-IBIS-1.5.0-
tx
reproductive system
uterine cancer
diagnoses
definition and etiology
definition:
Malignancy of the endometrial tissue.
etiology:
This is the most common gynecological cancer in women and the third most common female cancer overall (after breast and colorectal). It is seen primarily in post-menopausal women between 50-60 years old. Predisposing factors include obesity; DM; high blood pressure; infertility; history of irregular periods; late onset of menopause (over 52 years old); nulliparity; and use of estrogen therapy (unopposed estrogens) in a women who still has her uterus.
signs and symptoms
signs and symptoms:
Peri- or postmenopausal bleeding: uterine cancer must be ruled out in all cases
Pelvic exam with Pap smear containing endometrial component.
lab findings:
Vacuum aspiration of the endometrial cavity.
Endometrial biopsies.
Fractional D&C.
course and prognosis
The treatment is surgery. Irradiation is also used, although there is not much evidence proving that surgery and irradiation is superior to just surgery. Hormonal therapy of progestins is used with some success, while chemotherapy does not seem to work. Women on estrogens who are regularly seen by their gynecologists and who take progesterone have a much lower risk of developing uterine cancer than those women on just unopposed estrogens.
Overall, the general 5-year survival rate for endometrial cancer is somewhat favorable. Almost 63% of women will be alive after 5 years with no sign of the cancer; 28% will die within 5 years; and 9% will be alive but have the disease. However, in the U.S., the 5-year survival rate for stage one tumors reaches 90%.
differential diagnosis
Leiomyomas.
DUB.
footnotes