Huntsman Cancer Institute
Huntsman Cancer Institute researchers Dr. Maggie Janat-Amsbury, left, Jay Gertz and Jeffery M. Vahrenkamp look over some of their study findings published March 14, 2018, in the journal Cell Reports.

SALT LAKE CITY — More than 60,000 women will be diagnosed with endometrial cancer this year and more than 12,000 will die from it, according to American Cancer Society statistics.

One Utah cancer researcher believes that warrants a closer look at what's happening inside the body.

Jay Gertz and his colleagues at the Huntsman Cancer Institute focused for years on the cancer of the uterine lining and discovered that the way two very common hormones (estrogen and cortisol) interact when cancer is present makes a big difference.

"It was shocking to us that cortisol — known as the stress hormone — working together with estrogen was creating more aggressive cancer growth in some people," Gertz, a Huntsman cancer researcher and assistant professor of oncological sciences, said Wednesday. He said everyone has changing levels of estrogen and cortisol in their bodies, so it isn't just increased stress that exacerbates endometrial cancer, but the way the cortisol affects cancer cells in the uterus.

"In general, cortisol is actually growth-suppressive, it stops growth in the uterus," he said, adding that wasn't the case in the mouse models tested for the study published in Cell Reports.

The thinking now, with Gertz's latest research, might be that if a tumor is present in the endometrium, cortisol could be feeding it or making it more aggressive.

"Estrogen has gotten a lot of press and a lot of research is directed at it, so finding that the glucocorticoid receptor may have interaction is new and not a lot of people have looked at that to date," said Dr. Maggie Janat-Amsbury, a gynecologic oncologist at the University of Utah School of Medicine and member of Huntsman Cancer Institute's Women's Cancer Disease-Oriented Research Team that worked on the latest research.

"We know about estrogen's role in the disease, but what's interesting is we have a stress signal coming in and affecting the tumor's biology," Gertz said.

Researchers consulted genomic and molecular data from hundreds of endometrial cancer patients collected over the years and as more becomes available, Janat-Amsbury said the findings may be corroborated.

"Our vision will be to advance this into a clinical trial, to see if we can personalize treatment for endometrial cancer," she said. "Because no two women who hear the same diagnosis will actually have the same disease."

Previously believed to affect only post-menopausal women over about age 60, Janat-Amsbury said endometrial cancer is occurring more often in younger women who are still in their reproductive ages.

"This is not exclusively a disease of older women anymore," she said.

Once detected, the primary approach is surgery, a hysterectomy, or removal of the uterus. If the cancer is more advanced and has spread, radiation and/or chemotherapy is necessary. Beyond that, there is no acceptable treatment, the researchers said.

Once the research is verified in humans, Gertz said they will need to find the best ways to block the signals of estrogen and cortisol and the ways they act together.

He said doctors are pretty good at treating endometrial cancer, as it typically isn't very aggressive, but, "it is the most common gynecological cancer, so there are a lot of women suffering with it."

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"Uterine cancer is one of the few cancers that is on the rise, and I think that really warrants more research into the disease," Gertz said.

Their findings, Janat-Amsbury said, reiterate the need for new thinking about endometrial cancers, of which there has been just two classifications thus far. She said the types are variably different and exhibit differently in different women and cellular research like theirs is proving that.

"With all this molecular information, we can be more personalized in treatment," Janat-Amsbury said.