Endometrial cancer Flashcards
what age group are at the highest risk of developing endometrial cancer
post menopausal women
what is the aetiology of endometrial cancer
anything increasing levels of oestrogen such as:
- PCOS
- late menopause
- nulliparity
- obesity
- HRT
- tamoxifen
- carbohydrate intolerance
COCP is protective in terms of endometrial cancer risk true/false
true - although increase in oestrogen there is no bleeding every month and therefore protective
what is the main symptom of endometrial cancer
abnormal uterine bleeding
abnormal uterine bleeding is endometrial cancer until proven otherwise true/false
true - must find underlying cause
list some symptoms other than abnormal uterine bleeding that could be endometrial cancer
changes in discharge – blood, watery or purulent
pain is rare in early stages, mets could be present
what areas of the body is endometrial cancer likely to spread to via direct invasion
myometrium
cervix
fallopian tubes
endometrial thickness of what diameter is concerning in postmenopausal women
endometrial thickness of >5mm, pre-menopausal women the thickness varies throughout their cycle
what is the first line investigation for suspected endometrial cancer
TUVS - this is where endometrial thickness is measured
what is the gold standard investigation for diagnosing endometrial cancer
endometrial biopsy for histological analysis
how are endometrial cancers categorised
type 1 and type 2 cancers
which type is most common
type 1, most commonly endometrioid adenocarcinomas
which type of endometrial cancer is oestrogen dependent
type 1
what genes are associated with type 1 endometrial cancer
PTEN, KRAS, PIK3CA mutations
lynch syndrome
what endometrial cancers come under type 2
serous carcinoma and clear cell
which type of endometrial cancer is more aggressive/worse prognosis
type 2, also not associated with oestrogen
who will type 2 typically present in
much older women
type 2 endometrial cancer is associated with which mutation
p53
describe FIGO staging of endometrial cancer type 1A, 1B and 1C
1A - confined to uterus
1B - uterus + <1/2 myometrial invasion
1C - uterus + >1/2 myometrial invasion
describe FIGO staging of endometrial cancer stages II nS III
II - cervical stromal invasion but not beyond uterus
III - invades serosa or adnexae
describe FIGO staging of endometrial cancer stages IVA and IVB
IVA - invasion of bladder or bowel mucosa
IVB - distant metastases including inguinal lymph nodes
grading of tumours is split into 3 grades, describe each
grade 1 - 5% or less solid growth
grade 2 - between 6-50% solid growth
grade 3 - >50% solid growth
outline the management of endometrial cancer
main treatment is surgical - hysterectomy + bilateral salpingo-oophrectomy
adjuvant radiotherapy to prevent recurrence
if widespread disease consider chemotherapy
what is the treatment of endometrial cancer if the patient is unsuitable for surgery
radiotherapy + high dose progesterones
