8. How will the new study be carried out?

More than 2,000 women who have had recent surgery for early stage uterine cancer (stage I or II) will take part in the study. Participants will be divided randomly (as in a flip of a coin) into two groups. One group will receive pills containing estrogen and the other will receive identical-appearing pills that do not contain estrogen (a placebo) for 3 years. The study is double-blinded—that is, neither physicians nor patients will know which women are taking the placebo and which are taking estrogen. Women in both groups will have check-ups every 6 months for 3 years and then annually for 2 more years.

9. Who is eligible for this study?

Women with endometrial cancer who were treated with a total hysterectomy and bilateral salpingo-oophorectomy and found to be at surgical stage IA, IB, IC, IIA, or IIB may be eligible for this study. These women must have at least one indication for ERT, including hot flashes, vaginal atrophy (dryness), increased risk of cardiovascular disease, or increased risk of osteoporosis. Women must have recovered from the effects of the recent surgery and be entered in the study within 12 weeks of surgery.

Ten Important Facts To Know About Cancer

1. Don't use tobacco. If you do, quit. This is the single most important thing you can do to prevent cancer. 2. Eat at least five servings of fruits and vegetables each day. Fruits and vegetables may lower your risk for some kinds of cancer. 3. If you are a woman, age 50 or older, get a mammogram every one to two years. 4. There is no upper age limit for the Pap test. Even women who have gone through menopause should have regular checkups, including a pelvic exam and a Pap test. 5. Cancers of the colon and rectum are more likely to occur as people get older. Three tests can help find these cancers early: rectal exam, guaiac stool test, and sigmoidoscopy. Ask your doctor how often you should have these tests. 6. Prostate cancer is the most common cancer in American men, especially older men. Discuss with your doctor early detection tests and their benefits and drawbacks. 7. Avoid too much sunlight; wear protective clothing; use sunscreen. 8. Avoid unnecessary x-rays. 9. If you do have cancer, find out what your treatment choices are and which are best for you. And before getting treatment, get a second opinion from another doctor.

What You Need To Know About Cancer of the Colon and Rectum

Introduction

The diagnosis of cancer of the colon or rectum, also called colorectal cancer, raises many questions and a need for clear, understandable answers. We hope this National Cancer Institute (NCI) booklet will help. It provides information on the symptoms, detection and diagnosis, and treatment, in addition to information on possible causes and prevention of cancers of the colon and rectum. Having this important information can make it easier for patients and their families to handle the challenges they face.

Together, cancers of the colon and rectum are among the most common cancers in the United States. They occur in both men and women and are most often found among people who are over the age of 50.

Cancer research has led to real progress against colorectal cancer -- a lower chance of death and an improved quality of life for people with this disease. The Cancer Information Service and the other NCI resources listed in the "National Cancer Institute Information Resources" section can provide the latest, most accurate information on colorectal cancer. Publications mentioned in this booklet and others are available from the Cancer Information Service at 1-800-4-CANCER. Many NCI publications are also available on the Internet at the Web sites listed in the "National Cancer Information Resources" section at the end of this booklet.

Understanding the Cancer Process

Cancer affects our cells, the body's basic unit of life. To understand cancer, it is helpful to know what happens when normal cells become cancerous.

The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as they are needed to keep the body healthy and functioning properly. Sometimes, however, the process goes astray -- cells keep dividing when new cells are not needed. The mass of extra cells forms a growth or tumor. Tumors can be either benign or malignant.

Benign tumors are not cancer. They often can be removed and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body. Most important, benign tumors are rarely a threat to life.

Malignant tumors are cancer. Cells in malignant tumors are abnormal and divide without control or order. These cancer cells can invade and destroy the tissue around them. Cancer cells can also break away from a malignant tumor. They may enter the bloodstream or lymphatic system (the tissues and organs that produce and store cells that fight infection and disease). This process, called metastasis, is how cancer spreads from the original (primary) tumor to form new (secondary) tumors in other parts of the body.

The Colon and Rectum

The colon and rectum are parts of the body's digestive system, which removes nutrients from food and stores waste until it passes out of the body. Together, the colon and rectum form a long, muscular tube called the large intestine (also called the large bowel). The colon is the first 6 feet of the large intestine, and the rectum is the last 8 to 10 inches.

Understanding Colorectal Cancer

Cancer that begins in the colon is called colon cancer, and cancer that begins in the rectum is called rectal cancer. Cancers affecting either of these organs may also be called colorectal cancer.

Colorectal Cancer: Who's at Risk?

The exact causes of colorectal cancer are not known. However, studies show that the following risk factors increase a person's chances of developing colorectal cancer:

• Age. Colorectal cancer is more likely to occur as people get older. This disease is more common in people over the age of 50. However, colorectal cancer can occur at younger ages, even, in rare cases, in the teens.

• Diet. Colorectal cancer seems to be associated with diets that are high in fat and calories and low in fiber. Researchers are exploring how these and other dietary factors play a role in the development of colorectal cancer.

• Polyps. Polyps are benign growths on the inner wall of the colon and rectum. They are fairly common in people over age 50. Some types of polyps increase a person's risk of developing colorectal cancer.

• A rare, inherited condition, called familial polyposis, causes hundreds of polyps to form in the colon and rectum. Unless this condition is treated, familial polyposis is almost certain to lead to colorectal cancer.

• Personal medical history. Research shows that women with a history of cancer of the ovary, uterus, or breast have a somewhat increased chance of developing colorectal cancer. Also, a person who has already had colorectal cancer may develop this disease a second time.

• Family medical history. First-degree relatives (parents, siblings, children) of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves, especially if the relative had the cancer at a young age. If many family members have had colorectal cancer, the chances increase even more.