Endometrial cancer

Question 1

Two major type of endometrial cancer

Answer 1

1. Type 1 - Endometroid adenocarcinoma

2. Type 2 - Serous papillary carcinoma

Question 2

What is type 1 endometrial cancer called?

Answer 2

Endometrioid adenocarcinoma

Question 3

Frequency of type 1 endometrial cancer?

Answer 3

Accounts for 90% of endometrial adenocarcinomas

Question 4

What demographic is type 1 endometrial cancer common in?

Answer 4

Younger women

Question 5

Which endometrial cancer is oestrogen dependant?

Answer 5

Type 1 - Endometrioid adenocarcinoma

Type 2 is oestrogen independant

Question 6

Prognosis of type 1 endometrial cancer

Answer 6

GOOD

Question 7

What demographic is type 2 endometrial cancer common in?

Answer 7

Elderly dependant

Question 8

Prognosis of type 2 endometrial cancer?

Answer 8

Poor prognosis

Question 9

Mean age of endometrial cancer diagnosis?

Answer 9

54

Question 10

Genetic cause of endometrial cancer

Answer 10

HNPCC gene

Question 11

Etiology of endometrial cancer

Answer 11

High circulating levels of oestrogen.

Question 12

Risk factor of endometrial cancer

Answer 12

1. Obesity
2. Nulliparity
3. Late menopause
4. Tamoxifen therapy for breast cancer
5. HRT/oestrogen therapy
6. PCOS

Question 13

How can we reduce the risk of endometrial cancer?

Answer 13

Use of oral contraceptive pill can reduce incidence of endometrial cancer by up to 50%

Question 14

Clinical features of endometrial cancer

Answer 14

1. Abnormal bleeding
   - post menopausal bleeding
   - irregular vaginal bleeding
   - intermenstrual bleeding
   - heavy bleeding

Question 15

Major symptoms of endometrial cancer

Answer 15

POSTMENOPAUSAL BLEEDING

Question 16

Ix for endometrial cancer

Answer 16

1. Speculum
2. Bimanual exam
3. Transvaginal ultra sound
4. Endometrial biopsy

Question 17

Transvaginal ultrasound - results

Answer 17

1. Allows for a quick and accurate assessment of endometrial thickness
   - < 4 mm thickness : cancer is very unlikely

Question 18

> 4 mm thickness on TVS leads onto;

Answer 18

1. Hysteroscopy to visualise the whole endometrium

2. Direct biopsy to be performed to confirm endometrial cancer diagnosis

Question 19

Who should be fast tracked on suspected cancer pathway?

Answer 19

women >= 55 years who present with postmenopausal bleeding should be referred using the suspected cancer pathway

Question 20

Mx of Endometrial cancer

Answer 20

1. Localised disease is treated with total abdominal hysterectomy with bilateral salpingo-oophorectomy.
2. Patients with high-risk disease may have post-operative radiotherapy