Endometrial Cancer

Question 1

What are the 2 types of endometrial cancer?

Answer 1

• endometrioid adenocarcinoma
• most common
• unopposed oestrogen
• hyperplasia with atypical precursor
• uterine serous + clear cell carcinoma
• high grade, more aggresive, worst prognosis
• generally older women
• serous intraepithelial carcioma precursor

Question 2

What are the risk factors for endometrial cancer?

Answer 2

• post-menopause
• high circulating oestrogen levels
• obesity
• unopposed E2 therapy/Tamoxifen
• Polycystic Ovary Syndrome (PCOS)
• early menarche/late menopause
• atypical endometrial hyperplasia
• HNPCC/Lynch type II familial cancer syndrome

Question 3

What are the symptoms of endometrial cancer?

Answer 3

• abnormal vaginal bleeding
• post menopausal bleeding (PMB)

Question 4

What are the investigations for endometrial cancer?

Answer 4

• pelvic + speculum examination
• trans vaginal US (endometrial thickness and contour
• endometrial biopsy (if endometrium > 4mm or irregular)

Question 5

What are the different stages of endometrial cancer?

Answer 5

1A. inner half of myometrium

1B. outer half of myometrium

2. invades cervix

3A. serosa/adnexa

3B. vaginal/parametrium

3C. pelvic/para-aortic nodes

4. bladder/bowel/intra-abdominal/inguinal nodes

Question 6

What is the treatment for endometrial cancer?

Answer 6

• total laparoscopic hysterectomy TLH + bilateral salpingoopherectomy, peritoneal washings (early stage)
• chemotherapy (high risk histology)
• radiotherapy (advanced stage)
• progesterone (palliative)

Question 7

What are the cure rates for endometrial cancer?

Answer 7

1B. 85%

2A. 75%

2B. 60%

3B. 30%

4. 21%