Endometrial Cancer Flashcards
What is endometrial cancer?
Endometrial cancer is a malignancy arising from the lining of the uterus, also known as the endometrium.
What is the most common type of endometrial cancer?
The most common type is endometrioid adenocarcinoma, which is usually oestrogen-dependent.
What is the most common age group affected by endometrial cancer?
It most commonly affects postmenopausal women, typically aged 50-70 years.
What are the risk factors for endometrial cancer?
Risk factors include obesity, unopposed oestrogen therapy, polycystic ovary syndrome (PCOS), tamoxifen use, and Lynch syndrome.
How does obesity increase the risk of endometrial cancer?
Obesity increases oestrogen levels through peripheral conversion of androgens to oestrogen in adipose tissue, promoting endometrial proliferation.
What are the protective factors against endometrial cancer?
Protective factors include combined oral contraceptives, parity, and physical activity.
What are the common symptoms of endometrial cancer?
Symptoms include postmenopausal bleeding, intermenstrual bleeding, and abnormal vaginal discharge.
What is the significance of postmenopausal bleeding in endometrial cancer?
Postmenopausal bleeding is the most common presenting symptom and warrants urgent investigation to exclude malignancy.
What investigations are used to diagnose endometrial cancer?
Investigations include transvaginal ultrasound (TVUS), endometrial biopsy, and hysteroscopy with biopsy.
What ultrasound finding is suggestive of endometrial cancer?
An endometrial thickness >4 mm in postmenopausal women is concerning for malignancy.
What is the role of hysteroscopy in endometrial cancer?
Hysteroscopy allows direct visualisation of the endometrium and targeted biopsy of suspicious areas.
What staging system is used for endometrial cancer?
The FIGO staging system is used to classify endometrial cancer based on tumour extent, nodal involvement, and metastases.
What are the stages of endometrial cancer?
Stage I: Confined to the uterus. Stage II: Cervical involvement. Stage III: Local or regional spread. Stage IV: Distant metastases.
What is the primary treatment for early-stage endometrial cancer?
The primary treatment is total hysterectomy with bilateral salpingo-oophorectomy (THBSO).
What is the role of adjuvant therapy in endometrial cancer?
Adjuvant therapy, including radiotherapy or chemotherapy, may be used in advanced stages or high-risk cases to reduce recurrence.
How is advanced or metastatic endometrial cancer treated?
Treatment involves a combination of chemotherapy, hormonal therapy (e.g., progestogens), and palliative care.
What are the complications of endometrial cancer?
Complications include metastases, anaemia from chronic bleeding, and treatment-related side effects like lymphoedema or bowel dysfunction.
What are the risk factors for Lynch syndrome-associated endometrial cancer?
Lynch syndrome increases the risk of endometrial cancer due to inherited mutations in mismatch repair genes (e.g., MLH1, MSH2).
What genetic testing is recommended for women with suspected Lynch syndrome?
Testing includes microsatellite instability (MSI) testing and immunohistochemistry (IHC) for mismatch repair proteins in tumour tissue.
How is endometrial hyperplasia related to endometrial cancer?
Endometrial hyperplasia, particularly with atypia, is a precursor lesion to endometrial cancer.
How is endometrial hyperplasia with atypia managed?
Management includes hysterectomy or progestogen therapy for women desiring fertility preservation.
What is the prognosis for endometrial cancer?
Prognosis is excellent for early-stage disease (Stage I), with a 5-year survival rate of >90%.
What are the common sites of metastasis in endometrial cancer?
Common sites include the pelvic lymph nodes, peritoneum, lungs, and liver.
How can endometrial cancer be prevented?
Prevention strategies include maintaining a healthy weight, using combined oral contraceptives, and managing risk factors like PCOS.
What is the role of hormonal therapy in endometrial cancer?
Hormonal therapy with progestogens is used for advanced or recurrent disease, particularly in oestrogen receptor-positive tumours.
What psychological support might be needed for women with endometrial cancer?
Support includes counselling to address anxiety, depression, body image concerns, and impact on fertility or sexual health.
