Endometrial cancer is cancer that starts in the endometrium, or inner lining of the uterus (the hollow, pear-shaped organ that is part of your reproductive system). It is sometimes also referred to as uterine cancer. Endometrial cancer usually occurs after natural menopause, with 60 being the average age at diagnosis. The most common symptom of endometrial cancer is abnormal bleeding or discharge that isn’t part of your regular period. If you’ve already gone through menopause (no periods for one full year), having any bleeding or discharge again could be a warning sign. Other symptoms include unusual pelvic pain or pressure, difficult or painful urination, and pain during intercourse. The breast cancer treatment tamoxifen (sometimes called by its brand name, Nolvadex) increases the risk of developing endometrial cancer, but not nearly enough to outweigh its benefits against breast cancer in most women. Up to one-half of breast cancer patients who are treated with tamoxifen may develop an endometrial lesion within 6-36 months. Therefore, any patient who develops bleeding while taking tamoxifen requires evaluation. Tamoxifen is a non-steroidal "anti-estrogen" that binds to the estrogen receptor and is used primarily for adjuvant therapy in breast cancer. However, it can also act as a pro-estrogen agonist in a low estradiol environment. The agonist properties can affect the endometrium, and does, in a high percentage of patients (50%). Tamoxifen may cause the endometrium to appear thickened, irregular, and cystic. Most patients tend to have a multiplicity of findings.
Tamoxifen and the endometrium. Target audience Health professionals providing gynaecological care, and patients. Values The evidence was reviewed by the. Tamoxifen is one of the most important treatments for breast cancer, especially in postmenopausal patients. It acts primarily as an anti-estrogenic agent.