Gynaecological Cancer Flashcards
(16 cards)
What are the types of gynaecological cancer
Endometrial
Cervical
Ovarian
Most common
What is the most commonl gynae cancer
Endometrial
V
Ovarian (becoming more common)
V
Cervical
What is the endometrium and how do hormones affect it
Endometrial glands supported by stroma
Proliferation stimulated by oestrogen
Progesterone makes the endometrium more secretory but constant progesterone long thins the endometrium
Oestrogen causing endometrial cancer
Long term oestrogen, unopposed and excessive
Leads to endometrial hyperplasia
Then adenocarcinoma
Endometrial cancer risk factors
Excess oestrogen exposure
- obesity
- nulliparity
- tamoxifen
- early menarche and late menopause
Genetics
- BRCA
- HNPCC
- Lynch and Cowden syndrome
Age Smoking Diabetes
Endometrial cancer red flags
- postmenopausal bleeding
- LOW Haematocrit
- abnormal discharge in postmenopausal women
- less common = vaginal bleeding in pre-menopausal women
Reducing risks of endometrial cancer
Hormonal IUD
Cervix histology
Cervical canal - columnar
Outer cervix - squamous
Where meet - squamocollumnar junction
Starts inside cervix at birth… makes its way out further and further until later reproductive years
Changes to the squamocullumnar junction
Cervical metaplasia - changing columnar to squamous as it makes its Way out in age - the transformation zone
TZ is vulnerable for HPV
How does HPV progress
Leads to precancerous cervical intraendoithelial neoplasia
This can progress to squamous cell carcinoma and adenocarcinoma
Risk factors how cervical cancer
- risk of HPV exposure - early sex, multiple partners, high risk partners
- smoking, HIV, immunosuppressive drugs
- age
- clahmydia
- herpes
- OCP
- socioeconomic factors
Red flags for cervical cancer
• Abnormal vaginal bleeding
• Postcoital bleeding
• Intermenstrual bleeding (between periods
- abdominal discharge
Need speculum exam
Ovarian cancer precancerous
- no identifiable precancerous stage
3/4 have spread beyond diagnosis
Where can O cancer arise from
- most are epithelial cells
Outer surface of ovary
Fallopian tubes
Ovarian cancer risk factors
Age
Obesity
Smoking
BRCA 1 and 2
HNPCC
Lynch and family history
Nulliparity
Early menarche
Late menopause
Ovarian stimulation
Red flags ovarian cancer
Abdominal distension
Pelvic/abdominal mass
Ascites
Change in bowel habits
Fatigue
Unexplained weight loss
Urinary frequency change
Pelvic pain
