Endometrial Cancer Flashcards
What type of cancer is most often associated with post-menopausal women?
Endometrial cancer
Any woman presenting with postmenopausal bleeding has endometrial cancer until proven otherwise.
What is endometrial hyperplasia?
A precancerous condition involving thickening of the endometrium
Most cases will return to normal over time, with less than 5% developing into endometrial cancer.
Name the two main types of endometrial hyperplasia.
- Hyperplasia without atypia
- Atypical hyperplasia
What are the treatments for endometrial hyperplasia?
- Intrauterine system (e.g. Mirena coil)
- Continuous oral progestogens (e.g. levonorgestrel)
What is the primary aetiology of endometrial cancer?
Develops from unopposed oestrogen
List some risk factors for endometrial cancer.
- Increased age
- Earlier onset of menstruation
- Late menopause
- Oestrogen only HRT
- No or fewer pregnancies
- Obesity
- PCOS
- Tamoxifen
What are some protective factors against endometrial cancer?
- Combined oral contraceptive pill
- Mirena coil
- Increased pregnancies/higher parity
- Cigarette smoking
What is a key clinical feature of endometrial cancer?
Postmenopausal bleeding
What are some other clinical features of endometrial cancer?
- Postcoital bleeding
- Intermenstrual bleeding
- Unusually heavy menstrual bleeding
- Abnormal vaginal discharge
- Anaemia
- Raised platelet count
- Weight loss, fatigue
What symptoms indicate possible metastasis in endometrial cancer?
- Cough
- Dyspnoea
- Haemoptysis
- Abdominal pain
- Jaundice
- Bone pain
- Hypercalcaemia
- Pathological fractures
What are the referral criteria for transvaginal ultrasound in women over 55?
- Unexplained vaginal discharge
- Visible haematuria, plus raised platelets, anaemia, or elevated glucose
What is the normal endometrial thickness post-menopause?
Less than 4mm
What investigations are performed for endometrial cancer?
- Transvaginal ultrasound
- Pipelle biopsy
- Hysteroscopy (with endometrial biopsy)
What are the stages of endometrial cancer according to FIGO?
- Stage 1: Confined to uterus (85% survival)
- Stage 2: Invades cervix (75% survival)
- Stage 3: Invades ovaries, fallopian tubes, vagina, or lymph nodes (45% survival)
- Stage 4: Invades bladder, rectum, or beyond pelvis (25% survival)
What is the primary surgical management for endometrial cancer?
- Total abdominal hysterectomy with bilateral salpingoophorectomy
- Radical hysterectomy (including lymph nodes, surrounding tissue, and top of vagina)
What are the medical management options for endometrial cancer?
- Radiotherapy
- Chemotherapy
- Palliation
