-ups, and managing lifestyle factors for long-term well-being.
About Dr. Sarita Sharma
Dr. Sarita Sharma is an Assistant Professor of Gynecologic Oncology at the National Cancer Institute in Jhajjar and the All India Institute of Medical Sciences in New Delhi. Additionally, she holds the position of Editorial Fellow and Early Career Editorial Board Member at the International Journal of Gynaecological Cancer.
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