Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be talking to you about endometrial cancer. And you can find written notes on this topic at zero to finals.com slash endometrial or in the cancer section of the zero definals obstetrics and gynecology book.

So let's get straight into it.

Endometrial cancer is cancer of the endometrium, which is the lining of the uterus.

Around 80% of cases are adenocarsinomas.

It's an estrogen-dependent cancer, meaning that estrogen

stimulates the growth of the endometrial cancer cells. Atomt it for you, for your exams,

any woman presenting with postmenopausal bleeding has endometrial cancer until proven otherwise.

The key risk factors to remember are obesity and diabetes.

Let's talk about endometrial hyperplasia.

Endometrial hyperplasia is a pre-cancerous condition involving thickening of the endometrium.

The risk factors, presentation and investigations of endometrial hyperplasia are similar to

endometrial cancer. Most cases of endometrial hyperplasia will return to normal over time.

Less than 5% will go on to become endometrial cancer. There are two types of endometrial

hyperplasia to be aware of, hyperplasia without atypia and atypical hyperplasia. Endometrial

hyperplasia may be treated by a specialist using progestogens with either the intrauterine system,

for example the Myrina coil, or with continuous oral progestogens, for example,

madroxyprogestrone or levo-nogestrel.

Next let's talk about the risk factors.

You can think of the risk factors for endometrial cancer in relation to the patient's exposure

to unopposed estrogen.

Unopposed estrogen refers to estrogen without progesterone.

Unopposed estrogen stimulates the endometrial cells and increases the risk of endometrial hyperplasia and endometrial cancer. The risk of

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