Endometrial Cancer's Impact Varies Across Racial Groups
- Popular “Howard Stern Show” sidekick Robin Quivers, 72, was diagnosed with stage 3 endometrial cancer in 2012. Trouble urinating kick-started doctors’ quest to discover a grapefruit-sized mass on organs in her pelvic area. She underwent a hysterectomy, chemotherapy, and radiation, and continues immunotherapy for treatment.
- A new study published in Cancer Epidemiology, Biomarkers & Prevention says computer modeling predicts Black women are three times more likely to be diagnosed and potentially die from endometrial (also called uterine) cancer by 2050 compared to white women.
- Another study published in the medical journal Cancer Control points to possible reasons behind the disparity in how endometrial cancer affects Black women citing, “Black women receive less guideline-concordant treatment, undergo fewer hysterectomies, receive fewer minimally invasive procedures (which are considered standard of care), and experience higher rates of recurrence than white [women].”
- Endometrial cancer begins when cancerous cells form in the tissues of the endometrium, or lining of the uterus. Symptoms typically associated with this type of cancer include vaginal bleeding and pelvic pain.
- Endometrial cancer patients have had more treatment options in recent years, as new combination therapies are allowing them to live longer, healthier lives. Immunotherapy and chemotherapy have been shown to help slow disease progression compared to chemotherapy alone.
Quivers was diagnosed with endometrial cancer – also called uterine cancer – and according to a new study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR), more Black women are expected to be diagnosed with this type of cancer over the next three decades.
As for mortality, “among White women, the number of deaths from uterine cancer per 100,000 people is expected to rise from 6.1 in 2018 to 11.2 in 2050. For Black women, the rate is projected to increase from 14.1 to 27.9 per 100,000 during the same period.”
WATCH: How Can Medical Practitioners Reduce Racial Disparities?
Another study published in the medical journal Cancer Control examined why Black women are at higher risk and noted that, “Relative to all other races, Black women receive less guideline-concordant treatment, undergo fewer hysterectomies, receive fewer minimally invasive procedures (which are considered standard of care), and experience higher rates of recurrence than white [women].”
To help close these gaps in care, researchers recommend increasing awareness of endometrial cancer symptoms and reducing delays in treatment—both for patients and healthcare providers.
Quivers, meanwhile, “continues to do well after battling endometrial cancer amid ongoing immunotherapy treatments.”
“When you’re in and out of treatment, you’re always recovering and trying to get back to where you were,” Quivers told People Magazine.
Expert Resources to Help Patients Living With Endometrial Cancer
- Advanced or Recurrent Endometrial Cancer Patients Have New Hopeful Combination Therapy Option
- Combo Immunotherapy-Chemo Treatment May Help Slow Progression of Advanced Endometrial Cancer: Studies Show Promising Results
- Hope for Endometrial Cancer: FDA Approves Durvalumab/Chemotherapy Combination for Hard-to-Treat Advanced Disease
- ‘The Google Earth of Endometrial Cancer’ — a New, Molecular Snapshot Could Lead to Better Treatment of the Disease
Robin’s Cancer Journey
Quivers’ cancer journey began in 2012 when she was diagnosed with endometrial cancer.
Endometrial cancer begins when cancerous cells form in the tissues of the endometrium, or lining of the uterus.
After a woman has been diagnosed with endometrial cancer, her doctor will stage the cancer based on its spread within the body. A pelvic exam and imaging tests help your doctor learn if the cancer has spread or metastasized.
Some common risk factors for endometrial cancer include:
- Obesity
- Taking estrogen-only hormone replacement therapy after menopause
- Having never given birth or started menstruation at an early age
- Having a family history of endometrial cancer
As for Quivers, her diagnosis was not a straight line.
“Nobody was able to diagnose it,” she told People Magazine.
Her symptoms began after she started having trouble urinating and feeling more fatigued. She went to the doctor to get some answers, and her CT scans, MRIs, and biopsies remained inconclusive. Quivers described the period of uncertainty as “scary” and “bizarre.”
Further tests finally found the culprit, a grapefruit-size mass on “every organ in her pelvic area.”
Following the discovery, a hysterectomy was ordered, and the popular radio host underwent the procedure.
A hysterectomy is a procedure that removes part or all of the uterus (or womb), often along with the cervix, according to the National Cancer Institute. Women who receive a diagnosis of uterine, ovarian, and cervical cancer may have their cancer treated with a hysterectomy.
Following the procedure, Quivers began chemotherapy and radiation treatments that spanned 15 months.
“When you’re in and out of treatment, you’re always recovering and trying to get back to where you were,” Quivers said.
After undergoing intensive treatment, Quivers reached remission, which lasted for more than three years. Then, in late 2016, she experienced a relapse and needed additional treatment after the cancer returned and metastasized to her lymph nodes. After getting her cancer under control, she undergoes immunotherapy infusions periodically.
The immune system uses its white blood cells to attack abnormal or foreign cells in the body. Cancerous cells can prevent the immune system from doing its job and attacking foreign cells. Cancer produces certain proteins that protect the tumor from white blood cells. As a result, the body does not recognize the tumor as abnormal. However, immunotherapy treatments stop this from happening and ensure that the white blood cells recognize the cancer cells properly and attack them.
Better Understanding Endometrial Cancer and Treatment Options
In recent years, endometrial cancer patients have seen an increasing number of treatment options emerge to make battling the disease more manageable.
WATCH: New Combination Therapy for Advanced Endometrial Cancer Patients
The impact of new combination therapies on advanced endometrial cancer – a type of cancer that affects the lining of the uterus – is a significant advance for treating the disease. Patients are living longer, healthier lives.
Durvalumab (brand name IMFINZI) is an immunotherapy drug that’s often used alongside chemotherapy.
Olaparib (brand name LYNPARZA) is a PARP inhibitor, a type of drug that helps treat some cancers by blocking an enzyme called PARP that helps repair damaged DNA in cells. Olaparib destroys cancer cells, especially cells that already have trouble repairing their DNA. Sometimes, it’s used as an add-on to durvalumab.
“For a long time, patients with early-stage endometrial cancer generally do very well with a combination of surgery, maybe some radiotherapy,” says Dr. Shannon Westin, a professor in the Department of Gynecologic Oncology and Reproductive Medicine at the University of Texas, MD Anderson Cancer Center in Houston, TX.
“However, there’s a population of patients who are diagnosed at a later stage, stage three or four, or who have their cancer come back after initial therapy. And those patients have had a really hard time,” she adds.
According to Westin, the latest treatments combine immunotherapy with standard chemotherapy plus a drug that prevents cancer cells from fixing their own DNA.
The results are encouraging, especially for patients who have late-stage endometrial cancer or whose disease has come back.
Some known side effects of durvalumab and Olaparib include:
Durvalumab can cause inflammation in various parts of the body, which can lead to:
- Skin rashes
- Diarrhea
- Liver inflammation
Olaparib may lead to side effects such as:
- Fatigue
- Nausea
- Blood-related issues such as anemia
- Increased risk of developing certain other cancers due to the DNA repair inhibition.
Another U.S. Food and Drug Administration (FDA) approved combination therapy for advanced or recurrent endometrial cancer to be used with traditional chemotherapy is dostarlimab-gxly (brand name Jemperli). It is an immune checkpoint inhibitor, a type of immunotherapy that helps reinvigorate the body’s immune system to fight cancer.
WATCH: Treatment for Advanced or Recurrent Endometrial Cancer
Dostarlimab-gxly was already approved for metastatic and recurrent endometrial cancer in cases where chemotherapy did not work. Now, dostarlimab-gxly is approved as part of the first treatment for patients who have a specific set of genetic mutations called mismatch repair deficiency (dMMR) or microsatellite instability-high (MSI-H). These genetic factors are associated with a much greater response to the checkpoint inhibitor class of drugs.
Questions for Your Doctor
If you have been diagnosed with endometrial cancer, you may want to ask your doctor a few questions to ensure you are well informed about your diagnosis and the treatment journey that awaits.
- What stage is my endometrial cancer?
- What are the treatment options available for my specific type and stage of endometrial cancer?
- What are the potential side effects of each treatment option, and how can they be managed?
- What is the expected prognosis for my condition?
- Are there any clinical trials or experimental treatments that I may be eligible for?
- How often will I need follow-up appointments and tests to monitor my condition?
- Are there any lifestyle changes or dietary recommendations that can help improve my prognosis or manage side effects?
- What support services are available to help me cope with the emotional and practical aspects of living with endometrial cancer?
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