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GYN Cancer Flashcards

(90 cards)

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1
Q

Is cervical carcinoma more prevalent among old or younger women?

A

younger women

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2
Q

What are some etiological factors contributing to gynecological cancers? (6 answers)

A

Poor, early sexual activity, multiple partners, pelvic lesions (HPV & HSII), Smoking, Nulliparity

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3
Q

What had helped to increase the early detection of cervical cancer?

A

Pap smears

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4
Q

what portion of cervical cancer is caught in the early non-invasive stage?

A

2/3

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5
Q

What is a gynecologic cancer risk factor specific to married women? (1 answer)

A

Those with husbands that have penile cancer

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6
Q

What does the effect of DES (Diethylstilbestrol) have on the risk for gynecological cancer?

A

Those that were exposed to DES before birth have a higher risk to develop Clear Cell Cervical and Vaginal cancer

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7
Q

What is attributing to the increase in endometrial cancer? (2 answers)

A

An aging population, Diets high in fats and calories

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8
Q

What is the peak incidence age for gynecological cancer?

A

58

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9
Q

What are two other health conditions that contribute to the occurrence of gynecological cancer?

A

Diabetes and hypertension

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10
Q

Those that are 50 lbs heavier are likelier to develop gynecological cancer. True or False?

A

True, 9x more likely

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11
Q

What are the nodes involved in the gynecological cancer region? ( 5 answers) “Physicians Commonly Intervene Extra Objectively”

A

Periaortic, Common Iliac, Internal Iliac, External Iliac, and Obturator Nodes

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12
Q

What is the outermost portion of the Gyn tract?

A

Vulva

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13
Q

What are the three sections of the vulva?

A

Labia majora, Labia Minora, and Clitoris

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14
Q

Where is the perineum located in female anatomy?

A

Between the vulvovaginal complex and anal verge

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15
Q

Explain the vagina. Characteristics? Dimensions? Location? ( 4 answers)

A

Muscular tube, 6-8 inch sup from the vulva, Ant to rectum, and Post to Bladder

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16
Q

What is the most inferior portion of the uterus that extends into the apex of the vagina?

A

The cervix

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17
Q

Explain the cervix. Characteristics? ( 3 answers)

A

Firm/round structure, 1.5 cm to 3 cm diameter, protrudes into the vagina creating spaces called fornices

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18
Q

Explain the Cervical Os. (1 answer)

A

canal the extends into the vagina through the cervix into the uterine cavity

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19
Q

Explain the Uterus. Characteristics? Dimensions? Location? (4 answers)

A

Hollow muscular structure, Overlays the bladder, extend laterally to fallopian tubes (transfer tube for eggs into the uterus), and Parametrium is tissue lateral to the uterine cervix

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20
Q

What are three important structures to consider in gynecological cancer?

A

Bladder, rectum and Small Bowel

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21
Q

What portion of the anatomy should be considered in the treatment design for gynecological cancer? ( 2 answers)

A

Primary lesions and draining lymphatics (inguinal, Pelvic and Para-aortic)

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22
Q

What is the most common malignant female genital carcinoma?

A

Endometrium Cancer

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23
Q

Endometrium cancer is ___ most common in women.

A

4th

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24
Q

What is the mucous membrane lining the uterus called?

A

Endometrium

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25
What is the smooth muscle portion of the uterus called?
Myometrium
26
What is the outer portion of the uterus called?
Perimetrium
27
What two factors are contributing to the increase in endometrial cancer?
Hormone exposure w/o progesterone and obesity (3-5x more likely)
28
What does endometrium cancer present as? (2 answers)
Postmenopausal bleeding (1/3 of experience is cancer) and sometimes putrid discharge
29
What percentage of gynecological diagnosis are early stage?
80%
30
What are some prognostic factors for endometrial cancer? (4 answers)
Grade, Depth of Invasion, Nodal involvement, Tumor size
31
What is the gold standard for the detection of endometrial cancer?
Fractional dilation and curettage
32
What are some technologies used for diagnostics of endometrial cancer? (4 answers)
CT/MRI, Cystoscopy, Proctoscopy, and CA-125 levels
33
What is the staging system used for endometrium cancer?
FIGO staging, (only difference is FIGO staging indicates the depth of invasion)
34
What is the relative 5-year survival rate for endometrium cancer?
15-90% depending on staging
35
What is the most common histology of endometrial cancer?
Adenocarcinoma
36
What is the method of spread for endometrial cancer? (2 answers)
Pelvic and Para-aortic nodes
37
What are the treatment options for endometrium cancer? (3 answers)
Surgery, RT, and Chemo ( all depend on stage, grade, and status)
38
What does TAH stand for in gynecological cancer situations?
Total Abdominal hysterectomy
39
What is the radiotherapy regime used for endometrial cancer?
EBRT with 50 Gy boost to 75 Gy brachytherapy
40
What is the name of the devices used to aid in the treatment of the vaginal cuff? (2 answers)
Vaginal Cylinders and Colpostats
41
What type of imaging is used for treatment planning?
Orthogs
42
Describe the simulation/set-up for endometrial cancer. ( 3 answers)
Pt flat, pillow for comfort, immobilize feet,
43
What other devices are utilized in simulation to add image clarification? (2 asnwers)
Rectal and Vaginal markers
44
What are the critical structures to consider when treating endometrium cancer?
Endometrial cavity (75-90 Gy), Bladder/Rectum (65-75 Gy), Small bowel (below 50 Gy), Nodes (45-50 Gy)
45
What age group does ovarian cancer mostly affect?
50-70 yo
46
Ovarian cancer is the ____ leading cause of cancer deaths in women.
5th
47
What are some of the risk factors for Ovarian Cancer? ( 6 answers)
Older age, Family History, Late/Few pregnancies, Late menopause, Other cancer history, Diets high in meats and fats.
48
What is the most deadly of the Gyn Cancers?
Ovarian Cancer
49
Why is ovarian cancer so deadly?
Symptoms don't present until widely disseminated
50
What are the common symptoms of Ovarian Cancer? (4 answers)
Abdominal, Pelvic Pain, Nausea, and Constipation
51
What is the route of spread for ovarian cancer?
into the abdominal cavity lymph nodes through pelvic nodes
52
What percentage of Ovarian Cancers are epithelial?
90%
53
What staging system is used for ovarian cancer?
FIGO
54
What is the treatment of choice for early-stage ovarian cancer?
TAH with bilateral salpinhoopherectomy
55
What is the treatment of choice for epithelial ovarian tumors?
Debulking and surgical evaluation
56
What is true about early-stage ovarian cancer?
Usually have good outcomes
57
In the case of ovarian cancer, XRT is often given pre or post-op?
Post-op
58
The entire peritoneal cavity is included in the treatment field for ovarian cancer. True or False?
True
59
Cervical carcinoma is more prevalent among what demographics?
Younger women 20-50, Poor women and early sexual active women
60
What two viruses are found in 99% of cervical cancers?
HPV 16 and 18
61
What two lifestyle factors influence the risk of cervical cancer?
Nulliparity and Smoking
62
What does cervical cancer present as?
Bleeding, Slow growing, Hematuria and discharge
63
At what age are routine pap smears recommend for women?
21
64
What are diagnostics taken for cervical cancer?
Colposcopy with biopsy for abnormal pap smear
65
What are some imaging diagnostics utilized for Cervical cancer?
PET/CT, MRI. Cytoscopy, and Proctoscopy
66
What are some of the lymph nodes involved in cervical cancers?
Parametrial, Pelvic, Common iliacs and paraaortics.
67
In the case of Cervical cancer, increased invasion means?
Poor outcome
68
What is the most common histology of cervical cancer?
Squamous Cell Carcinoma
69
What staging system is used for cervical cancer?
FIGO
70
What is the treatment of choice for early-stage cervical cancer?
TAH with a small vaginal cuff dissection
71
Whats a hysterectomy?
Removal of uteres
72
What is the difference between a total and radical hysterectomy
Total involves the removal of the cervix and radical involved the removal the vagi
73
what is the advantage of brachytherapy?
high does to tumor with little exposure to critical structures
74
What is the advantage,e of placing the patient prone for cervical cancer?
Allows the bowel to be placed outside the field
75
What are some devices used for the cervix during the process of radiotherapy?
Rectal/vagina markers, rectal barium
76
Where is point A for cervical cancer?
2 cm superior to cervical os and 2 cm lateral to the endometrial cancer
77
Where is point B for cervical cancer?
3 cm lateral from Point A
78
What does vuvla cancer present as?
suspicious lump, exophytic, labia majora (most common)
79
What age group does ovarian cancer mostly affect?
Women less than 50
80
What is the predictable vulvar cancer lymphatics spread?
Superficial inguinal, Deep femoral and then eventually pelvic nodes
81
What are diagnostics taken for vulva cancer?
CT and cystourethroscopy
82
What is the often used treatment for vuvlar cancer?
vulectomy with node dissection
83
What are some symptoms of vulva cancer?
Most desquamation and smaller tissue thickness, which can be resolved with bolus
84
What is the 5-year survival rate for Vulva cancer?
70%
85
Why is it important to have a vuvla cancer patient set-up uniquely? (pt frog legged and bolus)
Patients need to physically widen the field being treatment and also bolus is used to bring the dose higher on the skin
86
What is the most common location of vulva cance?
posterior third fo vagina
87
What is the dose limit for endometrial cancer?
45-50 Gy, boost to 10-15 Gy
88
What is the dose limit for vuvla cancer?
50 Gy, boot to 15-20 Gy
89
What is the dose limit for cervical cancer?
45 Gy, boost to 10-15 Gy
90
What is the dose limit for vaginal cancer?
45-50 Gy

Principles and Procedures (27 decks)

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