1. Adult Medical-Surgical Nursing Reproductive Health Module: Endometrial Cancer

2. Endometrial Cancer: Description  Adenocarcinoma of the body of the uterus

3. Endometrial Cancer: Risk Factors related to Aetiology  Older age group, usually post-menopausal women  Obesity (related to ↑ oestrogen)  HRT especially unopposed oestrogen (without progesterone)  Late menopause (after 52 years)  Nulliparity  Smoking

4. Endometrial Cancer: Clinical Manifestations  Inter-menstrual bleeding per vagina  *Post-menopausal bleeding. Any post- menopausal bleeding is suspect and should be investigated

5. Endometrial Cancer: Screening and Prevention  Regular (annual) Papanicolau (Pap) smear and pelvic/ vaginal ultrasound  Avoid smoking, alcohol and drug abuse  Weight control  Cautious use of HRT

6. Endometrial Cancer: Diagnosis  Pap smear  Ultrasound scan: pelvic and vaginal  Colposcopy, D&C (curettings for histology)  Further assessment if cancer detected:  IVP  Barium studies (bowel)  Liver scan  Bone scan

7. Endometrial Cancer: Management  Radical surgery:  Total Abdominal Hysterectomy and Bilateral Salpingo-oophrectomy  Radiation therapy (may be pre-operative or post-operative):  External beam  Internal pack to vault (brachytherapy)  Regular follow-up to detect in case of any metastases

8. Endometrial Cancer: Nursing Considerations  Emotional and psychological support to the patient and her family  Health education related to lifestyle, promoting good nutrition, ↓ smoking  Health awareness related to radiation therapy: fatigue, nausea, reduced immunity and bone marrow function  Genital hygiene (post-surgery or radiation)