Endometrial Cancer Flashcards
What is endometrial cancer?
Cancer of the endometrium of the uterus
Who is normally affected by endometrial cancer?
Post-menopausal women
How many women are affected before menopause?
25%
What is the prognosis of endometrial cancer?
Good
What are the 2 categories of endometrial cancer?
Endometrioid adenocarcinoma
Uterine serous and clear cell carcinoma
What is the commonest type of endometrial cancer?
Endometrioid adenocarcinoma
Which type of endometrial cancer has a worse prognosis?
Serous and clear cell carcinoma
Who does serous and clear cell carcinoma usually affect?
Older women
What leads to an increased risk of endometrial cancer?
Exposure to unopposed oestrogen
What causes increased unopposed oestrogen?
- Nulliparity
- Obesity
- Early menarche
- Late menopause
- Polycystic ovary syndrome
What reduces the risk of the increased oestrogen ?
Progesterone
What is the classic symptom of endometrial cancer?
Postmenopausal bleeding
Change in intermenstrual bleeding in premenopausal women
What are unusual features of endometrial cancer?
Pain and discharge
What is the first line investigation for endometrial cancer?
Trans-vaginal ultrasound
What predictive value does a normal endometrial thickness have?
A high negative predictive value
How is the diagnosis of endometrial cancer confirmed?
Hysteroscopy with endometrial biopsy
What is the management of endometrial cancer dependent on?
The stage of the cancer
What is the management of endometrial cancer confined to the uterus?
Hysterectomy with bilateral Salpingo-oophorectomy
What is the management of cancer spread outside the uterus?
Combination chemotherapy and radiotherapy
What is the management of a frail, elderly lady who isn’t fit for surgery?
Progesterone therapy
What is used for palliation?
Progesterone
What is 1A staging?
Inner half of myometrium
What is 1B staging?
Outer half of myometrium
What is 2 staging?
Invades cervix
What is 3A staging?
Serosa
What is 3B staging?
Vagina
What is 3C staging?
Pelvic or para-aortic lymph nodes
What is 4 staging?
Bladder/ Bowel/ Intra-abdominal/ Inguinal nodes
What are the protective factors against endocmtrial cancer?
Smoking
COCP
Mulitparity
What condition is associated with endometrial cancer?
PCOS
What gene is associated with an increased risk of endocmetrial cancer?
HNPCC
Colorectal cancer
What hormonal drug therapy is associated with an increased risk of endometrial cancer?
Tamoxifen
Which women should be referred down the suspected cancer pathway?
All women >= 55 years who present with postmenopausal bleeding should be referred using the suspected cancer pathway
What would you see on an TV ultrasound that would cause suspicion of endometrial cancer?
Endometrial thickness >4mm
<4mm has a negative predictive value
