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Year Three - Reproductive System > Endometrial Cancer > Flashcards

Endometrial Cancer Flashcards

1
Q

What is endometrial cancer?

A

It is defined as the proliferation of malignant cells in the endometrium

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2
Q

What is the most common classification of endometrial cancer?

A

Adenocarcinoma

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3
Q

What is the pathophysiological cause of endometrial cancer?

A

Unopposed oestrogen

This results from an endogenous or exogenous lack of progesterone

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4
Q

What are the thirteen risk factors associated with endometrial cancer?

A

Post-Menopausal

Nulliparity

Early Menarche

Late Menopause

Breast Cancer

Polycystic Ovarian Syndrome

Diabetes Mellitus

Obesity

Hypothyroidism

Hypertension

Lynch Syndrome

Oestrogen HRT Administration

Tamoxifen Administration

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5
Q

What are the six protective factors associated with endometrial cancer?

A

Multiparity

Combined Oral Contraceptive Pill

Aspirin

Exercise

Smoking

Caffeine Intake

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6
Q

What are the six clinical features of endometrial cancer?

A

Vaginal Bleeding

Vaginal Discharge

Vaginal Dryness

Pyometra

Pelvic Pain

Weight Loss

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7
Q

What three types of vaginal bleeding are associated with endometrial cancer?

A

Post menopausal bleeding

Heavy menstrual bleeding

Inter menstrual bleeding

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8
Q

What is pyometra?

A

It is defined as a collection of pus in the uterine cavity

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9
Q

What two clinical features indicate advanced endometrial cancer?

A

Pelvic Pain

Weight Loss

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10
Q

What five investigations are used to diagnose endometrial cancer?

A

Blood Tests

Transvaginal Ultrasound

MRI Scans

Endometrial Biopsy

Hysteroscopy

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11
Q

What three blood test results indicate endometrial cancer?

A

Decreased Haemoglobin Levels

Decreased Platelet Levels

Increased Ca-125 Levels

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12
Q

When are transvaginal ultrasound scans used to diagnose endometrial cancer?

A

They are the first line investigation, which should be conducted as an urgent referral in all women over 55 years old who present with postmenopausal bleeding

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13
Q

What are the two features of endometrial cancer on transvaginal ultrasound scans?

A

Endometrial Thickness > 4mm

Irregular Endometrial Contour

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14
Q

How are MRI scans used to diagnose endometrial cancer?

A

They are used to confirm the diagnosis of endometrial cancer and determine its staging

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15
Q

When are endometrial biopsies used to diagnose endometrial cancer?

A

A positive transvaginal ultrasound scan of endometrial thickness > 4mm

OR

In cases of persistent bleeding in those with an endometrial thickness < 4mm

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16
Q

When are hysteroscopies be to investigate endometrial cancer?

A

High risk cases

OR

Multiple high risk factors

OR

Significant endometrial thickness

17
Q

What criteria is used to stage endometrial cancer?

A

International Federation of Gynaecology & Obstetrics (FIGO) Staging System

18
Q

What is stage one endometrial cancer?

A

This is defined as endometrial cancer limited to the body of the uterus

19
Q

What is stage two endometrial cancer?

A

This is defined as endometrial cancer limited to the body of the uterus and cervix

20
Q

What is stage three endometrial cancer?

A

This is defined as endometrial cancer which extends to the uterine serosa, peritoneal cavity and/or lymph nodes

21
Q

What is stage four endometrial cancer?

A

This is defined as endometrial cancer which extends to the vagina or parametrium

22
Q

What is the management option of stage one endometrial cancer?

A

Total hysterectomy and bilateral salpingooophorectomy, plus peritoneal washings

23
Q

What is total hysterectomy and bilateral salpingooophorectomy?

A

It involves removal of the uterus, cervix and adnexa

24
Q

What is the management option of stage two A endometrial cancer?

A

Total hysterectomy and bilateral salpingooophorectomy, plus peritoneal washings

25
Q

What is the management option of stage two B endometrial cancer?

A

Exploratory laparotomy with Wertheim’s radical hysterectomy

26
Q

What is exploratory laparotomy with Wertheim’s radical hysterectomy?

A

It involves removal of the uterus, cervix, vaginal tissue and pelvic lymph nodes

27
Q

What is the management option of stage three endometrial cancer?

A

Exploratory laparotomy with maximal de-bulking surgery

In most cases, surgical management is followed by radiotherapy or chemotherapy

28
Q

What is the management option of stage four endometrial cancer?

A

Palliative care, involving tumour debulking, chemotherapy and hormonal therapies

29
Q

What are the four chemotherapy agents used to manage endometrial cancer?

A

Doxorubicin

Pacilaxel

Carboplatin

Cisplatin

30
Q

What are the two hormonal therapies used to manage endometrial cancer?

A

Progesterone

Tamoxifen

31
Q

What progesterone pill is used to manage endometrial cancer?

A

Provera

32
Q

What is endometrial hyperplasia?

A

It is a precancerous condition, in which there is abnormal thickening of the endometrium

33
Q

What are the two classifications of endometrial hyperplasia?

A

Endometrial Hyperplasia Without Atypia

Atypical Endometrial Hyperplasia

34
Q

What is the malignancy risk in endometrial hyperplasia with atypia?

A

Low

35
Q

What are the two management options of endometrial hyperplasia without atypia?

A

Oral progesterone

Progesterone intrauterine system

36
Q

What is the malignancy risk in atypical endometrial hyperplasia?

A

High

37
Q

What is the management option of atypical endometrial hyperplasia?

A

Total abdominal hysterectomy and bilateral salpingooophorectomy

Year Three - Reproductive System (52 decks)

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