A hormonal intrauterine device (IUD) may be an effective treatment option for women who have early endometrial cancer or a precancerous condition and are not good candidates for hysterectomy, according to a study presented at the Society of Gynecologic Oncology’s 2021 virtual annual meeting. Investigators enrolled 165 women with obesity and an average age of 53 between December 2012 and October 2019, with 154 completing 6-month follow-up. They also considered the responses of 47 women who were treated with the IUD and metformin. Another 47 received the IUD and participated in a weight-loss program. At 6 months, IUD effectiveness ranged from 57% for those who also received metformin to 67% for those in the weight-loss group. About 82% of women who had a precancerous condition and used the hormonal IUD had a complete pathological response at 6 months, compared with a rate of 43% among those with cancer. “While the chance of a response in endometrial cancer is a lot less, it’s still [almost] 50%,” said the presenting investigator. “Keep in mind, these women have basically no treatment choices. They’re unsuitable for surgery. If you would operate on them, they would either run a very high risk of dying as a consequence of this operation or very severe complications from the procedure. Many of these women choose not to have surgery. So, now they have a 50% chance of the cancer completely going away. It’s obviously not as high as we want it, but it’s 50%.”

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