November 18, 2016 | by Samantha Bonar
Many “PBS Newshour” fans were stunned and saddened to learn of the death of co-anchor Gwen Ifill, 61, on Nov. 14.
According to media reports, the respected veteran journalist had been suffering from endometrial cancer for less than a year. She had taken a few weeks off for “health reasons” in May and again recently.
Adding to the tragedy is that endometrial cancer, which occurs in the lining of the uterus and is the most common gynecologic cancer, is highly treatable if caught early. Unfortunately, its symptoms are sometimes mistaken by women for signs of menopause.
However, race is a strong factor in outcome. For unknown reasons, uterine cancer tends to be more aggressive in African-American women, like Ifill, who also generally have worse outcomes, according to Ernest Han, M.D., Ph.D., an assistant professor and surgeon in the Division of Gynecologic Oncology at City of Hope. According to the latest Centers for Disease Control and Prevention statistics, African-American women diagnosed with endometrial cancer are twice as likely to die as white women.
Symptoms of endometrial, or uterine, cancer include vaginal bleeding or discharge in between periods and, particularly after menopause, difficult or painful urination, as well as pain during intercourse.
Women experiencing these symptoms need to immediately consult a gynecologist.
Endometrial cancer is the most common gynecologic cancer, but it’s very treatable if it’s diagnosed in time," said Han.
About 60,050 new cases of uterine cancer will be diagnosed this year in the U.S., and an estimated 10,470 women will die from the disease, according to the American Cancer Society.
Most often affecting women over age 50, endometrial cancer has been linked to a hormonal imbalance triggered by a number of factors, including obesity. Fat cells produce excess estrogen but, after menopause, women no longer produce extra progesterone to balance out this disparity. It has also been linked to hormone replacement therapy, such as Premarin, prescribed for menopausal symptoms.
There is also a genetic risk factor called HNPCC (hereditary nonpolyposis colon cancer), which also predisposes certain people to other cancers including ovarian, gastric and small bowel, pancreatic, urothelial and brain cancers.
Other risks factors for developing endometrial cancer include having polycystic ovary syndrome, diabetes and/or hypertension; taking tamoxifen (for breast cancer treatment); early periods and late menopause (after age 55); and never being pregnant.
African-American women seem to be at particularly high risk.
“A study conducted a year ago looked at a large cancer database and found that the incidence of aggressive endometrial cancer was rising the highest among non-Hispanic black women, and five-year survival rate was lowest among non-Hispanic black women,” Han said. Current studies show that the cancer types in this population are more aggressive, and that socioeconomic factors — such as access to health care, financial issues — are affecting their outcomes, he added.
“African-American women are suffering more from this type of disease,” he said. “It could be biologic or genetic, as well as access to care. It could be several factors going on. I don’t think it’s completely clear at this point. For whatever reason, these women seem to have worse disease types and not as good outcomes as Caucasian patients.”
It's crucial for African-American women to not ignore one of the most common early signs of endometrial cancer: abnormal bleeding, especially postmenopause.
The best thing women can do to detect and prevent endometrial cancer “is monitor for symptoms,” Han said. “Be aware of your body. Pelvic pain and abnormal vaginal bleeding or discharge, particularly for longer than a few weeks, can be warning signs for cancer and should be evaluated by your health care provider.” Vaginal bleeding after making the transition into menopause should always be checked, he added.
“Bleeding is a common [postmenopause] symptom that usually gets patients to their doctors,” Han said. “Even if patients have symptoms, though, if it’s an aggressive type, it’s a more aggressive disease.”
Learn more about City of Hope's gynecological cancers program. If you are looking for a second opinion or consultation about your treatment, request an appointment online or contact us at 800-826-HOPE. Please visit Making Your First Appointment for more information.