Endometrial cancer

Question 1

In who do most cases of endometrial cases occur in?

Answer 1

post-menopausal women

Question 2

What is the underlying risk factor of endometrial cancer?

Answer 2

unopposed oestrogen

Question 3

What are the RF for endometrial cancer?

Answer 3

o	Obesity, TDM, HTN
o	Nulliparity
o	Anovulatory cycles such as PCOS
o	Early/late menopause
Tamoxifen!! - causes endometrial hyperplasia 
o	Genetic predisposition, HNPCC confers high risk to endometrial, ovarian and colorectal cancer  
o	Breast cancer 
o	Oestrogen only HRT

Question 4

What are protective factors of endometrial cancer?

Answer 4

o Parity

o COCP

Question 5

What is presentation

Answer 5

o PMB (red flag sx)
o If premenopausal - heavy or irregular periods
o PV discharge
o Pyometra - serious and life-threatening infection of the uterus

Question 6

What are ix and results

Answer 6

Normal examination
TVS - endometrial thickness >4mm requires biopsy
Hysteroscopy
CT/MRI - preoperative sstaging

Question 7

what cells are most endometrial cancers made up of

Answer 7

adenocarcinomas

Question 8

Explain FIGO staging for endometrial ca

Answer 8

I
Body of uterus only
II 
Body and cervix
III
Advancing beyond uterus but not pelvis
IV
Extending outside pelvis e.g. bladder

Question 9

What is the treatment of Endometrial ca

Answer 9

1. total hysterectomy w bilateral salpingo-oophorectomy
2. Radiotherapy - adjuvant (brachytherapy/external beam)
3. Progesterone therapy - delivered via coil or tablets (form of palliation used for those unfit for surgery)

Question 10

What is the 5yr survival for stage 1

Answer 10

80%

Question 11

What is brachytherapy

Answer 11

localised radiotion