Gynae Cancers Flashcards
(22 cards)
What type of cancer is cervical cancer most commonly?
Squamous Cell Carcinoma
What is strongly associated with cervical cancer?
HPV (16+18)
What is the treatment for HPV?
Mostly self-limiting.
Nooooo treatment.
What are non-intercourse related risk factors for cervical cancers?
HIV
COCP >5 years
Increased number of full term pregnancies
Family history
How can cervical cancer present?
Abnormal bleeding
Discharge
Pelvic pain
Dyspareunia
When observing a patients uterus what signs would indicate an urgent referral for colposcopy?
Ulceration
Inflammation
Bleeding
Visible tumour
(Still refer even if smear is normal)
What is the recommended cervical screening programme?
Starts at 25
Every 3 years until 49
Then every 5 years until 64.
(HIV+ screened yearly
Post-partum wait 12 weeks)
What type of cancer is most commonly seen in Endometrial Cancer?
Adenocarcinoma
Oestrogen-dependent
What are the treatment options for endometrial hyperplasia?
Progestogens:
- Mirena Coil (IUD)
- Continuous oral progestogens (medroxypreogesterone or levonorgesterl)
What is a risk factor for endometrial cancer?
Large exposure to unopposed oestrogen:
- increased age
- early menarche
- late menopause
- no preggo
- obesity
- PCOS
- Tamoxifen
(not oestrogen related - HNPCC/Lynch)
What are the signs and symptoms of endometrial cancer?
Postmenopausal bleeding
Urgent referral.
What investigations would be suitable for suspected endometrial cancer?
- Transvaginal US (see thickness, should be <4mm in postmeno)
- Pipelle biopsy
- Hysteroscopy
What is Stage 3 Endometrial Cancer?
Invaded ovaries, fallopian tubes, vagina or lymph nodes.
What are the treatment options for endometrial cancer?
S1+2: TAH + BSO (remove uterus, cervix and adnexa)
Progesterone can slow the cancer.
What is a Krukenberg tumour?
Metastasis in the ovary typically from a primary GI cancer, normally stomach.
“signet ring” on histology.
What are risk factors for ovarian cancers?
> 60
BRCA
Increased ovulations
Frequent use of clomifene
What are signs and symptoms of ovarian cancer?
Abdo bloating Early satiety Loss of appetite Urinary symptoms Ascites Hip/groin pain
What is the referral criteria for ovarian cancer?
If physical examination reveals
- ascites
- pelvic mass
- abdo mass
What is the most important initial investigation in suspected ovarian cancer?
CA125 (>35 is signif)
What tumour markers should be tested in women under 40 with suspected ovarian cancer?
AFP + HCG
What are risk factors for vulval cancer?
> 75
HPV
Lichen sclerosus
How will vulval cancer typically present?
Labia majora
Irregular mass
Ulceration
Bleeding
