A TOOWOOMBA obstetrician who has treated women for a condition that, if left untreated, could lead to endometrial cancer has welcomed new Queensland research that has found the preventative effects of pregnancies.
Dr Brendan Miller is a Catholic doctor trained in NaPro Technology, a women’s health science that corrects abnormal reproductive and gynaecological disorders, including conditions that could lead to common cancers such as endometrial cancer.
He said new research by the Queensland Institute of Medical Research (QIMR) Berghofer that found each additional pregnancy experienced by a woman, including those that resulted in miscarriage, could reduce the risk of endometrial cancer, was consistent with the NaPro Technology approach to gynaecological health.
The study from QIMR Berghofer found each additional pregnancy, up to eight pregnancies, significantly reduced the risk of endometrial cancer by 15 per cent.
Dr Miller said in the course of treating women through NaPro Technology, practices such as charting their menstrual cycle had picked up “red flags” of endometrial cancer.
“When it comes to NaPro Technology and endometrial cancer, just the very act of women charting their cycles and having awareness that a bleeding is out of place … that’s then a red flag that there might be perhaps some endometrial hyperplasia, which is a precursor to endometrial cancer,” Dr Miller said.
Endometrial hyperplasia is a condition where the lining of the uterus is abnormally thick from having too many cells.
Dr Miller has offered women with endometrial hyperplasia a treatment of natural progesterone, a “pro-gestation” hormone that helps maintain the early stages of a pregnancy, during the phase of the menstrual cycle when the body prepares for a possible pregnancy, or the luteal phase.
“I’ve had a number of women who were doing the NaPro for fertility reasons where I picked it up, and it’s probably a number like five or six over the course of a few years,” he said.
“None of the patients for NaPro had endometrial cancer, but they did have endometrial hyperplasia and that’s probably the precursor to endometrial cancer, so if they’d gone on without any treatment it would have become endometrial cancer.
“Hopefully we’ve actually reversed what may have become endometrial cancer in a number of women through the NaPro Technology.”
Endometrial cancer, otherwise known as uterine cancer, is the most common cancer of the uterus, and is the fifth most common cancer diagnosed among Australian women.
The cancer begins in the layer of cells that forms the lining or endometrium of the uterus.
Cancer Australia estimates endometrial cancer affected about 3115 women in 2019 and claimed about 350 lives in 2018.
Researchers working on the QIMR Berghofer study examined pregnancy data from 30 studies conducted around the world, including Australia, held by the Epidemiology of Endometrial Cancer Consortium.
This included 16,986 women with endometrial cancer and 39,538 women who have never had the disease.
Miscarriages could also prevent cancer
Dr Miller, known to his patients as “Dr Pink and Blue”, said he was surprised by additional findings in the QIMR study that showed pregnancies that ended in miscarriage could also reduce the risk of endometrial cancer by roughly seven per cent.
He believed the presence of progesterone in early pregnancies could have resulted in the positive findings.
“One thing they mentioned in the paper was that a miscarriage between four and eight weeks had the same protective effect against endometrial cancer as a year being on the oral contraceptive pill,” he said.
“The oral contraceptive pill has got a reasonably natural oestrogen but it’s got a synthetic progestogen, and the idea of the progestogen is to counteract the effect of the oestrogen so that women on the pill don’t get endometrial cancer.
“I’m actually wondering, is it that when you’re pregnant, it’s a natural progesterone, rather than the synthetic progestogen that’s in the pill, so natural progesterone is going to target progesterone receptors perhaps more effectively than that progestogen in the pill.”
Dr Miller said the NaPro Technology research on the effects of progesterone in early pregnancy led him to obstetrics and gynaecology in 2006.
“I had a friend who kept losing babies at about 20 weeks, and I suggested a treatment of progesterone to her,” Dr Miller said.
“At this stage I was a GP, and I had just done the NaPro training in the states.
“Her obstetrician said it was a load of nonsense.
“That made me think, maybe I should do obstetrics as well.”
When Dr Miller graduated from his obstetrics fellowship, his institution gave an honorary fellowship to an American researcher “who had discovered that progesterone in the context of shortened cervix reduced the risk of pre-term birth”.
“It was one of those amazing moments when I’d trained for eight years for this reason and suddenly someone else had made it mainstream,” he said.
He said other gynaecological and obstetric practices including the availability of natural progesterone in pharmacies and the use of fertility-tracking phone apps were coming into line with what NaPro had done for decades.
Dr Miller said NaPro also encouraged the use of robotic surgery for the treatment of endometriosis, a disorder where the tissue that forms the lining of the uterus grows on the outside.
“One of the reasons I came to Toowoomba was it was this robot sitting here,” he said.
“I had really easy access to robotic surgery, and I think that’s a real game-changer for very difficult endometriosis treatment.
“It feels in fact you’re able to do an even better job.”
Queensland’s first certified FertilityCare educator praises study
FertilityCare practitioner Cathryn Marshall, who works predominantly with Dr Miller’s patients, said it was important for women to realise the gynaecological and reproductive benefits of pregnancies.
“Any research that we can get that helps women understand what’s going on with their body and know that there are ways they can avoid those kinds of cancers, I think it’s wonderful that people are looking into this stuff,” Mrs Marshall said.
“It’s wonderful that, as sad as a miscarriage is, that at least there is somehow benefits for the woman.”
Mrs Marshall, who is the first Queenslander certified to teach the Creighton method to aspiring practitioners in Australia, said for many women endometrial cancer was a shock and the treatment could be “quite invasive”.
“Most of the time it would probably be a hysterectomy or something they would have to go through, along with other cancer treatment,” she said.
MORE STORIES ON WOMEN’S HEALTH:
- I was crippled with endometriosis for 12 years. This women’s health science changed my life
- Queensland’s first Creighton educator ready to teach aspiring practitioners the life-giving method
- Brisbane NaPro doctor welcomes study showing contraceptive pill can change a woman’s brain
- Catholic ethicist says some fertility clinics misleading desperate couples with false IVF success rates