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Thursday 27th October 2016

IUD delays uterine cancer

4th October 2010

An intrauterine device commonly used as a contraceptive may also be effective in treating some patients with endometrial cancer, new research has shown.


Patients with early-stage uterine cancer who wish to preserve their fertility and avoid a hysterectomy could be fitted with a "coil" that releases the hormone progesterone.

The small-scale study fitted IUDs in the wombs of carefully selected patients with cancer that had not spread beyond the inner lining of the uterus.

Currently, oral hormone therapy is the most widely used alternative to surgery, which spares women's fertility.

The IUD treatment was found to be just as effective.

Gynaecologic oncologist Lucas Minig said that patients must be screened very carefully to make sure their disease had not spread before being offered the treatment.

Minig, who published the study with a research team from the European Institute of Oncology in Milan, said the trial results looked promising for the treatment of younger women with endometrial cancer who might still want to get pregnant.

Around 75,000 women die of endometrial cancer worldwide annually, with around 300,000 new cases diagnosed every year.

In its early stages, the disease is effectively treated by the surgical removal of the uterus and ovaries.

As many as 5% of cases are found in women still in their 20s and 30s, however, who may later wish to have children.

Oral treatment with the synthetic progesterone slows tumour growth but is not well tolerated by some women.

The study included 34 patients between the ages of 20 and 40 treated between 1996 and 2009.

The IUDs were given to 20 women who did not yet have endometrial cancer, but had a precursor condition known as atypical endometrial hyperplasia (AEH), and to 14 who had early-stage cancer that had not spread beyond the inner lining of the uterus.

The IUDs released progesterone-hormone levonorgestrel over the course of one year. The women also received monthly injections of the hormone GnRH for six months to stop their bodies from producing oestrogen, which stimulates tumour growth.

During follow-up examinations using biopsies and pelvic ultrasounds performed every six months, 19 of the 20 patients with AEH had an initial complete response to therapy, and 15 had no relapse.

Among the group with endometrial cancer, eight out of 14 had an initial complete response to therapy with two of patients relapsing within an average of three years.

Nine of the women who took part in the study later gave birth. Those who relapsed were either given hysterectomies or a second course of the IUD and GnRH treatment and remained alive and disease-free at the time of publication in the Annals of Oncology.

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