Endometrial Cancer

Question 1

protective factor against endometrial cancer

Answer 1

smoking

Question 2

peak age of endometrial cancer

Answer 2

75-79 y/o

Question 3

causes of high oestrogen that are risk factors for endometrial cancer

Answer 3

PCOS, early menarche, late menopause, nulliparity, tamoxifen and obesity

Question 4

what is tamoxifen used to treat

Answer 4

oestrogen receptor +ve breast cancer

Question 5

mechanism of tamoxifen

Answer 5

oestrogen receptor antagonist

Question 6

what alternative to tamoxifen carries a lower risk of endometrial cancer

Answer 6

raloxifene

Question 7

true/false - HNPCC increases endometrial cancer risk

Answer 7

true

Question 8

presentation of endometrial cancer

Answer 8

abnormal or post-menopausal bleed

dark brown or red

Question 9

initial assessment

Answer 9

speculum and pelvic exam - should be normal

Question 10

process of investigations for endometrial cancer

Answer 10

transvaginal US for endometrial thickness –> if >4mm –> biopsy –> pathology

Question 11

what system is used to stage

Answer 11

FIGO

Question 12

investigation used to stage

Answer 12

MRI

Question 13

2 histological types

Answer 13

endometrioid adenocarcinoma

serous and clear cell carcinoma

Question 14

endometrioid adenocarcinoma is less/more common and less/more aggressive than serous clear cell carcinoma

Answer 14

more common

less aggressive

Question 15

surgical management

Answer 15

total laparoscopic hysterectomy
bilateral salpingoopherectomy
peritoneal washings

Question 16

palliative management

Answer 16

progesterone

Question 17

indications for chemo and radiotherapy

Answer 17

chemo –> high risk histology

radio –> advanced stage