Doctors trial the coil to prevent womb cancer

Cancer Research UK

NEW research in Yorkhill Hospital and Glasgow Royal Infirmary is investigating whether a form of the contraceptive coil can stop women from developing womb cancer.

The Cancer Research UK funded clinical trial - named POET* - is examining whether an intra uterine system (IUS) or coil, that releases a hormone, can prevent cancer of the lining of the womb - endometrial cancer - in high-risk patients.

This particular type of coil, traditionally used for birth control, is inserted into the womb to release the hormone progestagen. One effect of this hormone is to reduce the thickness of the wall of the womb. It is this feature that scientists believe could be the key to reducing the rate of endometrial cancer in women who are at an inherited risk of the disease.

These women who have an inherited a condition called HNPCC** or Lynch syndrome, will be eligible for the trial.

Endometrial cancer is the fifth most common cancer in women in the UK, with most cases being diagnosed after the menopause. While two per cent of British women will develop endometrial cancer, the rate rises to 60 per cent for those women with HNPCC.

Scientists are now recruiting local women from around the Glasgow area aged between 35 and 65, who have HNPCC, to take part in the trial. This is part of a UK-wide trial that aims to recruit 220 women in all and will run for four years.

Each woman on the trial will undergo an examination including an ultrasound scan and biopsy of the womb. If these results are normal then the women will be randomly divided into two groups. One group will receive yearly monitoring, and the other group will receive yearly monitoring and be fitted with a coil called the Mirena IUS.

An annual ultrasound will be carried out in all the women to check for any signs of cancer and a questionnaire will be used to analyse the psychological effects of monitoring and the acceptability of the coil.

Dr Victoria Murday, local researcher at the Yorkhill Hospital, said: "We are uncertain how effective it is to screen for endometrial cancer in women at increased risk of the disease, so prevention is the key.

"Earlier research has provided evidence that Mirena IUS may reduce the risk of endometrial cancer, and we hope that this study can show that it has this effect for women at high risk, who otherwise might opt for hysterectomy."

The research is a collaboration between Queen Mary's University of London, St George's University of London and Cancer Research UK.

Kate Law, Cancer Research UK’s clinical trials director, said: "It’s vital that we continue to research prevention techniques like the one we are trialing in this study. We need to learn if we can offer those women at high risk of womb cancer more options to help prevent the disease."

For more information about this trial please visit either the POET website or the Cancerhelp UK website. Alternatively, call our specialist nurses on 020 7061 8355.

Ends

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Notes to Editor

*POET - Prevention Of Endometrial Tumours

**Hereditary nonpolyposis colon cancer (HNPCC) is an inherited condition associated with an increased risk for a variety of cancers, especially bowel cancer. This condition is also sometimes called Lynch syndrome. Other than bowel cancer, womb cancer is the most common cancer linked with this syndrome.

Out of every 100 women who carry the HNPCC gene fault, approximately 60 will develop womb cancer at some point in their lives. In this group of women, womb cancer does tend to start at a younger age than in the general population, which can make it more difficult to diagnose because it is more likely to present before the menopause when irregular bleeding may not be noticed.

About 1 in 6 womb cancers in women with the HNPCC gene fault are diagnosed before age 40. If womb cancers in these women can be picked up at an early stage by screening, it is hoped that they have a better chance of being cured, but the effectiveness of screening (by ultrasound or biopsies of the lining of the womb) is still uncertain.

Cancer of the uterus is commonly referred to as 'womb cancer' or ‘endometrial cancer’. Each year there are over 6,400 new cases.

Progestagen is a synthetic version of the hormone progesterone.

Centres taking part in this trial: Princess Anne Hospital, Southampton; St George’s Hospital, London; Elizabeth Garrett Anderson Hospital, UCL, London; Southend University Hospital, Southend; Basildon University Hospital, Basildon; Addenbrookes Hospital, Cambridge; City Hospital, Birmingham; Liverpool Women’s Hospital, Liverpool; St Mary’s Hospital, Manchester; Queen Elizabeth Hospital, Gateshead; Yorkhill Hospital/Royal Glasgow Hospital, Glasgow; Belfast City Hospital, Belfast.

Anyone affected by cancer can contact Cancer Research UK’s cancer information nurses on 0808 800 4040 (freephone) or visit the charity’s patient information website www.cancerhelp.org.uk.

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