Endometrial Cancer

Question 1

What symptom is endometrial cancer until proven otherwise?

Answer 1

Post menopausal bleeding

Question 2

What are the two big risk factors?

Answer 2

• Obesity

- T2 Diabetes

Question 3

Explain how the following conditions increase your risk:

• PCOS
• Obesity

Answer 3

PCOS
- less likely to ovulate -> reduced number of corpus lutems -> reduced progesterone production -> more unopposed oestrogen exposure

Obesity
- source of oestrogen -> adipose cells contain AROMATASE -> Aromatase converts testosterone into oestrogen

Question 4

What hormone fuels endometrial cancer?

Answer 4

Oestrogen - causes hyperplasia of endometrial lining

Question 5

What kind of cancer makes up 80% of endometrial?

Answer 5

Adenocarcinoma

Question 6

What 4 things act as protective factors?

Answer 6

• Smoking
• Mirena coil
• COCP
• Increased no. of pregnancies

Question 7

Explain what would be cause for an urgent (2 week referral) and what would cause a routine referral?

What would come as a result of a routine referral?

Answer 7

Urgent - post-menopausal bleeding

Routine - >55 w/ unexplained vaginal discharge or visible haematuria

Routine = TVUS

Question 8

What is a normal post-menopausal endometrial thickness?

Answer 8

<3mm (in Scotland can be <4mm in England)

Question 9

What is the common age range?

Answer 9

50-60

Question 10

What kind of abnormal bleeding may patients present with?

Answer 10

• Heavy
• Intermenstrual
• Post-coital

Question 11

What are the 4 subtypes of endometrial cancer?

Answer 11

Endometroid - 80%

Serous

Much less common:

• Mucoid
• Clear Cell

Question 12

What sign would make endometrial hyperplasia be termed atypical?

Answer 12

“Rounding-up” - round nuclei in cells surrounding glands

Question 13

What is the only way to be able to differentiate between ends. hyperplasia and cancer?

Answer 13

Biopsy