Endometrial Cancer Flashcards
Risk factors:
Who gets endometrial cancer? [4]
Predisposing conditions [3]
Post-menopausal women on HRT
High oestrogen women
HNPCC carriers
Nulliparity, early menarche, late menopause
Women with cervical/endometrial polyps
Atypical endometrial hyperplasia
Cancer - cervix, vulva, bladder, anal
Risk factors:
Think of some groups who have high-circulating oestrogen? [4]
Why are PCOS more at risk of endometrial cancer?
Protective factors [2]
- Obese women
- E2 or tamoxifen therapy
- Early menarche or Late menopause women
- T2DM
PCOS - anovulatory cycles
Protective factors: parity, COCP
Endometrial cancer comes in 2 main types called?
Which is more common
1* - Endometrioid adenocarcinoma
2 - Uterine Serous and Clear Cell Carcinomas
Which type of endometrial cancer is more dangerous?
Uterine Serous and Clear cell carcinomas are higher grade, more aggressive and come with worse prognosis
Who gets which kind of endometrial cancer? [2]
Women with high oestrogen get Endometrioid adenocarcinoma
Older women tend to get the uterine serous and clear cell carcinomas
How does an endometrial cancer present? [3]
Post-menopausal bleeding
PV discharge
Irregular and heavy periods in pre-menopausal women
What else causes post-menopausal bleeds? [3]
8% - Endometrial cancer Otherwise: - HRT - Vaginitis - Polyps - Other cancers
Investigation of post-menopausal bleeding [3]
Pelvic and speculum Exam
Transvaginal US (TVS)
Endometrial biopsy or hysteroscopy
(Confirm diagnosis by histology)
What signs would you look for on Transvaginal US? [2]
Endometrial thickening and irregular contour would suggest cancer
Most cases of endometrial cancer are caught early, how would we treat one of those? [4]
Total Abdominal Hysterectomy and Bilateral Salpingoophorectomy with washings
+/- radiotherapy
How else can we treat endometrial cancer? [2]
High risk histology can indicate chemotherapy
If its advanced we can use Radiotherapy
Treatment of advanced stage of endometrial cancer [3]
External Beam RT
+
Brachytherapy: Caesium Insertion (intra-cavity)
or Vault Hysterectomy
How can we treat endometrial cancer if we need to palliate?
Progesterone therapy
How often is endometrial cancer cured?
Early 85% but more advanced is down to 21%
Overall 5YS is around 78%
Pathological prognostic features of endometrial cancer [4]
- Histological type: Type 1 or Type 2 carcinoma
- Histological grade: well-differentiated, moderately differentiated, poorly differentiated
- Stage
- LVSI - lymph or vascular space invasion
