Endometrial Cancer Flashcards
what is the most common type of endometrial cancer?
adenocarcinoma
how does oestrogen impact endometrial cancer?
- oestrogen-dependent cancer
- oestrogen stimulates the growth of endometrial cancer cells
what the types of endometrial hyperplasia?
- hyperplasia without atypia
- atypical hyperplasia
how is endometrial hyperplasia treated?
progestogens
* intrauterine system
* continous oral progestogens
what are the risk factors for developing endometrial cancer?
unopposed oestrogen
* increased age
* earlier onset menstruation
* late menopause
* oestrogen only hormone replacement therapy
* no or fewer pregnancies
* obesity
* PCOS
* tamoxifen
- type 2 diabetes
- hereditary non-polyposis colorectal cancer or lynch syndrome
how does PCOS increase the exposure to unopposed oestrogen?
lack of ovulation
1. ovulation occurs –> corpus luteum
2. corpus luteum produces progesterone
3. provides endometrial protection during the luteal phase of the menstrual cycle
does not occur in PCOS
how does obesity increase the exposure to unopposed oestrogen?
adiopse tissue is a source of oestrogen
1. adipose tissue contains aromatase
2. aromatase converts androgens into oestrogen
how does tamoxifen increase the risk of endometrial cancer?
anti-oestrogen effect on breast tissue but oestrogenic effect on endometrial tissue
how does type 2 diabetes increase the risk of endometrial cancer?
- increased production of insulin
- insulin stimulates the endometrial cells
- increases the risk of hyperplasia and cancer
what are protective factors for endometrial cancer?
- COCP
- mirena coil
- increased pregnancies
- cigarette smoking
how does endometrial cancer present?
postmenopausal bleeding
* postcoital bleeding
* intermenstrual bleeding
* unusually heavy menstrual bleeding
* abnormal vaginal discharge
* haematuria
* anaemia
* raised platelet count
what type of referral should be made if a postmenopausal women presents with bleeding?
2 week urgent cancer referral
when should women over 55 years get a transvaginal ultrasound?
- unexplained vaginal discharge
- visible haematuria
what investigations are undertaken in endometrial cancer?
- transvaginal ultrasound
- pipella biopsy
- hysteroscopy
what is stage 1 endometrial cancer?
confined to the uterus
