Endometrial Cancer Flashcards

1
Q

What is endometrial cancer?

A

A malignancy that occurs in the endometrium of the uterus

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2
Q

What is the most common form of endometrial cancer?

A

Adenocarcinoma

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3
Q

What are the risk factors for endometrial cancer?

A

Increased age
Earlier onset of menstruation
Late menopause
Oestrogen only HRT
Nulliparity
Obesity
PCOS
Tamoxifen

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4
Q

What are the protective factors against endometrial cancer?

A

COCP
Mirena coil
Multiple pregnancies
Cigarette smoking

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5
Q

What is the presentation of endometrial cancer?

A

Post-menopausal bleeding
Post coital bleeding
Intermenstrual bleeding
Menorrhagia
Abnormal vaginal discharge
Haematuria
Anaemia
Raised platelet count
Dyspareunia
Pelvic pain
Weight loss

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6
Q

Who should be referred via an urgent 2 week wait pathway for endometrial cancer?

A

Anyone with post-menopausal bleeding

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7
Q

Who should be referred for a transvaginal ultrasound to investigate for endometrial cancer?

A

Women over 55 years with:
- Unexplained vaginal discharge
- Visible haematuria plus raised platelets, anaemia, or elevated glucose

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8
Q

What are the investigations used to diagnose endometrial cancer?

A

Transvaginal ultrasound
Pipelle biopsy
Hysteroscopy with endometrial biopsy

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9
Q

What is measured in a transvaginal ultrasound investigating endometrial cancer?

A

Endometrial thickness
- Normal endometrial thickness is <4mm post-menopause

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10
Q

What staging system is used to stage endometrial cancer?

A

FIGO staging system (International federation of gynaecology and obstetrics)

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11
Q

What are the different FIGO stages of endometrial cancer?

A

Stage 1 - confined to the uterus
Stage 2 - Invades the cervix
Stage 3 - invades the fallopian tubes, vagina, ovaries or lymph nodes
Stage 4 - Invades bladder, rectum or beyond the pelvis

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12
Q

What are the differential diagnoses of endometrial cancer?

A

Uterine fibroids
Endometrial polyps
Cervical cancer
Endometrial hyperplasia
Endometriosis

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13
Q

What is the typical treatment of stage 1 and 2 endometrial cancer?

A

Total abdominal hysterectomy with bilateral salpingo-oopherectomy

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14
Q

What additional treatments may be used in the management of endometrial cancer?

A

Radiotherapy
Progesterone to slow progression
Chemotherapy
Radical hysterectomy
- Also involved removing lymph nodes around the area, and the top of the vagina

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