Cervical cancer

Question 1

where does cervical cancer happen?

Answer 1

because cervix is an opening to the uterus, the wall of the cervix is where the malignancy happens

Question 2

etiology & risks of cervical cancer?

Answer 2

• HPV infection (human papilloma virus)
• Hx of STDs
• multiple sex partners, early age sex
• smoking (organ specific carcinogens)

Question 3

Human papilloma virus

Answer 3

• more than 100 strains
• approx 40 are sexually transmitted
• strain 6 & 11 cause 90% of genital warts
• strain 16 & 18 responsible for approx 70% of cervical cancer

Question 4

strain 6 & 11 of HPV

Answer 4

cause 90% of genital warts

Question 5

strain 16 & 18 of HPV

Answer 5

responsible for approx 70% of cervical cancer

Question 6

what are some things that can be done in protection for cervical cancer?

Answer 6

• gardasil: 3 shots, 0, 2, 6 months protection for approx 6 yrs
• pap smear (papnicolaou test): smear of cervix, look at epithelial cells in lab if squamous cells normal-negative, if shows squamous cells dysplasia-precancerous squamous cell malignancy 3 different scoring for positives (CIN)

Question 7

Patho of cervical cancer

Answer 7

• squamous cell origin
• initial dysplasia (precancerous legion)
• then carcinoma in situ (in epithelial layer), progresses in cone shape (large to small)
• later invasive CA (deeper layers)
• several years between precancerous & invasive stage
• CIN (levels of cervical intraepithelial neoplasia)
• mets via lymphatics

Question 8

what is CIN

Answer 8

levels of cervical intraepthelial neoplasia

CIN 1, CIN 2, CIN 3

Question 9

cervical cancer has what kind of cell origin?

Answer 9

squamous cell origin

Question 10

Diagnosing cervical cancer

Answer 10

• PAP smear (for screening & diagnosis)

- colpsocopy (scope cervix & vagina - view cervix to determine location & extent of location)

Question 11

manifestations of cervical cancer

Answer 11

• vaginal discharge(not purulent, not heavy)
• metorrhagia (bleeding between menses- abnormal, in women that are post menopausal any vaginal bleeding is abnormal)
• more frequent menses
• pelvic/back pain

Question 12

treatment of cervical cancer

Answer 12

• all cases surgical excision (cervix relatively accessible) found early -excision (some examples of sx: laser surgery, cryosurgery-freezing, probe that has very low temp and causes necrosis
• if pick up later, invasive- radiation and surgery
• more advanced- radical hysterectomy
• conization: surgical instrument that extracts cone shaped tissue
• LEEP (loop electrosurgical excision procedure) - common for CIN 1&3 (want to remove all)

Question 13

when is LEEP commonly used (loop electorsurgical excision procedure)

Answer 13

common for CIN 1 & 3, because want to remove all of cancer

Question 14

how many levels of CIN (cervical intraepithelial neoplasia) is there?

Answer 14

three

Question 15

CIN 1 (cervical intraepithelial neoplasia)

Answer 15

-mild dysplasia, LSIL (low grade squamous intraepithelial lesion)

Question 16

CIN 2 (cervical intraepithelial neoplasia)

Answer 16

-moderate dysplasia, HSIL (high grade squamous intraepithelial lesion)

Question 17

CIN 3(cervical intraepithelial neoplasia)

Answer 17

-severe dysplasia & carcinoma in situ, HSIL (high grade squamous intraepithelial lesion)