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Endometrial Cancer

From Mediwikis

Endometrial Cancer

A common cancer between 50 and 60yrs (75% occurs post menopause). It is a slow growing cancer, which is well contained with early symptoms. It has an excellent prognosis if detected early. Note that there is not currently a screening programme in the UK for Endometrial Cancer as patients tend to present at an early enough stage that cure is likely.

Hyperplasia of endometrium

A pre cancerous condition

  • Simple hyperplasia – (1-3% progress to cancer) doesn’t need treatment
  • Atypical hyperplasia - (25% progress to caner) requires treatment

Risk Factors

Linked to oestrogen exposure.

  • Nulliparity
  • Post menopausal
  • Obesity
  • Tamoxifen (treatment for breast cancer)
  • Late menopause and early menarche
  • Age
  • Polycystic Ovarian Syndrome (PCOS)

Signs and Symptoms

  • PMB - Post Menopausal Bleeding, this is the most common presenting feature
  • PCB - Post Coital Bleeding (must rule out cervical cancer as well)
  • Mild crampy pain
  • Discharge

Investigations

  • Transvaginal USS – to assess endometrial thickness (>3mm is abnormal)
  • Pipelle biopsy
  • Hysteroscopy and biopsy
  • Diagnosis made by histology

Management

  • Total abdominal hysterectomy (includes bilateral oopherectomy)
  • Radiotherapy and progesterone therapy (when hysterectomy is not suitable)