Gynae-Oncology Flashcards
(31 cards)
What is the commonest gynaecological cancer?
Endometrial
Name some risk factors for endometrial cancer
Obesity Early menarche/late menopause Nulliparity PCOS Unopposed oestrogen Previous breast/ovarian Ca BRCA1/2 Endometrial polyps Diabetes Parkinson’s
What factors decrease the risk of endometrial cancer?
Continuous combined HRT COCP Smoking Exercise Tea and coffee
What is the management of endometrial hyperplasia?
Progesterones or surgery
What type of cancer generally occurs in the uterus?
Endometrial adenocarcinoma
What staging is used for endometrial Ca?
FIGO
Briefly describe the FIGO staging for endometrial Ca
1 - limited to myometrium
2 - cervical spread
3 - uterine serosa, ovaries, vagina, lymph nodes
4 - bladder/bowel involvement, distant mets
What investigations can be done for suspected endometrial Ca?
US TV- increased endometrial thickness
Biopsy - pipelle
Hysteroscopy
What is the management of endometrial Ca?
Surgery - hysterectomy and bilateral SPO
Radiotherapy
Advanced disease - chemo/hormone/radio
What is a woman’s lifetime risk of ovarian Ca?
1 : 50
What increases the risk of ovarian Ca?
Obesity Nulliparity Early menarche/late menopause Unapposed oestrogen Family hx Endometriosis BRCA1/2
What factors decrease the risk of ovarian Ca?
COCP Breastfeeding Pregnancy Hysterectomy/oophorectomy Sterilisation
What are the symptoms of ovarian Ca?
Non-specific Abdo swelling Pain Anorexia N+V Weight loss Vaginal bleeding
What is the management of ovarian Ca?
Surgery and chemotherapy
What is the age distribution of cervical Ca?
Bimodal 30s and 80s
What increases the risk of cervical Ca?
HPV Young age at first intercourse Multiple partners Smoking Long term COCP immunosuppression/HIV Non-compliant with screening
What decreases the risk of cervical Ca?
HPV vaccine
Compliance with screening
Which types of HPV are most likely to be oncogenic?
16 and 18
How is HPV oncogenic?
Produces proteins E6 and E7 which suppress the product is of p53 tumour suppressor gene in keratinocytes therefore increases proliferation
What is the management of cervical Ca?
Cone biopsy if need to preserve fertility
Radical hysterectomy
Chemo/radiotherapy
Give some complications of treating gynaecological cancers with radiation
Vaginal dryness Vaginal stenosis Radiation cystitis Radiation proctitis Loss of ovarian function
Describe the cervical smear programme
25-50 every 3 years
50-65 every 5 years
Describe the outcomes/pathway of a smear result
Normal - routine recall
Borderline/mild dyskaryosis - check HPV status. Positive = colposcopy and histology, negative = routine recall
Moderate/severe dyskaryosis - colposcopy and histology
What is the management of CIN?
Large loop excision of transformation zone (LLETZ) Cold knife cone Cryocautery Diathermy Laser
