Endometrial Cancer Flashcards
What are the risk factors for endometrial cancer?
Unopposed oestrogen (high circulating oestrogen):
- Obesity
- PCOS
- Early menarche or late menopause
- Tamoxifen (breast cancer treatment) or E2 therapy
Nulliparity
Diabetes Mellitus
HNPCC
What factors are protective against endometrial cancer?
Smoking
COCP
Endometrial cancer comes in 2 main types called?
1 - Endometrioid Adenocarcinoma
2 - Uterine Serous & Clear Cell Carcinomas
Which type of endometrial cancer is more common?
Endometrioid Adenocarcinoma
Which type of endometrial cancer is more dangerous?
Uterine Serous & 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?
PMB - classic symptom
IMB - in pre-menopausal women
What else causes post-menopausal bleeds?
8% - Endometrial cancer Otherwise: - HRT - Vaginitis - Polyps - Other cancers
How would we investigate a case of abnormal vaginal bleeding? (ie investigations for endometrial cancer)
Pelvic & speculum Exam
Transvaginal US - first line
followed by Hysteroscopy w/ endometrial biopsy
(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 & Bilateral Salpingoophorectomy with washings
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%
