Why do so many women ignore one of the most obvious warning signs of uterine cancer? It’s a cancer that usually announces itself early, but women wait, or brush off the warning signs, and that allows the disease to take hold.
Uterine cancer, also called endometrial cancer, is not rare, and it can strike anyone. Anne Bancroft, the Oscar-winning actress best known as Mrs. Robinson in The Graduate, died of this disease. She never spoke publicly about her illness, a missed opportunity to build greater awareness, and where are the public health campaigns to prevent it? Uterine cancer needs a champion to yell the warning signs from the rooftops.
Each year, thousands of women in Canada and tens of thousands in the U.S. are diagnosed, and the numbers are climbing. Yes, we’re living longer. But there’s another culprit: obesity. You may not know this, but in addition to the ovaries, fat tissues actively produce estrogen. Too much estrogen is like fertilizer that keeps making the lining of the uterus grow. Research shows obesity can triple the risk.
A recent study points to another concern. Researchers found that women who frequently use chemical hair straighteners have more than double the risk of developing uterine cancer. Why? Possibly because of hormone-disrupting chemicals absorbed through the scalp. Are Black women, who use these products most frequently, advised by their salons of this danger?
Other risks are harder to avoid. Women who start menstruating early, or reach menopause late, spend more years with estrogen acting on the uterus. Estrogen itself isn’t the enemy. It’s essential for reproduction. Each month it makes the uterine lining thicken for a possible pregnancy. Progesterone usually balances this growth, but when it’s absent, or insufficient, the lining can grow too thick, or irregularly. Over time, this increases the chance that abnormal cells will form, and some can become cancerous.
That’s why women who never have children, or who don’t breastfeed, are at higher risk. Pregnancy and breastfeeding both give the uterus a long holiday from estrogen. It’s also why hormone therapy after menopause must be handled carefully. Estrogen on its own increases risk, but combined with progesterone, it can be safe. Other risks, like taking tamoxifen for breast cancer, or inheriting genetic conditions such as Lynch syndrome, can’t be avoided, but they do mean vigilance is even more important.
Uterine cancer is one of the cancers that almost always sends a signal. The red flag is bleeding. Before menopause, if periods suddenly change, get heavier, or if bleeding happens between cycles, don’t let anyone brush off the incident. After menopause, even a single spot of blood is abnormal.
Diagnosis isn’t complicated. An ultrasound can measure the thickness of the uterine lining, but the most reliable test is a biopsy, done in a quick office procedure. If the results aren’t clear and bleeding continues, more investigation is needed. This is where women must be their own advocates. Too many walk away reassured when they shouldn’t.
Caught early, uterine cancer is highly curable. Surgery to remove the uterus, sometimes along with the fallopian tubes and ovaries, is often enough. If the cancer is more advanced, radiation, or chemotherapy may follow. For younger women who want children, hormone therapy can sometimes delay surgery. The key is catching the cancer before it spreads.
Don’t wait for someone to make uterine cancer their cause célèbre before getting active with prevention and early detection. Maintain a healthy weight. Don’t let strong chemicals seep into your scalp, and above all, never ignore abnormal bleeding, before or after menopause, not even one drop.
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Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!

