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January 13, 2025 14 mins
About 61,000 cases of endometrial cancer are expected to be diagnosed in the U.S. this year. Our guest is Dr. Sharyn Lewin, Director of Gynecologic Oncology at the Holy Name Medical Regional Cancer Center in Teaneck, NJ to talk about diagnosis and treatment options, and the organization she founded to fight women’s cancers, the Lewin Fund. For more, visit thelewinfund.org.
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Speaker 1 (00:01):
Welcome to get connected with Nina del Rio, a weekly
conversation about fitness, health and happenings in our community on
one oh six point seven Light FM.

Speaker 2 (00:12):
Welcome and thanks for listening. To get connected for the
next few minutes, A conversation about women's health, specifically endometrial cancer.
About sixty one thousand cases if endometrial cancer are expected
to be diagnosed in the US in the next year.
Our guest is doctor Sharon Lewin, director of gynecologic oncology
at the Holy Named Medical Regional Cancer Center in Teneck,

(00:33):
New Jersey, to talk about diagnosis and treatment options for
endometrial cancer and the organization she founded to fight women's cancers,
the Leuwenfund. You can find out more at the leuinfund
dot org, b lwn fund dot org. Doctor Lewin, thank
you for being on the show.

Speaker 3 (00:51):
Thank you for having me today.

Speaker 2 (00:53):
Prior to joining Holy Name, doctor Sharon Lewin was on
the faculty of the Columbia University College of Physicians and
Surgeon for fun years and was the first medical director
of the New York Presbyterian Hospital Woman to Woman program.
So you are the person we should be speaking to.
Let's start from the very beginning of this topic. What
is endometrial cancer?

Speaker 3 (01:14):
Thank you so much for having me. It's so important
that we educate listeners about endometrial cancer or uterine cancer. So,
endometrial cancer is a type of cancer that starts in
the lining of the uterus, known as the endometrium. It
is actually one of the most common gynecologic cancers, and
what we now know is that the rates of endometrial

(01:36):
cancer are actually increasing. We see that this year alone,
over sixty one thousand women in the United States will
be diagnosed with endometrial cancer. And when we look at
data from something called the SERE database, we know that
these rates of endometrial cancer are projected to increase over
the next five to ten years. It not only is

(01:59):
the most common gynecologic cancer that we see in the
United States, but also the most common cause of gynecologic
cancer death in the United States as well too. So
thank you for the opportunity to talk about it and
really educate, you know, listeners about the signs and symptoms.

Speaker 2 (02:13):
So let's talk about those numbers to begin with. So
there's I'm assuming a hereditary factor, also other risk factors.
Let's start with hereditary factors, how does that figure into
the rate of cases.

Speaker 3 (02:26):
So the hereditary component is a small factor. Women who
may have something called Lynch syndrome. For example, Lynch syndrome
is one of the hereditary forms of endomeutral cancer, where
women cannot only get endomeutral cancer at young ages, they
can also have a constellation of cancers things like ovarian

(02:47):
colon cancer, stomach cancers. Those are the most common cancers
associated with that syndrome. But hereditary causes are one small fraction,
and it's important that we definitely rule hereditary cancers out
when we're evaluating women. Unfortunately, though, there are a lot
of non hereditary causes. And what we've learned too, is

(03:07):
that half of all cancers in the United States can
actually be prevented with lifestyle issues, which is particularly important
for endometrial cancer at least certain subsets of endomutrial cancer.
We know that a lot of women develop endometrial cancer
from what's called unopposed estrogen, which happens when women are overweight.
They have too much estrogen from their fat stores essentially

(03:29):
that are circulating in their bodies, which sort of bombards
the uterus, leading to a thickened lining which ultimately turns
into a cancer. It's important that women stay in an
ideal body weight. They exercise, they eat healthy, they don't smoke,
they limit their alcohol, they do their screening test, things
of that sort. But being overweight is also a major
risk factor for endomutral cancer as well as other cancers.

Speaker 2 (03:51):
Unfortunately, I'm sure you saw the news just recently. I
believe seventy five percent of Americans are overweight or obese.
So this is figuring into all sorts of health.

Speaker 3 (03:59):
Issues exactly, and that's probably why the rates of endomutral
cancer are a rising.

Speaker 2 (04:04):
So looking at other factors, age, age of menopause, Have
you given birth, how do other factors figure in?

Speaker 3 (04:12):
Yes, and those do as well too. So again it's
unopposed estrogen as well, So things like being pregnant and breastfeeding,
and age of menopause and age of onset of men
sees and things like that, those are all protective factors
as well. I think the biggest risk factor now though,
definitely is overweight obesity. That's one thing to really think

(04:35):
about for the unopposed estrogen. Of course, the hereditary factors,
but what we're also seeing there are certain demographics of
women that are getting much more aggressive subtypes of endometrial cancer,
things like cirrus and clear cell, and these much more
aggressive hostologies, and those are not necessarily related to weight
or any of these other factors that we mentioned, and

(04:58):
we are trying to do a lot of research to
figure out why that is.

Speaker 2 (05:01):
So can you drill down a little bit more on
what you mean by that there's different types of endometrial cancer, correct?
Is that what you're talking about? That's correct?

Speaker 3 (05:09):
So the endometrium is the lining of the uterus. That's
where the cancer starts, endometrial cancer, But there are other
forms of uterine cancer, for example, like a sarcoma would
be a cancer that starts in the muscle wall of
the uterus. I think today we're really talking about endometril cancer,
which is the lining of the endometrium. But then we
further classify it based on the cell type, and there

(05:31):
are different cell types. One cell type, for example, is endometroid,
which happens to have a better outcome or prognosis compared
to some of these more aggressive cell types like I
mentioned cirrus and clear cell for example, those tend to
be much more aggressive. They tend to present at later stages,
and unfortunately, we do see some racial subsets of women

(05:54):
and to get these more aggressive cell types and often
present with much later stages. And that's a real active
area of research among a lot of groups right now
to try and change these demographics.

Speaker 2 (06:06):
So there are typical demographics of women who are less
likely to be diagnosed early. Is that about having lack
of medical care symptoms being misdiagnosed perhaps, Well, that's what.

Speaker 3 (06:17):
Is so important about this today, is that we haven't
really figured out why that is. It's important for women
to know if there's any bleeding after menopause that's definitely
abnormal or any discharge. So if there are any bleeding
or discharge after menopause that is abnormal and requires a
biopsy and evaluation right away. We do see a lot

(06:37):
of women who has felt that their periods have returned
and they think that that's normal, and it's absolutely abnormal.
So anything we can do to help women understand that
any bleeding or discharge after menopause is abnormal and they
need to see their gynecologists right away. We also see
that a lot of women after they have their children,
they stop going to the gynecologist and that's also a

(06:58):
very bad thing because these cancers tend to develop as
women age and are in menopause, and so women definitely
need to continue seeing their gynecologists every year. So I think,
you know, for earlier detection purposes, if women could continue
to see their gynecologists annually and also recognize science and
symptoms for earlier detection, that will absolutely help.

Speaker 2 (07:19):
Another question about symptoms, what else should we be looking
for besides abnormal bleeding, perhaps especially if we're younger.

Speaker 3 (07:25):
So women are still menstruating and still having their periods.
Any change in the menstrual cycle, particularly over the age
of thirty five or so, for example, heavier periods or
bleeding in between periods, that definitely warrants an evaluation. We
also just want to encourage women to know their bodies,
so if they develop any pelvic pain, any recurrent bloating,

(07:48):
you know, feeling full too quickly, any digestive issues, you know.
Some of these are symptoms that women may have that
aren't alarming, but if it's repetitive symptoms that are happening
a lot, people should really see their their doctors and
get it evaluated.

Speaker 2 (08:02):
For our conversation on endometrial cancer, Our guest is doctor
Sharon Lewin, director for the Division of Gynecologic Oncology at
Holy Name in Teeneck, New Jersey. She's recognized both nationally
and internationally for her acumen and performing laparoscopic, robotic and
open surgery to treat complex gnecologic cancers and related malignancies
of the upper abdomen and the pelvic colorectal areas. She's

(08:23):
also president and executive director of the nonprofit The Luin
Fund to Fight Women's Cancers, dedicated to eliminating medical, economic,
and psychosocial challenges faced by women with cancer. You're listening
to get connected on one OO six point seven light
FM Imina del Rio. Before we talk about treatment, I
would like to ask about you. Of all the things
you could have studied or practiced, why did you focus

(08:45):
on women's cancers.

Speaker 3 (08:47):
Thank you for asking that. So I've always been very
passionate about women's health. My grandmother was a gynecologist and
she was really my first inspiration. She was a real pioneer.
Women at that time were not doctors or specially gyaniccoglogists,
so she always talked to me about being a woman
physician and taking care of women so she was my
earliest role model, and I always wanted to follow in

(09:07):
her footsteps and become a gynecologist and take care of women.
That was my earliest memory. But then when I entered
Obgian that's the path that we start in. I really
fell in love with the cancer patients. I remember calling
my parents as an intern on my first rotation, which
was gun oncology, and most of these women are just

(09:27):
wonderful women who happened to have just very bad luck
to have cancer, and I felt really driven and compelled
to help them. And that's where my path started. And
I had a lot of wonderful role models, and so
the path took off from there. So I've always been
interested in women's health, but just the cancer part of
it actually came during my residency. Just had a real

(09:49):
passion for the women that I met and wanted to
help them.

Speaker 2 (09:52):
So how did your work lead you to build the
Luin Fund?

Speaker 3 (09:55):
During my time at Columbia. Actually, when I was on
faculty there, a grateful patient who actually hassed away from
a very aggressive form of endo mutual cancer, left to
be question in her will for us to continue some
of the work we were doing for women with gynecologic cancers.
It's interesting some of the global data state that half
of women when they're diagnosed with gnacologic cancers don't know

(10:16):
the signs or symptoms, and another half don't even have
not even attended a screening program. So she really recognized
the work that we were doing to not only support
women with cancers, but also to sort of change those
statistics in terms of prevention and education. So she left
to be question her will for us to start to
Luin Fund to fight Women's cancers, and it has since

(10:38):
grown since that time a real grassroots organization to really
help women and their families who are affected by cancer
a lot of education and prevention. But I think honestly
it's totally voluntary. No one on the board takes a salary,
thank you for asking about it. It's a real passion
project for us. But now, really since COVID, any patient

(10:59):
with cancer, I mean, people are really struggling financially to
even make ends meet when it comes to transportation and food,
and there are a lot of people that are in
real need, and so we're really fulfilling an important need
for these patients as well as funding some real groundbiaking
research with Dana Farber and Stone Kettering and a lot
of other partners. So thank you for asking. We're very

(11:20):
proud of what we do.

Speaker 2 (11:21):
There's a lot on the website. Actually, there is the
Hereditary Cancer Quiz on your site and other information. Since
we're talking about strategies, you mentioned that weight can be
an issue. What are some preventative strategies women should be
aware of?

Speaker 3 (11:34):
Certainly exercise. The data now says at least thirty minutes
of moderate intense exercise five days a week, maintaining a
healthy diet, lots of fresh shruit and vegetables, staying in
an ideal body weight, limiting alcohol and not smoking. And
also the prevention screening guidelines are very important as well too,

(11:55):
and also knowing your family history. If you have a
family history that is suggestive of a hereditary syndrome cancers
in your family, especially uterine colon breast ovarian cancer, you
may meet criteria for genetic testing, so please speak to
your doctors about that as well too.

Speaker 2 (12:11):
Is there anything else that someone listening should be aware of?

Speaker 3 (12:14):
Just that there are wonderful new treatments now for indemutrial
cancer that I should mention, And so if someone is
diagnosed with endometrial cancer. The future is still bright. We
do you know. Our societies have made a lot of
research and clinical trials and put a lot forth to
really change the face of particularly advanced and recurrent indimutrial

(12:37):
cancer for women. Immunotherapy, for example, which works on patients
immune system and combination with chemotherapy, has been approved by
the FDA. Particularly one type of immunotherapy called Jim Purley
is now FDA approved for women in combination with chemotherapy
for those with advanced or recurrent disease. So the future
is bright for our patients that have advanced or recurrent DEAs.

(13:00):
Of course, there are some unique side effects, so people
have to talk to their doctors and see if it's
right for them. But hopefully we will turn the tide
and talk to people about prevention and really recognizing early
signs and symptoms for earlier detection.

Speaker 2 (13:15):
You can find out more about the topic at the
Leeuwinfund dot org, b l e Wifund dot org. Our
guest has been Sharon Lewin, director of gynecologic Oncology at
the Holy Named Medical Regional Center in Tenech, New Jersey.
Thank you for being on the show.

Speaker 3 (13:30):
Thank you so much for having me.

Speaker 1 (13:32):
This has been get connected with Nina del Rio on
one oh six point seven light Fm. The views and
opinions of our guests do not necessarily reflect the views
of the station. If you missed any part of our
show or want to share it, visit our website for
downloads and podcasts at one oh six to seven lightfm
dot com. Thanks for listening.
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