Endometrial Cancer Flashcards
Who gets endometrial cancer?
- Post-menopausal women
- High oestrogen women
- HNPCC carriers
- Atypical endometrial hyperplasia
Think of some groups who have high-circulating oestrogen?
- Obese women
- E2 or tamoxifen therapy
- PCOS
- Early menarche or late menopause women
Endometrial cancer comes in 2 main types called?
- Endometrioid adenocarcinoma
- Uterine Serous and Clear Cell Carcinomas
Which type of endometrial cancer is more common?
Endometrioid adenocarcinoma
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?
- 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?
Abnormal vaginal bleeding i.e. post-menopausal bleeding
What else causes post-menopausal bleeds?
Endometrial cancer (8%)
Otherwise:
- HRT
- Vaginitis
- Polyps
- Other cancers
How would we investigate a case of abnormal vaginal bleeding?
- Pelvic and speculum exam
- Transvaginal US
- Endometrial biopsy or hysteroscopy (confirm diagnosis by histology)
What signs would you look for on Transvaginal US?
Endometrial thickening (>4mm) and irregular contour would suggest cancer
Most cases of endometrial cancer are caught early, how would we treat one of those?
Total Abdominal Hysterectomy and Bilateral Salpingo-oophorectomy with peritoneal washings
(Removal of uterus, cevix, ovaries and fallopian tubes)
How else can we treat endometrial cancer?
High risk histology can indicate Chemotherapy
If its advanced we can use Radiotherapy
What kinds of RT can we use in endometrial cancers?
External Beam RT Caesium Insertion (intra-cavity or vault)
How can we treat endometrial cancer if we need to palliate?
Progesterone can help
How often is endometrial cancer cured?
Early 85% but more advanced is down to 21%
Overall 5YS is around 78%
