Gynaecological Cancers Flashcards
(32 cards)
Give 5 predisposing factors of vulval cancer
Increasing age Smoking Persistant HPV infections Vulval Intraepithelial Neoplasia (VIN) Lichen sclerosis
What type of cancers are 95% of vulval cancers?
Adenocarcinomas
Give 5 clinical features of vulval cancer
Pain on vulva Itching Lump or wart like growth Raised and thickened patches of skin Open sores Blood-stained vaginal discharge Burning pain on passing urine
How is vulval cancer investigated?
Biopsy of lesion
Check for metastatic spread - CT/MRI, colposcopy, cystoscopy, proctoscopy, chest X-ray
How is vulval cancer treated?
Surgical –>
Wide local excision
Radical vulvectomy
May also require lymph node removal
Other –> chemo/chemoradiotherapy
Give 2 predisposing factors of vaginal cancer?
Increasing age
HPV infection
Give 4 areas where metastatic spread to the vagina is common
Cervix
Uterus
Bowel
Vulva
Give 3 clinical features of vulval cancer
Abnormal vaginal bleeding
Pain on urination
Lump in vagina
Vaginal itch
How is vaginal cancer treated?
Partial/total vaginectomy
+/- vaginal reconstruction
May need radical hysterectomy
Give 4 predisposing factors of cervical cancer
<45 yrs old Persistent HPV infection Cervical intraepithelial neoplasia (CIN) Smoking HIV (weakened immune system)
Where are cervical cancers most likely to occur?
Transformation zone
Give 4 clinical features of early cervical cancer
Pain when having sex
Pelvic or lower back pain
Vaginal bleeding- post menopause, between periods, after sex
Unusual discharge
Give 4 clinical features of advanced cervical cancer
Constipation Flank pain Incontinence Leg swelling Haematuria Urinary frequency
How is cervical cancer staged?
Stage 0: CIN
Stage 1: only in cervix
Stage 2: cervix and local surrounding tissue
Stage 3: Cervix and lower vagina or pelvic wall
Stage 4: cervix and bowel/bladder/lungs
What type of biopsy is done to stage cervical cancer?
Cone biopsy
How is stage 1 and 2 cervical cancer treated?
Surgery and radiotherapy
How is stage 3 and 4 cervical cancer treated?
Radiotherapy
What is a trachelectomy?
Surgery for women who may still want to have children. Remove cervix and upper vagina and then reattach lower vagina to uterus
Who is screened for cervical cancer and how often?
Women aged 25 to 49 –> every 3 years
Women aged 50 to 64 –> every 5 years
What does the cervical screening test involve?
Sample of cells taken from cervix sent for liquid based cytology.
If abnormal changes are found a follow up HPV test and colposcopy are ordered.
If high grade changes are found on the smear the cells can be removed/destroyed at colposcopy
Who is vaccinated against HPV and which types are covered?
Girls aged 12-13
4 strains of HPV (including 16 and 18)
Give 5 predisposing factors of uterine cancer
>60 yrs old Obesity PCOS Tamoxifen Nulliparous Early menarche Late menopause
UNOPPOSED OESTROGEN
Give 2 protective factors against uterine cancer
COCP
HRT
Give 3 clinical features of uterine cancer
Abnormal vaginal bleeding (postmenopausal, heavy, intermenstrual)
Watery, pink, foul smelling vaginal discharge
Lower abdominal pain
Pain during sex
