Endometrial cancer

Question 1

what are causes of post menopausal bleeding?

Answer 1

endometrial cancer
hormone replacement therapy
peri-menopausal bleeding
atrophic vaginitis
cervical/endometrial polpys
other cancers i.e.cervical, vulva, bladder, anal

Question 2

what is the presentation of endometrial cancer?

Answer 2

post menopausal bleeding

abnormal vaginal bleeding

Question 3

how would you investigate post menopausal vaginal bleeding?

Answer 3

trans-vaginal USS to assess endometrial thickness and contour

endometrial biopsy

Question 4

what staging is used for endometrial cancer?

Answer 4

FIGO

Question 5

what is stage 1 endometrial cancer?

Answer 5

1a - inner half of the myometrium

1b - outer half of myometrium

Question 6

what are the 2 types of endometrial cancer?

Answer 6

type 1: endometrioid adenocarcinoma

type 2: uterine serous and clear cell carcinoma

Question 7

what type of endometrial cancer is more common in older women and is more aggressive?

Answer 7

uterine serous and clear cell carcinoma

Question 8

what are the treatment options for endometrial cancer?

Answer 8

total abdominal hysterectomy with salpingectomy and peritoneal washings
chemotherapy
radiotherapy - advanced stage
palliative progesterone

Question 9

what are the risk factors for endometrial cancer?

Answer 9

post menopausal women
high oestrogen levels;
- obesity
- unopposed oestrogen therapy / tamoxifen
- PCOS
- early menarche/ late menopause 

atypical endometrial hyperplasia

HNPCC/lynch type II familial cancer syndrome

Question 10

how is the type and stage of endometrial cancer diagnosed?

Answer 10

histology of endometrium

pathological diagnosis

Question 11

what imaging modality would you use to stage endometrial cancer and why?

Answer 11

MRI;

• depth of myometrial invasion
• cervical involvement
• lymph node involvement