Gynaecological Cancer Flashcards
(24 cards)
Increase in uterine cancer
Obesity / decrease in children
Common OSCE station - post menopausal bleeding or cervical smear
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What causes cervical cancer?
HPV / Smoking / OCP (oral contraceptive pill) - long term use
Abnormal smears are more common in?
Smokers
HPV infection
Easily transmitted through sexual contact, a condom won’t help. Up to 75% affected in there life / oncogenic and non-oncogenic
Cervical screening programme
Starts at 25, every 3 years. Stops at 65 if all smears have been clear since 50.
Cervical cancer is most common where?
Southern Hemisphere
Cervical cancer symptoms
Post coital bleeding / foul discharge / asymptomatic / IMB or PMB
Cervical staging
Clinical staging - by examination / MRI - 95% accurate / 1-confined to the cervix, 2- to an adjacent structure, 3- more advanced local spread 4- metastasis (lung, liver, bone, brain)
Cervical cancer treatment
Surgery if stage 1 / Radiotherapy above stage 1, combine with chemo as it radio sensitises the cancer / Radial hysterectomy (curative treatment for stage 1 disease)
Cervical cancer - radical trachelectomy
Remove cervix but implant the uterus directly onto the vagina
What’s the prognosis for 5 year survival of cervical cancer according to staging
80,60,40,20
Ovarian cancer risk factors
Related to number of ovulations - Nulliparity, infertility, diet, high socio economic status, family Hx (BRACA gene)
Ovarian cancer - screening test
UKTOCS - not useful due to being advanced and small numbers. Screening must only be done for those who are very very high risk
Ovarian cancer and primary care
Commonly told its irritable bowel, an examination must taken place, IBS not given to someone who has altered bowel habit over 55. Do a CA125 and then an ultrasound if abnormal
Risk of malignancy index RMI
RMI = U x M (menaupause status) x Ca125 =>250 refer to specialist MDT
Ovarian cancer features
Important sign is pelvic mass, upper abdominal mass (common site is the omentum due it blood supply), ascites
Ovarian cancer staging
Surgical staging / CT staging. 1-ovaries, 2- pelvic extension, 3- peritoneal deposits, 4-
Ovarian cancer treatment
Surgery - hysterectomy, removal of tubes and ovaries, biopsies. Debunking - hysterectomy, removal of tubes and ovaries / Chemo given
Uterine cancer causes
Obesity, Nulliparity, late menopause, pcos, oestrogen replacement therapy (must be balanced, therefore also given progesterone replacement therapy) , Tamoxifen (2-3 x increase)
Clinical features of uterine cancer
Post menopausal bleeding
Uterine cancer treatment
Hysterectomy, remove ovaries, radiotherapy (15-20%), hormonal treatment (progesterone as most of these cancers are hormonally caused)
Vulval cancer
More than 50% >70. HPV, VIN particularly in younger women
Vulval cancer treatment
Radical excision (not commonly done, more common to use a wide local excision) / groin lymph nodes / Radiotherapy / Chemotherapy
