Endometrial Cancer Flashcards
What is endometrial cancer?
A malignancy that occurs in the endometrium of the uterus
What is the most common form of endometrial cancer?
Adenocarcinoma
What are the risk factors for endometrial cancer?
Increased age
Earlier onset of menstruation
Late menopause
Oestrogen only HRT
Nulliparity
Obesity
PCOS
Tamoxifen
What are the protective factors against endometrial cancer?
COCP
Mirena coil
Multiple pregnancies
Cigarette smoking
What is the presentation of endometrial cancer?
Post-menopausal bleeding
Post coital bleeding
Intermenstrual bleeding
Menorrhagia
Abnormal vaginal discharge
Haematuria
Anaemia
Raised platelet count
Dyspareunia
Pelvic pain
Weight loss
Who should be referred via an urgent 2 week wait pathway for endometrial cancer?
Anyone with post-menopausal bleeding
Who should be referred for a transvaginal ultrasound to investigate for endometrial cancer?
Women over 55 years with:
- Unexplained vaginal discharge
- Visible haematuria plus raised platelets, anaemia, or elevated glucose
What are the investigations used to diagnose endometrial cancer?
Transvaginal ultrasound
Pipelle biopsy
Hysteroscopy with endometrial biopsy
What is measured in a transvaginal ultrasound investigating endometrial cancer?
Endometrial thickness
- Normal endometrial thickness is <4mm post-menopause
What staging system is used to stage endometrial cancer?
FIGO staging system (International federation of gynaecology and obstetrics)
What are the different FIGO stages of endometrial cancer?
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
What are the differential diagnoses of endometrial cancer?
Uterine fibroids
Endometrial polyps
Cervical cancer
Endometrial hyperplasia
Endometriosis
What is the typical treatment of stage 1 and 2 endometrial cancer?
Total abdominal hysterectomy with bilateral salpingo-oopherectomy
What additional treatments may be used in the management of endometrial cancer?
Radiotherapy
Progesterone to slow progression
Chemotherapy
Radical hysterectomy
- Also involved removing lymph nodes around the area, and the top of the vagina
