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preventable risk factors, including eating
salty food and smoked meats.
When doctors are relatively sure that additional screening will improve the outcome,
they might recommend an upper endoscopy,
says Bryan McIver, MD, PhD, a cancer specialist and founding member of the World
Congress on Thyroid Cancer. During this
screening, a physician passes a small, lighted
video camera called an endoscope down the
throat to check for abnormalities.

PHOTO AND ICONS BY GETTY IMAGES

Endometrial Cancer:
Deciphering the Disease

Endometrial cancer tends to grow slowly but
can be difficult to find because pelvic examinations will have normal results until the
disease is more advanced. And the diagnosis
often requires removing a small amount of
tissue from the inner lining of the uterus,
called the endometrium, which is not done
during an annual exam.
Women often have uterine bleeding as an
early symptom. Being aware of any irregular
bleeding, especially after menopause, can
make it easier to diagnose endometrial cancer in the early stages. If vaginal bleeding,
discharge or spotting occurs, a transvaginal
ultrasound can help diagnose the disease. A
thickened endometrium calls for more testing.
"If a postmenopausal woman were to
start having vaginal bleeding, just because
they have a normal or negative Pap smear
doesn't mean they can't have some sort of
gynecological malignity," says McDonald of
the American Society of Clinical Oncology.
Sometimes, he adds, an abnormal gynecological exam can warrant more testing of
the uterus.
Out-of-balance estrogen and progesterone levels and a higher body mass index
are risk factors for endometrial cancer.
In some instances, family history means
patients may need to consider having the
ovaries, fallopian tubes and uterus removed

to prevent endometrial cancer. "If a person
does have one of those hereditary cancer
genes," McDonald says, "sometimes there
are additional screening strategies that we
can employ."
When endometrial cancer is diagnosed at
stage 1, 90 percent of women will be cancerfree five years after treatment.

Make It Personal

Even as populationwide screening is not
recommended for some cancers, it's essential
to keep updated on breakthroughs and new
recommendations for screening and to stay
watchful of your overall health. Eating nutritiously, controlling your weight and getting
enough exercise may help address moderate
risk factors in many diseases, including cancers where screening is not recommended.
Keep in mind: Completing a blood panel
as part of your annual physical may help
doctors spot cancer-related anemia or other
irregularities in the blood early on.
Take a personalized path to your health.
Working with a physician to understand your
specific risks makes it easier to tailor cancer
screenings based on your family history and
unique needs as you age, McIver says. "There
is immense knowledge in having a better
understanding of family cancer," he says.
Beyond lifestyle and family connections,
consider your environment. Prior work at a
chemical plant, for example, might warrant
screening in specific people, McIver says.
"With each person," he says, "you need to
clearly understand the risk profile." *

Watchful Eye
on the Pancreas

UVA Health offers a clinic dedicated to
the detection and treatment of pancreatic cysts, which can increase a person's
risk of developing pancreatic cancer.
Learn more at uvahealth.com/cystclinic.

Early Clues
of Pancreatic
Cancer

Pancreatic cancer is tough
to find but can show early
clues. In some people, a
cyst (water- or mucusfilled structure) is spotted
in the pancreas. This most
often happens when a
person has an imaging
scan of the abdomen for
other reasons.
Although most pancreatic cysts are benign (noncancerous), their presence
may increase a person's
risk of developing cancer.
The most common cause
of these cysts is pancreatitis, an inflammation of
the pancreas. If monitored
closely by a dedicated
team, changes in these
pancreatic cysts can be
diagnosed early and successfully treated.
UVA Health offers one
of the first programs in
the country dedicated
to the detection and
treatment of pancreatic
cysts. The UVA Pancreatic
Cyst Clinic is part of
the Pancreatic Cancer
Program, a comprehensive approach to preventing and curing this
deadly disease through
advanced screening procedures, clinical trials
and advanced surgical
procedures. The diverse
team includes surgeons,
gastroenterologists, nurse
practitioners and nurses,
pathologists, radiologists
and genetic counselors-
all specially trained to
ensure that patients
receive the highest level
of care.

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Vim & Vigor - Summer 2020 - UVA

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