Jolanta Flieger

From Inflammation to Malignancy: The Link Between Endometriosis and Gynecological Cancers

Endometriosis, a chronic estrogen-dependent disease, is associated with a risk of developing gynecological cancers. The mechanisms of this association remain unclear, but emerging evidence implicates key signaling pathways, including PI3K/AKT/mTOR and ARID1A alterations, in malignant transformation. This article examines current reports on the association between endometriosis and cervical, ovarian, and endometrial cancers, with particular emphasis on diagnostic challenges and molecular mechanisms. Imaging methods such as ultrasound, magnetic resonance imaging, and computed tomography (CT) are used for diagnosis, as well as biomarkers such as Cancer Antigen-125 (CA-125) and Human Epididymal protein 4 (HE4), but their specificity is limited, motivating research into novel molecular and non-invasive diagnostics. Laparoscopy is an invasive diagnostic method, serving as the gold standard for confirming the diagnosis. We discuss personalized clinical strategies, including risk-based surveillance for patients with atypical lesions or ARID1A alterations, and implications for ovarian cancer management in endometriosis. Prospective cohort studies will be necessary to further understand the complex mechanisms of endometriosis’s malignant transformation. Optimizing therapy and improving quality of life require a holistic, individualized approach to patient care. This review provides an integrated synthesis of epidemiological and molecular evidence, highlighting both established and emerging targets for diagnosis and treatment in endometriosis-associated malignancies.

Micro- and Macronutrients in Endometrial Cancer—From Metallomic Analysis to Improvements in Treatment Strategies

Endometrial cancer is reported to be one of the most prevalent cancers of the female reproductive organs worldwide, with increasing incidence and mortality rates over the past decade. Early diagnosis is critical for effective treatment. Recently, there has been a growing focus on the role of nutrition and micronutrient and macronutrient status in patients with gynecologic cancers, including endometrial cancer. In the following paper, we have conducted an in-depth narrative literature review with the aim of evaluating the results of metallomic studies specifically concerning the micro- and macronutrient status of patients with endometrial cancer. The main objective of the paper was to analyze the results regarding the nutritional status of endometrial cancer patients and describe the role of chosen elements in the onset and progression of endometrial carcinogenesis. Further, we have focused on the evaluation of the usage of the described elements in the potential treatment of the abovementioned cancer, as well as the possible prevention of cancer considering proper supplementation of chosen elements in healthy individuals. Calcium supplementation has been proposed to reduce the risk of endometrial cancer, although some studies offer conflicting evidence. Deficiencies in phosphorus, selenium, and zinc have been inversely associated with endometrial cancer risk, suggesting they may play a protective role, whereas excessive levels of iron, copper, and cadmium have been positively correlated with increased risk. However, the molecular mechanisms by which these elements affect endometrial carcinogenesis are not fully understood, and current findings are often contradictory. Further research is needed to clarify these relationships and to evaluate the potential of nutritional interventions for the prevention and treatment of endometrial cancer.