Question

Discuss how one can decrease their risk for Endometrial CA

2. Discuss the mode of spread of this cancer

3. Describe the lymphatic drainage of the uterus

Answer 1

1. Steps to reduce the risk of Endometrial cancer.

a) Weight loss by regular walking, diet and physical exercises.

b) Levonorgestrel Intrauterine system.

c) Bisphosphonates,

d) Estrogen based nonprogestin Harmone replacement therapy

e) Combined oral contraceptives.

2. 3 Modes of spread of Endometrial cancer.

Local invasion, lymphatic and hematogenous spread. Vaginal metastasis occurs by submucosal lymphatic or vascular metastasis in 10% of patients with clinical stage 1 disease. In lymphatic spread, it involves pelvic lymph nodes80%, para aortic nodes 78%, mediastinal nodes 50%, Inguinal nodes40%.

3. Lymphatic drainage of uterus:

a) Upper portion: superficial Inguinal and aortic.

Fundus and superior uterine body: Aortic( prevand para Aortic lymph node).

Cornu: Superficial Inguinal lymph node.

b) Middle portion ( uterine body): External iliac nodes.

c) Lower portion ( cervix): Internal and external iliac nodes, sacral nodes.