25) Endometrial Cancer; Uterine Sarcoma

Question 1

What is Endometrial Cancer?

Answer 1

• It’s a malignancy of endometrial lining of uterus
• It’s hormone-dependent
• Usually occurs in Post-Menopausal Women
• It’s of Adenocarcinoma-Type

Question 2

What are the Types of Endometrial Cancer?

Answer 2

• Type 1 = Oestrogen-Dependent
• Type 2 = Oestrogen Independent

Question 3

What are the Causes of Type 1 & 2?

Answer 3

Type 1 - DEPENDENT

• PCOS
• Obesity
• History of Breast Cancer
• Long-term exposure to INCREASED Oestrogen Levels

Type 2 - INDEPENDENT

• Associated with Endometrial ATROPHY
• Multiparity
• Combination of Oral Contraceptives

Question 4

What are the Clinical Features of Endometrial Cancer?

Answer 4

• Abnormal bleeding in post-menopausal
• vaginal discharge, dysuria, abdo cramps
• Reproductive age = menorrhagia / metrorhagia
• Pelvic pain, back pain,
• Simpsons sign (lower abdo pain before bleeding)

Question 5

What is the Diagnosis & Treatment for Endometrial Cancer?

Answer 5

DIAGNOSIS

• Transvaginal Ultrasound - to measure enometrial thickness (For Hyperplasia)
• Pelvic Exam

TREATMENT

• Total Hysterectomy = Of the Cervix and Vagina
• Radical Hysterectomy = Of the Upper Vagina, Cervix, Uterus and Parametrial Tissue
• Radiotherapy
• Adjuvant Chemotherapy

Question 6

What are the STAGES of Endometrial Cancer?

Answer 6

• Stage 1 – Confined to corpus uteri (uterine body)
• Stage 2 – Extends to the cervix
• Stage 3 –extends to vagina, ovaries + lymph nodes
• Stage 4 – Extends to rectum, bladder and metastasis to distant organs