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Abramson Cancer CenterNCI CANCERLIT® Search: Endometrial Cancer - June 2002
National Cancer Institute®
Last Modified: June 1, 2002
- [Expression of p53 protein in women with endometrial cancer]
- [Umbilical metastasis - "Sister Joseph's nodule" of an endometrial adenocarcinoma: a case report and review of the literature]
- The influence of applicator angle on dosimetry in vaginal vault brachytherapy.
- Intrauterine progesterone treatment of early endometrial cancer.
- Evaluation of endometrial polyps.
- Expression of a retinol dehydrogenase (hRoDH-4), a member of the retinol/steroid dehydrogenase family implicated in retinoic acid
- Endometrial disorders in 406 breast cancer patients on tamoxifen: the case for less intensive monitoring.
- Leiomyosarcoma of the rectum after pelvic radiation therapy for endometrial carcinoma.
- Resource utilization for patients undergoing hysterectomy with or without lymph node dissection for endometrial cancer.
- A prospective cohort study of cigarette smoking and the risk of endometrial cancer.
- Tamoxifen regulates human telomerase reverse transcriptase (hTERT) gene expression differently in breast and endometrial cancer cells.
- Loss of PTEN expression is associated with metastatic disease in patients with endometrial carcinoma.
- Fertility-preserving treatment in young patients with endometrial adenocarcinoma.
- [Risks in hysteroscopy in patients with endometrial carcinoma--a prospective clinical study]
- Distinct sets of gene alterations in endometrial carcinoma implicate alternate modes of tumorigenesis.
- High frequency of microsatellite instability and loss of mismatch-repair protein expression in patients with double primary tumors of the
- Role of hysteroscopy in the detection and extraction of endometrial polyps: results of a prospective study.
- Detection of genomic alterations in human endometrial cancer by two-dimensional gel electrophoresis.
- Induction of hepatocyte growth factor in stromal cells by tumor-derived basic fibroblast growth factor enhances growth and invasion of
- Morbidity of adjuvant high-dose-rate brachytherapy for low to intermediate risk endometrial adenocarcinoma completely resected.
- Primary endodermal sinus tumor of the endometrium presenting as "recurrent" endometrial adenocarcinoma.
- [Hysteroscopic diagnosis of endometrial carcinoma]
- Primary endodermal sinus tumor of the endometrium presenting as "recurrent" endometrial adenocarcinoma.
- Risk of endometrial carcinoma associated with BRCA mutation.
- The expression analysis of the estrogen and progesterone receptors in endometrial carcinomas.
- [Metrorrhagia after 75 years old, only 10% are signs of a cancer]
- Para-aortic lymph node metastasis in relation to serum CA 125 levels and nuclear grade in endometrial carcinoma.
- Expression of telomerase genes as potential marker of neoplastic changes.
- Patterns of immunohistochemical staining for p53 expression in hyperplastic endometrium and adenocarcinoma.
- [Time-dependent and dose-dependent regulation of human progesterone receptor isoforms A and B in uterine endometrial carcinoma by human
- Evaluation of outpatient hysteroscopy and ultrasonography in the diagnosis of endometrial disease.
- CYP17 genetic polymorphism in endometrial cancer: are only steroids involved?
- Distinct lymphatic spread of endometrial carcinoma in comparison with cervical and ovarian carcinomas.
- Function of insulin-like growth factor (IGF-I) and its binding protein (IGFBP-1) in pathological proliferation of endometrium.
- Preoperative selection of patients with low-stage endometrial cancer at high risk of pelvic lymph node metastases.
- Pulmonary metastasis from endometrial carcinoma.
- Down-regulation of estrogen receptor by the methylation of the estrogen receptor gene in endometrial carcinoma.
- Endometrial cytology in early diagnosis of adenocarcinoma arising from adenomyosis uteri.
- PTEN expression in breast and endometrial cancer: correlations with steroid hormone receptor status.
- Androgen receptor (AR) expression in normal and cancerous human endometrial tissues detected by RT-PCR and immunohistochemistry.
- Endometrial carcinoma.
Table of Contents
1
UI - 11803862
AU - Ivanov S; Khadzhiolov N; Ivanov S
TI -
[Expression of p53 protein in women with endometrial cancer]
SO - Akush Ginekol (Sofiia) 2001;40(4):14-5
Many oncogenes and tumour suppressor genes are connected with the steps
of carcinogenesis. Fifteen patients with endometrial cancer were
immunohistochemically examined for the presence of abnormal p53 protein.
The immunopositivity was comparted in the cancer tissues and analyzed
with the conventional clinicopathological prognostic factors as grade,
stage, depth of myometrial invasion, lymph-vascular space invasion,
metastases in the lymph nodes and metastases in the abdominal cavity.
Abnormal expression of p53 was observed in 7 women with endometrial
cancer and in 5 patients we observed moderate cytoplasmatic reaction for
BCL-2. The correlation between the positive reaction reaction for p53
and BCL-2 means more aggressive tumor, respectively is a bad prognostic
factor. The overexpression of p53 is a very important parameter for the
progression of the endometrial cancer.
2
UI - 11803869
AU - Ivanova V; Karaivanov M; Marinov E; Gorchev G; Raicheva S
TI -
[Umbilical metastasis - "Sister Joseph's nodule" of an endometrial
adenocarcinoma: a case report and review of the literature]
SO - Akush Ginekol (Sofiia) 2001;40(4):33-6
The umbilical metastatic lesions have been termed the "Sister Joseph
nodule" by Sir Hamilton Bailey in 1949. SJN is an important diagnostic
finding, as it often is the first clue and sometimes the only physical
indication of an advanced intra-abdominal malignancy. SJN is most often
associated with malignancy of the stomach or ovary. It usually appears
late in the course of neoplastic disease and suggests a poor prognosis.
In our review of English language medical literature we could find only
27 reports of SJN in endometrial adenocarcinoma. We offer a case of SJN,
presenting as umbilical hernia, in a female patient, who, 12 years
previously, had undergone laparotomy with total hysterectomy and
bilateral salpingo-oophorectomy for endometrial adenocarcinoma. Three
years after the surgical excision of the umbilical lesion, the patient
underwent surgery for a tumor located subcutaneously in the suprapubic
area. Histologically, in the samples obtained with both surgical
interventions, endometrioid adenocarcinoma with squamous differentiation
was found. The clinical examination and imaging studies found no
evidence of other metastases. On the basis of clinico-pathological
analysis we offer a hypothesis about development of metastases and
discuss their prognostic significance.
3
UI - 11932216
AU - Hoskin PJ; Bownes P; Summers A
TI -
The influence of applicator angle on dosimetry in vaginal vault
brachytherapy.
SO - Br J Radiol 2002 Mar;75(891):234-7
AD - Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital,
Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK.
In vaginal vault brachytherapy, the critical normal tissues are bladder
and rectum; doses to these tissues may be affected by the position of a
single line applicator placed in the vagina. Dosimetry with the
applicator lying at its "natural" angle in the vagina with the patient
in the lithotomy position has been compared with the applicator held
horizontal as defined by a spirit level in 30 consecutive patients. A
mean change in angle of 19.7 degrees was found. This resulted in a mean
decrease in ICRU (International Commission of Radiation Units and
Measurements) rectal point dose when the applicator is horizontal of
12.9%, equivalent to a mean absolute dose reduction of 1.3 Gy for a
prescription dose of 5.5 Gy at 5 mm depth. An increase in mean dose to
the ICRU bladder point when the applicator is horizontal of 13.3%,
equivalent to an absolute mean dose increase of 0.5 Gy per fraction for
the same prescription dose, was also found. On the basis of these
findings, it is recommended that vaginal vault brachytherapy is
performed with a single line source held in the "corrected" horizontal
position to reduce bowel dose as this is the most sensitive critical
normal tissue.
4
UI - 11967486
AU - Montz FJ; Bristow RE; Bovicelli A; Tomacruz R; Kurman RJ
TI -
Intrauterine progesterone treatment of early endometrial cancer.
SO - Am J Obstet Gynecol 2002 Apr;186(4):651-7
AD - Kelly Gynecologic Oncology Service, Department of Gynecology and
Obstetrics, Johns Hopkins Hospital and Medical Institutions, Baltimore,
MD 21287, USA..
OBJECTIVE: Our purpose was to assess the feasibility of using a
progesterone-containing intrauterine device (IUD) to treat presumed
Federation Internationale Gynecologie et d'Obstetrique (FIGO) stage IA,
grade 1 endometrioid cancer in women at high risk for perioperative
complications. STUDY DESIGN: Candidates were women with American Society
of Anesthesiologists class III or IV grade 1 endometrioid cancer and no
imaging evidence of myometrial invasion. Subjects underwent
hysteroscopy, curettage, and IUD placement, followed by endometrial
biopsy every 3 months for 1 year. The records of similar patients
treated surgically during the 3 years before protocol initiation were
reviewed for comparison. RESULTS: Sixteen patients fulfilled study
criteria. Fourteen consented to participation; one was excluded at the
time of IUD placement (grade 2 disease identified) and one was lost to
follow-up. Twelve subjects have been followed up to 36 months; results
of biopsies were negative in 7 of 11 at 6 months and 6 of 8 at 12
months. No IUD-related complications, except for expulsion, occurred.
Sixteen complications (one fatal) occurred in 9 of the 15 control
patients. CONCLUSION: Intrauterine progesterone appears to eradicate
some cases of presumed stage IA, grade 1 endometrioid cancer in women at
high risk for perioperative morbidity.
5
UI - 11967489
AU - Goldstein SR; Monteagudo A; Popiolek D; Mayberry P; Timor-Tritsch I
TI -
Evaluation of endometrial polyps.
SO - Am J Obstet Gynecol 2002 Apr;186(4):669-74
AD - Department of Obstetrics & Gynecology, Division of Obstetrics and
Gynecology Pathology, New York University School of Medicine, New York,
NY, USA. steven.goldstein@med.nyu.edu
OBJECTIVE: Endometrial polyps are relatively common in all groups of
women. More polyps are being diagnosed with the widespread use of
transvaginal ultrasound scanning and sonohysterography. The reported
incidence of malignancy is low. The potential benefit of a noninvasive
technique to distinguish benign from malignant polyps is obvious. This
study was undertaken to evaluate endometrial polyps by color flow
Doppler ultrasound scanning and histopathologic examination. STUDY
DESIGN: This was an observational study of patients with an endometrial
polyp on sonohysterography who underwent interrogation of their polyp
with color Doppler ultrasound scanning and subsequently polypectomy.
Polyp volume, resistive index, pulsatility index, indication for scan
(bleeding vs incidental), and patient age were correlated with
histopathologic type of the polyp (nonfunctional, proliferative,
secretory, hyperplastic, or malignant). RESULTS: Of 61 patients studied,
42 patients (68.9%) were scanned for abnormal bleeding, and 19 patients
(31.1%) had their polyps discovered incidentally. There were no
statistically significant differences between histologic categories and
the resistive index, pulsatility index, or size of the polyp. The age of
patients with nonfunctional polyps was significantly greater than any
other group (P <.001). Ninety-four percent of the functional polyps were
discovered because of abnormal bleeding; 38% of the nonfunctional polyps
were discovered incidentally (P <.001). CONCLUSION: The data suggest
that the objective assessment of blood flow impedance (resistive index,
pulsatility index) in endometrial polyps and the size of these polyps
cannot replace surgical removal and pathologic evaluation to predict
histologic type. Patients with nonfunctional polyps were older and less
likely to have vaginal bleeding.
6
UI - 11967490
AU - Cain JM; Zaino R; Shearer D; Bennett RA; Olt G; Weisz J
TI -
Expression of a retinol dehydrogenase (hRoDH-4), a member of the
retinol/steroid dehydrogenase family implicated in retinoic acid
biosynthesis, in normal and neoplastic endometria.
SO - Am J Obstet Gynecol 2002 Apr;186(4):675-83
AD - Department of Obstetrics and Gynecology, Pennsylvania State University
College of Medicine, Hershey, USA.
OBJECTIVE: Retinoic acid plays an essential role in epithelial
differentiation, and retinoid homeostasis is disrupted in cancers of
epithelial origin. The goal of this study was to determine whether
hRoDH-4, an enzyme that can catalyze the first and rate-limiting step in
retinoic acid biosynthesis, is expressed in normal endometrium and, if
so, whether its expression is altered in endometrial cancer. STUDY
DESIGN: Proliferative, secretory, hyperplastic, and neoplastic
endometria were examined by immunocytochemistry for hRoDH-4 protein and
by reverse transcriptase-polymerase chain reaction for the hRoDH-4
transcript. RESULTS: In proliferative and secretory glandular epithelia,
immunoreactive hRoDH-4 was uniformly present. In endometrial cancers,
hRoDH-4 immunoreactivity was markedly reduced in many neoplastic
epithelial cells. Expression of hRoDH-4 in normal and neoplastic
endometrium was confirmed by findings on reverse
transcriptase-polymerase chain reaction. CONCLUSION: These findings are
consistent with the hypothesis that altered expression of enzymes
essential for in situ retinoic acid biosynthesis is an important
phenotypic change associated with the development of endometrial cancer.
7
UI - 11803101
AU - Vosse M; Renard F; Coibion M; Neven P; Nogaret JM; Hertens D
TI -
Endometrial disorders in 406 breast cancer patients on tamoxifen: the
case for less intensive monitoring.
SO - Eur J Obstet Gynecol Reprod Biol 2002 Feb 10;101(1):58-63
AD - Gynaecologic Surgery Department, Jules Bordet Institute, Brussels,
Belgium.
OBJECTIVES: To describe the endometrial appearance in postmenopausal
breast cancer patients on tamoxifen and to assess a routine surveillance
scheme for endometrial lesions. STUDY DESIGN: Three hundred and
seventeen postmenopausal breast cancer women already on tamoxifen at the
start of the study (group I) and 89 breast cancer women assessed before
any tamoxifen intake (group II) underwent an initial and then yearly
scans with transvaginal ultrasonography, followed by an hysteroscopy and
biopsy for women with an endometrium thickened above 8mm. Endometrial
thickness was also measured in 823 women with no breast cancer nor
tamoxifen intake (group III). RESULTS: Initial mean endometrial
thickness was 8.2mm in group I, 4.4mm in group II and 3.4mm in group III
(P<0.001). Eighteen percent endometrial lesions were found in group I
and 3.3% in group II. We observed a significant association between
endometrial pathology and both cumulated dose and total duration. Polyps
were the most frequent and first to appear pathology. Five cancers were
detected in group I, and all of them had taken tamoxifen for more than 3
years. CONCLUSION: Our surveillance scheme could be lightened; an
acceptable screening scheme might include a baseline assessment before
the start of tamoxifen and, if normal, yearly screening after 3 years of
tamoxifen therapy, yearly surveillance for women with an abnormal
baseline assessment and immediate investigation for symptomatic women.
8
UI - 12014748
AU - Caporale A; Giuliani A; Cosenza UM; Cannaviello C; Benvenuto E; Angelico
TI -
F
Leiomyosarcoma of the rectum after pelvic radiation therapy for
endometrial carcinoma.
SO - Am J Gastroenterol 2002 May;97(5):1270-1
9
UI - 11972382
AU - Brooks SE; Mullins CD; Guo C; Chen TT; Gardner JF; Baquet CR
TI -
Resource utilization for patients undergoing hysterectomy with or
without lymph node dissection for endometrial cancer.
SO - Gynecol Oncol 2002 May;85(2):242-9
AD - Department of Obstetrics, Gynecology, and Reproductive Sciences,
University of Maryland Schools of Medicine and Pharmacy, 405 W. Redwood
Street 3rd Floor, Baltimore, MD 21201, USA. sbrooks@umm.edu
OBJECTIVE: The objective was to study the association of age, comorbid
illness, race, and type of hospital with resource use in patients
undergoing hysterectomy and lymph node dissection for endometrial
cancer. METHODS: The study was a population-based analysis of patients
undergoing hysterectomy with a diagnosis of endometrial cancer in
Maryland 1994-1996. Chi-square and t tests determined differences in
means or proportions. Multivariate logistic regression methods were used
to build predictive models. RESULTS: The 1281 women underwent total
abdominal hysterectomy, 91%; total vaginal hysterectomy, 6%; radical
hysterectomy, 2.5%, laparoscopically assisted total vaginal
hysterectomy, 0.3%; 32% also underwent lymph node dissection. Neither
age, nor race, nor comorbid illness influenced admission to teaching
hospitals. Co-morbidity was documented in 56% of cases. African
Americans were more likely to have one (P = 0.002) or >1 co-morbid
illness (P = 0.045) than Caucasians. The most common complications were
anemia (13.6%), infection/fever (12%), cardiac (9.4%), pneumonia (8%),
ileus (5%), and bowel obstruction (5%). These complications occurred
with higher frequency in teaching hospitals (P = 0.0001), In large
hospitals (P = 0.0001), and in African American patients compared to
Caucasians (P = 0.028). Multivariate regression analysis revealed that
older age, admission to teaching or large hospitals, lymph node
dissection, heart disease, and African American race were associated
with significantly higher resource use. CONCLUSION: We documented age
and racial/ethnic differences in comorbid illness, complications, and
resource utilization for patients undergoing hysterectomy for
endometrial cancer. The differences in resource use for teaching
hospitals may be reflective of the severity of complications, which are
indirectly determined by length of stay. Given the higher costs and
skills required to care for elderly women with comorbid disease and
complications, quantification of the complexity of care is of utmost
importance for allocation of sufficient resources for the care of women
with endometrial cancer. (c) 2002 Elsevier Science (USA).
10
UI - 11986776
AU - Terry PD; Miller AB; Rohan TE
TI -
A prospective cohort study of cigarette smoking and the risk of
endometrial cancer.
SO - Br J Cancer 2002 May 6;86(9):1430-5
AD - Department of Epidemiology and Social Medicine, Albert Einstein College
of Medicine, 1300 Morris Park Avenue, Bronx, New York, NY 10461, USA.
pterry@aecom.yu.edu
Case-control studies have shown inverse associations between cigarette
smoking and endometrial cancer risk. However, two small prospective
cohort studies have not clearly supported an association. Moreover,
quantitative measures of smoking have been examined infrequently. Our
aim was to study the association between smoking and endometrial cancer
risk in a large prospective cohort. We used proportional hazards models
to estimate hazard ratios relating cigarette smoking to endometrial
cancer risk among 70 591 women aged 40-59 years at recruitment into a
randomised controlled trial of mammography screening for breast cancer.
During an average of 10.6 years of follow-up (751 833 person-years), a
total of 403 women were diagnosed with incident endometrial cancer. We
found that a reduced endometrial cancer risk was evident only among
women who currently smoked 20 cigarettes per day or more (hazard
ratio=0.62, 95% CI=0.42-0.92, P for trend=0.03). There was some
suggestion of an inverse association with smoking duration, but this was
less clear. The association did not vary with menopausal status,
relative body weight, or the use of hormone replacement therapy, but it
appeared to be stronger among parous than nulliparous women. The
underlying biological mechanisms of this association remain unclear.
Copyright 2002 Cancer Research UK
11
UI - 12032853
AU - Wang Z; Kyo S; Maida Y; Takakura M; Tanaka M; Yatabe N; Kanaya T;
TI -
Nakamura M; Koike K; Hisamoto K; Ohmichi M; Inoue M
Tamoxifen regulates human telomerase reverse transcriptase (hTERT) gene
expression differently in breast and endometrial cancer cells.
SO - Oncogene 2002 May 16;21(22):3517-24
AD - Department of Obstetrics and Gynecology, Kanazawa University, School of
Medicine, 13-1, Takaramachi, Kanazawa, Ishikawa 920-8641, Japan.
Tamoxifen is widely applied as an antiestrogenic agent for adjuvant
therapy in the treatment of breast cancer, while its estrogen-agonistic
activity occasionally causes proliferative disorders or carcinogenesis
at other sites, such as the uterus. We reported that estrogen activates
telomerase in breast and endometrial cancer cells. The present study
examines the effects of tamoxifen on the gene expression of human
telomerase reverse transcriptase (hTERT) in breast and endometrial
cancer cells. Tamoxifen inhibited the cell growth of MCF-7 cells, as
well as hTERT mRNA expression in the presence of estrogen (E2),
antagonizing the E2 effects. In contrast, tamoxifen stimulated the
growth of Ishikawa cells and activated hTERT mRNA expression in the
absence or presence of E2, exhibiting estrogen-agonistic action.
Transient expression assays revealed that these actions of tamoxifen are
achieved by transcriptional regulation of the hTERT promoter. An
estrogen responsive element (ERE) in the hTERT 5' regulatory region was
partly responsible for both the E2-antagonistic and -agonistic actions
of tamoxifen. Tamoxifen activated the MAP kinase cascade in Ishikawa
cells, but not in MCF-7 cells, and the activation of hTERT mRNA
expression was effectively blocked by MEK inhibitor, suggesting that the
MAP kinase pathway is involved in the tamoxifen-induced activation of
hTERT. These findings indicate that tamoxifen regulates hTERT expression
in a cell-type specific manner. Tamoxifen-induced activation of hTERT
may be one component of estrogen agonistic function of tamoxifen that is
involved in endometrial carcinogenesis induced by this agent.
12
UI - 12001116
AU - Salvesen HB; Stefansson I; Kalvenes MB; Das S; Akslen LA
TI -
Loss of PTEN expression is associated with metastatic disease in
patients with endometrial carcinoma.
SO - Cancer 2002 Apr 15;94(8):2185-91
AD - Department of Pathology, The Gade Institute, Haukeland University
Hospital, Bergen, Norway. salvesen@haukeland.no
BACKGROUND: The PTEN tumor suppressor gene frequently is involved in
endometrial carcinoma. Loss of heterozygosity and mutations reportedly
are common, although the biologic importance of these changes remain
largely unknown. The objective of this study was to assess the pattern
of PTEN expression by immunohistochemistry in a large series of patients
with endometrial carcinoma. METHODS: A population-based series of 316
patients with endometrial carcinoma who had long and complete follow-up
was investigated for PTEN expression and its correlation with
clinicopathologic variables, tumor markers, and survival. RESULTS: PTEN
protein expression was mainly cytoplasmic in tumor cells, with no
expression seen in 56 of 279 patients (20%) who had evaluable results. A
heterogeneous staining pattern was found in 70 tumors (25%). A
significant association between the loss of PTEN expression and
metastatic disease was identified (P = 0.05). However, PTEN staining did
not influence survival significantly. CONCLUSIONS: The loss of PTEN
expression is relatively frequent in endometrial carcinoma and is
associated significantly with metastatic disease. This indicates that
the PTEN system plays an important role in some endometrial carcinomas,
but further studies of PTEN protein expression related to various
genetic alterations are necessary. Copyright 2002 American Cancer
Society.
13
UI - 12001117
AU - Wang CB; Wang CJ; Huang HJ; Hsueh S; Chou HH; Soong YK; Lai CH
TI -
Fertility-preserving treatment in young patients with endometrial
adenocarcinoma.
SO - Cancer 2002 Apr 15;94(8):2192-8
AD - Division of Gynecologic Oncology, Department of Obstetrics and
Gynecology, Chang Gung Memorial Hospital and Chang Gung University,
Taoyuan, Taiwan.
BACKGROUND: Hormone therapy alone for early-stage, low-grade endometrial
carcinoma arising in young women has been reported occasionally in case
reports or small series. However, a comprehensive guideline for
selection, treatment, and follow-up is not available as yet. METHODS: In
the current study, the authors' evaluated the outcome of a cohort of
young women with clinically diagnosed endometrial adenocarcinoma Stage
IA, Grade 1 who were selected for fertility-preserving treatment by
stringent staging procedures and treated in a standard protocol using
combinations of megestrol acetate, tamoxifen, and gonadotropin-releasing
hormone analog (GnRHa). RESULTS: Nine eligible patients were treated
between 1991 and 1999. The median age of the patients was 32 years
(range, 30-39 years). Of the 9 patients, 8 (88.9%) achieved complete
remission after hormone therapy. Four patients had ever conceived (two
patients had three term pregnancies and underwent consolidation
hysterectomy after completion of family planning). Only one patient
underwent hysterectomy for failure to respond, whose tumor was estrogen
receptor (ER)/progesterone receptor (PgR) positive by immunostaining but
negative by ligand-binding method. Another patient, whose tumor was ER
negative/PgR positive, had residual carcinoma on the first assessment
and achieved complete remission after replacement of tamoxifen with a
GnRHa. Four responders later developed recurrent endometrial carcinoma.
One underwent immediate hysterectomy. Two were successfully re-treated
with hormone therapy, but the other did not respond and underwent
hysterectomy. All nine patients have been alive without evidence of
disease 25-113 (median, 69) months from initial diagnosis. CONCLUSIONS:
The treatment strategy described in the current study is feasible. A
larger multicenter trial of fertility-preserving treatment is warranted
for nulliparous young patients with well selected Stage I, Grade 1,
endometrial adenocarcinoma. Copyright 2002 American Cancer Society.
14
UI - 11987573
AU - Kudela M; Pilka R; Dzvincuk P; Lubusky D; Duskova M
TI -
[Risks in hysteroscopy in patients with endometrial carcinoma--a
prospective clinical study]
SO - Ceska Gynekol 2002 Mar;67(2):74-8
AD - Gynekologicko-porodnicka klinika, UP LF a FN Olomouc.
OBJECTIVE: The evaluation of the risk of hysteroscopy (HSC) in patients
with endometrial carcinoma with regard to the dissemination of disease
and the deterioration of its prognosis. DESIGN: A prospective
multicentric study. SETTING: Department of Obstetrics and Gynaecology
and Institute of Pathology of the Palacky Univerzity Medical School and
University Hospital, Olomouc; Obstetrical and Gynecological Departments
of collaborating hospitals. METHODS: Two groups of patients with
endometrial carcinoma were compared on the basis of cytological
examinations from the peritoneal cavity. The study group (n = 156)
consisted of patients whose diagnosis was made on the base of HSC and
targeted biopsy. The control group (n = 71) included patients with the
classical D&C. Both groups were comparable as to the distribution of
clinical stages of the disease (P < 0.05). Cytological examinations were
performed from the fluid obtained by the puncture of the cul de sac at
the end of the HSC procedure and from the peritoneal lavage at the
beginning of the following operation. Results of both groups were
compared and statistically evaluated. RESULTS AND CONCLUSIONS: The
comparison of the cytological findings from the punctures of the cul de
sac after the HSC and from the lavages at the following operation did
not show an increased penetration of malignant cells from the uterus
into the abdominal cavity. Similarly, the comparison of cytological
findings from the peritoneal lavages after HSC and probatory curettage
did not show a statistically significant difference between both groups.
We assume that HSC does not increase the risk of dissemination of tumour
cells into the peritoneal cavity and does not deteriorate the prognosis
of the disease.
15
UI - 12015762
AU - Koul A; Willen R; Bendahl PO; Nilbert M; Borg A
TI -
Distinct sets of gene alterations in endometrial carcinoma implicate
alternate modes of tumorigenesis.
SO - Cancer 2002 May 1;94(9):2369-79
AD - Department of Oncology, Lund University Hospital, Lund, Sweden.
anjila.koul@onk.lu.se
BACKGROUND: Endometrial carcinomas seem to carry a different prognosis
depending on the presence or absence of concomitant complex atypical
hyperplasia (hyperplasia). The molecular genetic profile of these two
pathogenetic types, based on the genes reportedly mutated in these
cancers, remains to be defined. Although microsatellite inability is
reported in approximately 25% of endometrial carcinomas, its relation
with the 2 pathogenetic types is not investigated. METHODS: To elucidate
their underlying genetic changes, we analyzed 53 sporadic endometrial
tumors, including 19 with and 34 without hyperplasia, for microsatellite
instability (MSI), DNA ploidy (by flow cytometry), and for mutations in
different genes. RESULTS: Microsatellite instability was present in 21%,
DNA nondiploidy in 15%, and mutations in the PTEN, KRAS,
CTNNB1/beta-catenin, TP53, and CDKN2A genes were detected in 32, 11, 13,
17, and 0% of the tumors, respectively. Microsatellite instability and
mutations in these genes were present in tumors both with and without
complex atypical hyperplasia. All cases with complex atypical
hyperplasia were early stage (I-II) endometrioid tumors and associated
with long progression free disease (P = 0.0004). Furthermore, most
tumors with hyperplasia had low World Health Organization or
International Federation of Gynecology and Obstetrics grade, had less
myometrial invasion, and showed expression of estrogen receptors. All
MSI tumors were diploid and had a significantly higher rate of PTEN
mutations, but similar rates of KRAS, beta-catenin, and TP53 mutations
compared with microsatellite stable tumors. TP53 mutations more often
were found in nondiploid tumors but never in tumors with PTEN, KRAS, or
beta-catenin mutations, and all PTEN mutations occurred in diploid
tumors. CONCLUSIONS: Thus, PTEN, KRAS, beta-catenin, and TP53 mutations
occurred in tumors both with and without hyperplasia, but PTEN and TP53
mutations were more common in tumors without hyperplasia. However, none
of these genes seems to clearly distinguish tumors with and without
hyperplasia, suggesting that other factors may be involved. Conversely,
alterations in the PTEN and TP53 genes seem to define distinct subgroups
of endometrial carcinoma, the former associated with diploidy and MSI,
the latter with macroscopic chromosomal instability. Copyright 2002
American Cancer Society.DOI 10.1002/cncr.10498
16
UI - 12015776
AU - Planck M; Rambech E; Moslein G; Muller W; Olsson H; Nilbert M
TI -
High frequency of microsatellite instability and loss of mismatch-repair
protein expression in patients with double primary tumors of the
endometrium and colorectum.
SO - Cancer 2002 May 1;94(9):2502-10
AD - Department of Oncology, the Jubileum Institution, University Hospital,
Lund, Sweden. maria.planck@onk.lu.se
BACKGROUND: Patients with the familial syndrome hereditary nonpolyposis
colorectal carcinoma (HNPCC) exhibit an increased risk for several tumor
types, of which the greatest lifetime risk is for colorectal and
endometrial carcinoma. HNPCC is caused by a germline mutation in one of
several identified mismatch repair (MMR) genes and typically presents
with microsatellite instability (MSI) and frequent loss of MMR protein
expression in the tumor tissue. The objective of this study was to
estimate the proportion of double primary tumors of the endometrium and
colorectum that displays tumor characteristics suggestive of MMR
deficiency. METHODS: The authors used the southern Sweden regional
population-based Cancer Registry to identify women who developed double
primary tumors of the endometrium and colorectum. Of the 256 women who
were diagnosed with carcinoma at both of these sites during the period
1958-1998, 39 women had developed their first tumor before age 50 years.
The authors successfully retrieved 67 tumors from 36 of these patients
and analyzed them for MSI and immunohistochemical expression of the MMR
genes, MLH1, MSH2, and MSH6. RESULTS: The MSI status of the 67 tumors
was high MSI in 37 tumors, low MSI in 13 tumors, and microsatellite
stable (MSS) in 17 tumors. Immunohistochemical loss of MMR protein
expression was correlated with MSI status and was demonstrated in 29
high MSI tumors, in 1 low MSI tumor, and in 1 MSS tumor. A concordant
loss of the same MMR protein in both tumors was found in 12 of 27
patients. CONCLUSIONS : The authors demonstrated a high frequency of MSI
(75%) in tumors from women with endometrial and colorectal carcinoma who
had their first tumor diagnosed before age 50 years and observed
concordant immunohistochemical loss of MMR protein expression,
suggestive of a possible underlying germline mutation, in 12 of 27
patients (44%). They concluded that double primary malignancies of the
colorectum and endometrium at a young age should make the clinician
suspect HNPCC. Copyright 2002 American Cancer Society.DOI
10.1002/cncr.10501
17
UI - 12015544
AU - Chui YK; Bhal PS
TI -
Role of hysteroscopy in the detection and extraction of endometrial
polyps: results of a prospective study.
SO - Am J Obstet Gynecol 2002 May;186(5):1104; discussion 1104
18
UI - 12015494
AU - Pohlod-Miller S; Fanning J; Gu P; Crist KA; You M
TI -
Detection of genomic alterations in human endometrial cancer by
two-dimensional gel electrophoresis.
SO - Am J Obstet Gynecol 2002 May;186(5):855-7
AD - Division of Gynecologic Oncology, Department of Obstetrics and
Gynecology, Medical College of Ohio, Toledo 43614-5809, USA.
OBJECTIVE: The purpose of this study was to detect genomic alterations
in human endometrial cancer by two-dimensional gel electrophoresis.
STUDY DESIGN: With use of a newly developed two-dimensional gel
electrophoresis assay, we scanned 19 high-risk DNA fragments for
alterations in human endometrial hyperplasias and adenocarcinomas. This
method includes cleaving of high-molecular-weight DNA, radioactive
labeling, and separating DNA fragments by two-dimensional gel
electrophoresis. By comparing the two-dimensional gel electrophoresis
profile (spots) of neoplastic with normal endometrium, genetic
alterations such as amplification, allelic loss, and hypermethylation or
hypomethylation can be detected. RESULTS: Seven of 8 human endometrial
adenocarcinoma (88%) and 1 of 2 hyperplasias (50%) revealed changes in
spot density. The number of spots changed per specimen was 4. The median
percentage of specimens with changes in an individual spot was 30%.
Eleven spots had a reduction or loss of spot density, and 8 spots had an
increase in spot density. CONCLUSION: By use of a novel two-dimensional
gel electrophoresis assay, we identified genetic alterations in 50% of
hyperplasias and 88% of endometrial adenocarcinomas.
19
UI - 11994390
AU - Yoshida S; Harada T; Iwabe T; Taniguchi F; Fujii A; Sakamoto Y; Yamauchi
TI -
N; Shiota G; Terakawa N
Induction of hepatocyte growth factor in stromal cells by tumor-derived
basic fibroblast growth factor enhances growth and invasion of
endometrial cancer.
SO - J Clin Endocrinol Metab 2002 May;87(5):2376-83
AD - Department of Obstetrics and Gynecology, Tottori University School of
Medicine, Yonago 683-8504, Japan. souichi@grape.med.tottori-u.ac.jp
Tumor progression is often regulated through interactions between
carcinoma cells and host stromal cells. In this study of endometrial
cancer, we investigated one mechanism potentially involved in hepatocyte
growth factor (HGF)-mediated cancer-stromal interactions. Endometrial
cancer cells (HEC-1 and ISHIKAWA) expressed the c-met receptor, but HGF
did not. HGF, however, did stimulate the proliferation and invasion of
these cells. The HGF gene was expressed in stromal cells, which had been
separated from primary cultures of endometrial cancers, 6.4 times more
than in isolated normal endometrial stromal cells. Immunohistochemical
staining revealed immunoreactive HGF in cancer stromal cells, the
staining intensity being more pronounced in cancer tissue than in normal
endometrium. The conditioned medium from normal epithelial cells and
cancer cell lines induced HGF production in normal stromal cells. We
identified basic fibroblast growth factor as an HGF inducer derived from
endometrial cancer cell lines. Basic fibroblast growth factor derived
from tumor cells may induce HGF in endometrial stromal cells, whereas
stromal cell-derived HGF leads to the invasive growth of carcinoma
cells. These interactions, mediated by HGF and HGF inducers, may play a
significant role in the progression of endometrial cancer.
20
UI - 11992393
AU - Pellizzon AC; Fogarolli RC; Miziara M; Baraldi H; Soares CR
TI -
Morbidity of adjuvant high-dose-rate brachytherapy for low to
intermediate risk endometrial adenocarcinoma completely resected.
SO - Int J Cancer 2001;96 Suppl():105-8
AD - Radiation Therapy Service, Arnaldo Vieira de Carvalho Cancer Institute,
Sao Paulo, Brazil. pellizon@aol.com
The aim of this retrospective analysis was to evaluate bowel and urinary
acute and late morbidity in patients with low to intermediate risk
endometrial carcinoma, submitted to total abdominal hysterectomy and
bilateral salpingo-oophorectomy, without lymphadenectomy, and
postoperative high-dose-rate brachytherapy (HDR-B) as the sole
outpatient basis, to a total dose of 30-50 Gy, given in two fractions
per week. A total of 4-5 fractions of 6-10 GY was delivered. Three
patients (4.2%) developed severe bowel complications, with one patient
experiencing severe rectal bleeding. Local control was observed in 68
(97.1%) patients. Five-year actuarial disease and complication-free
survival were 94.3% and 96.8%, respectively. In conclusion, it seems
that a modest dose fraction schedule of HDR-B yields very high local
control rates and low morbidity rates. Copyright 2002 Wiley-Liss, Inc.
21
UI - 11136577
AU - Patsner B
TI -
Primary endodermal sinus tumor of the endometrium presenting as
"recurrent" endometrial adenocarcinoma.
SO - Gynecol Oncol 2001 Jan;80(1):93-5
AD - New Jersey Gynecologic Oncology, P.A., 180 White Road, Suite 102, Little
Silver, New Jersey 07739, USA.
BACKGROUND: Primary endodermal sinus tumor of the endometrium is an
extremely rare malignancy with few reports in the world literature.
CASE: A case of primary endodermal sinus tumor of the endometrium is
presented. The case is unusual in several aspects: it occurred in a
patient with a history of breast cancer and long-standing tamoxifen use,
and was diagnosed only after presenting as an apparent unexpected
recurrence of endometrial adenocarcinoma. The tumor recurred despite
initial cytoreductive surgery and combination chemotherapy. CONCLUSION:
Rare types of endometrial cancers may present as unexpected recurrences
of previously resected endometrial adenocarcinomas. Appropriate therapy
depends on obtaining sufficient tissue to establish an accurate
diagnosis to ensure selection of proper chemotherapeutic agents.
Copyright 2001 Academic Press.
22
UI - 11519319
AU - Lazarov L; Mang'rova S; Lazarov N
TI -
[Hysteroscopic diagnosis of endometrial carcinoma]
SO - Akush Ginekol (Sofiia) 2001;41 Suppl 4():25-7
Searching of more effective methods for early diagnosis of Endometrial
Cancer has confirmed the hysteroscopy as most complete and sufficient
manner in this direction. In the present exposition the authors are
sharing their experience and making some practical conclusions that may
be useful for the physicians applying this method.
23
UI - 11749000
AU - Talerman A
TI -
Primary endodermal sinus tumor of the endometrium presenting as
"recurrent" endometrial adenocarcinoma.
SO - Gynecol Oncol 2002 Jan;84(1):184
24
UI - 11263938
AU - Levine DA; Lin O; Barakat RR; Robson ME; McDermott D; Cohen L; Satagopan
TI -
J; Offit K; Boyd J
Risk of endometrial carcinoma associated with BRCA mutation.
SO - Gynecol Oncol 2001 Mar;80(3):395-8
AD - Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York,
New York 10021, USA.
OBJECTIVE: Inherited mutations in the BRCA1 or BRCA2 genes are
associated with a greatly increased lifetime risk of breast and ovarian
cancers and a modestly increased risk of several other cancer types.
Several case reports of endometrial carcinoma in women with a BRCA
mutation have led to speculation regarding the effect of these genes on
the risk of endometrial cancer. The purpose of this study was to test
the hypothesis that germline mutation of a BRCA gene is associated with
an increased risk of endometrial carcinoma. METHODS: A retrospective
cohort of 199 consecutive Ashkenazi Jewish patients with endometrial
carcinoma was identified from a 12-year period at this institution. All
were genotyped for the three BRCA founder mutations (185delAG and
5382insC in BRCA1 and 6174delT in BRCA2) that exist in this population,
and the case frequency was compared to the known population frequency of
these mutations. Additionally, endometrial carcinomas occurring in
patients with BRCA mutations were assessed for somatic loss of the
wild-type BRCA allele. RESULTS: Germline BRCA mutations were identified
in 3 (1 in BRCA1 and two in BRCA2) of 199 (1.5%) patients, compared to a
frequency of 2.0% in this population generally. A relative risk of
endometrial carcinoma associated with BRCA mutation, as estimated by the
odds ratio, was calculated as 0.75 (95% CI = 0.24--2.34; P = 0.6). Loss
of the wild-type BRCA allele was observed in two of three tumors
associated with a BRCA mutation. CONCLUSIONS: For individuals with a
germline BRCA mutation, the lifetime risk of endometrial carcinoma is
not increased. Copyright 2001 Academic Press.
25
UI - 11977333
AU - Olech-Fudali E; Chibowski D; Skomra D; Walczyna B
TI -
The expression analysis of the estrogen and progesterone receptors in
endometrial carcinomas.
SO - Ann Univ Mariae Curie Sklodowska [Med] 2001;56():319-25
AD - Department of Pathomorphology, Medical University of Lublin.
The aim of the study was the analysis of expression of estrogen (ER) and
progesterone (PR) receptors in endometrial carcinomas. The expression of
each of the receptors was examined with reference to such parameters as:
patients' age, the relation to menopause, histological type and grading,
the depth of myometrial infiltration and the presence of endometrial
hyperplasia adjacent to the tumour. There were found very significant
correlations between the degree of histological grading and expression
of ER and PR and between values of index ER and PR. There was obtained
correlation between the expression and endometrial hyperplasia only for
PR.
26
UI - 11993434
AU - Blond B
TI -
[Metrorrhagia after 75 years old, only 10% are signs of a cancer]
SO - Soins Gerontol 2001 Oct;(31):8
27
UI - 12027821
AU - Ebina Y; Sakuragi N; Hareyama H; Todo Y; Nomura E; Takeda M; Okamoto K;
TI -
Yamada H; Yamamoto R; Fujimoto S
Para-aortic lymph node metastasis in relation to serum CA 125 levels and
nuclear grade in endometrial carcinoma.
SO - Acta Obstet Gynecol Scand 2002 May;81(5):458-65
AD - Department of Obstetrics and Gynecology, Hokkaido University School of
Medicine, Sapporo, Japan.
BACKGROUND: To investigate the relationship between preoperative serum
CA 125 levels and para-aortic lymph node (PAN) metastasis as determined
by systematic pelvic and para-aortic lymph node dissection in
endometrial carcinoma. METHODS: This study included 180 patients (n =
55, premenopausal; n = 125, postmenopausal) with endometrial carcinoma
treated by complete surgical staging. Cut-off values of preoperative
serum CA 125 levels for PAN metastasis were determined by receiver
characteristic curve (ROC) analysis. Logistic regression analysis was
used to determine independent predictors for PAN metastasis. RESULTS:
The median serum CA 125 levels of patients with PAN metastasis were
significantly higher than the levels of those with no metastasis in both
premenopausal and postmenopausal groups. Based on ROC analysis, we could
determine four cut-off values (70 and 210 U/mL for premenopausal
patients, 20 and 60 U/mL for postmenopausal patients) and categorize the
serum CA 125 levels into low, moderate and high groups. By logistic
regression analysis, the CA 125 level and nuclear grade were found to be
significant predictors of PAN metastasis, respectively. Using this
model, the patients were stratified into three risk groups. The
probabilities of PAN metastasis for patients in the low-risk,
intermediate-risk and high-risk groups were less than 2%, 2-25% and more
than 50%, respectively. CONCLUSIONS: Serum CA 125 levels and nuclear
grade are important risk factors for PAN metastasis in endometrial
carcinoma.
28
UI - 11820598
AU - Mazurek U; Witek A; Olejek A; Paul M; Skalba P; Wilczok T
TI -
Expression of telomerase genes as potential marker of neoplastic
changes.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():183-4
AD - Department of Molecular Biology, Biochemistry and Biopharmacy, Medical
University of Silesia, Katowice. umazurek@farmant.slam.katowice.pl
We conducted a quantitative analysis of TERT, TP1 and hTR mRNA
expression in various types of endometrial hyperplasia in perimenopausal
women, taking advantage of the real-time PCR assay. All women underwent
hysterectomy for gynecological reasons. Endometrial dating was
determined from the patomorphology of the endometrium and classified
into endometrial hyperplasia: simplex, complex and atypica. Our data
suggest that only hTR was observed in each normal and hyperplastic
endometrium specimens, suggesting that this factor constitutively
expressed in endometrium. The results obtained indicate that the
expression activity of the TERT subunit changes but not significantly,
depending on the stage of development of the hyperplasia.
29
UI - 11820604
AU - Terlikowski S; Lenczewski A; Famulski W; Sulkowska M; Dobrzycka B;
TI -
Stasiuk-Barmuta A; Kulikowski M
Patterns of immunohistochemical staining for p53 expression in
hyperplastic endometrium and adenocarcinoma.
SO - Folia Histochem Cytobiol 2001;39 Suppl 2():195-6
AD - Department of Pathophysiology of Pregnancy, Medical Academy, Bialystok,
Poland.
The p53, a tumour suppressor gene, is the most commonly mutated gene
human cancer. In this study, we performed immunohistochemical
investigations of the expression of p53 protein in hyperplastic
endometrium and adenocarcinoma. Positive immunostaining was detected in
7 (30%) cases of invasive adenocarcinoma, 2 (12%) cases of simple
hyperplasia with atypia and 2 (14%) cases of complex hyperplasia with
atypia. In simple and complex hyperplasia without atypia staining was
seen in occasional cells. The results suggested that endometrial
hyperplasia is not always accompanied by p53 protein accumulation, hence
its expression is not an early exponent of the neoplastic process.
30
UI - 11953087
AU - Zhang X; Wei L; Wang J; Tu Z
TI -
[Time-dependent and dose-dependent regulation of human progesterone
receptor isoforms A and B in uterine endometrial carcinoma by human
insulin-like growth factor-I]
SO - Zhonghua Fu Chan Ke Za Zhi 2002 Mar;37(3):164-7
AD - Department of Obstetrics and Gynecology, Peking University People's
Hospital, Beijing 100044, China.
OBJECTIVE: We study the regulation of human progesterone receptor
isoforms A and B in uterine endometrial carcinoma cell line by different
concentration of human insulin-like growth factor-I (IGF-I) for
different time, to investigate the roles of IGF-I and progesterone
receptor isoforms in uterine endometrial carcinoma. METHODS: The uterine
endometrial adenocarcinoma cell line HEC-IB was cultured in vitro and
the breast cancer cell line MCF-7 was used as control. Western blot was
applied to examine the changes of the two isoforms by different
concentration IGF-I for different time. RESULTS: (1) In HEC-IB cell
line, 10 ng/ml IGF-I made hPRB up-regulated in the first 24 h. But
according to lager concentration and longer time, human progesterone
receptor (hPR) B became down-regulated, which were significant at 20
ng/ml IGF-I for 72 h and 40 ng/ml IGF-I for 48 - 72 h.The change of hPRA
was like hPRB. (2) In MCF-7 cell line, 10 ng/ml and 40 ng/ml IGF-I made
hPRA and hPRB significantly up-regulated in 24, 48, 72 h. Twenty ng/ml
IGF-I made hPRB up-regulated also in the first 24 h. But in 48 h and 72
h, down-regulation of hPRB was detected. Twenty ng/ml IGF-I made hPRA
down-regulated in 24, 48, 72 h. CONCLUSIONS: (1) The regulation of IGF-I
to hPR isoforms has cell-type specific and dose-dependent and
time-dependent. (2) In HEC-IB cell line, 10 ng/ml IGF-I made hPRB
significantly up-regulated in 24 h. But following exposure to IGF-I at
larger concentration and longer time, hPRB became down-regulated. The
change of hPRA is like hPRB.
31
UI - 12052590
AU - Clark TJ; Bakour SH; Gupta JK; Khan KS
TI -
Evaluation of outpatient hysteroscopy and ultrasonography in the
diagnosis of endometrial disease.
SO - Obstet Gynecol 2002 Jun;99(6):1001-7
AD - Minimal Access and Surgical Training (MAST) Centre, Academic Department
of Obstetrics and Gynaecology, University of Birmingham, Birmingham,
United Kingdom. t.j.clark@bham.ac.uk
OBJECTIVE: To develop a multivariable approach to determine the added
value of tests in routine practice where some diagnostic information is
already available from clinical history. METHODS: Multivariable logistic
regression models were built in a stepwise fashion, considering the
clinical sequence used in the rapid access ambulatory diagnosis clinic
(clinical history followed
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