Gynaecological oncology Flashcards Preview

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Flashcards in Gynaecological oncology Deck (32):
1

What are the two types of cervical cancer and what is their prognosis

  • Squamous cell carcinoma - most common lower mortality
  • Adenocarcinoma - rarer higher mortality

2

Cervical cancer: epidemiology

Epidemiology

  • Commonest cancer in young women
  • Disease of low resource country w/out screening

 

3

Two cell types on endo and ecto cervix

On the vagina side - ectocervix - squamous

On the utrerus side - endocervix - columnar (mucous prodcing ergo cancer her is known as adenocarcinoma)

4

Cervical cancer: aetiology

Aetiology

Oncogenic HPV w/ smoking as co-factor --> premalignant disease-->ca over years

5

Cervical cancer: risk factors

Risk factors

Smoking

Having children

Immunosuppression

HPV

Herpes/STIs

OCD/IUD

Exposure to DES (abortion drug)

Young age

6

Cervical cancer: sx

Sx

Irregular periods (IMB)

Post coital bleeding

Smelly vaginal discharge from the surface of the tumour

Late stage – malignant pain and fistula

7

Cervical cancer: clinical assessment

Clinical assessment

Mass felt of seen on cervix

Screening detecting (subclinical)

8

Cervical cancer diagnosis

Diagnosis

Colposcopy and biopsy of lesion

MRI to assess for invasion

9

Cervical cancer: prognosis.

Prognosis

Good if picked up early

Poor if locally advanced

Good life quality if in remission, but late effects of radiotherapy might be an issue

10

Cervical cancer:management

Management

Loop diathermy (microscopic disease)

Hysterectomy w/ node removal (macroscopic disease)

May also have chemo radiotherapy

11

Cervical screening: frequency

  • Cervical screening offered to all women aged 25-49 every 3 years and 50-64 every 5 years
  • Screening involves a smear from the surface of the cervix via a speculum
  • If the cells are found to be abnormal the follow up is colposcopy

12

Endometrial cancer: epidemiology

Epidemiology

  • Commonest gynae cancer
  • Disease of affluent west

 

13

Endometrial cancer: aetiology

Aetiology

Disease of the menopause

Type one (low grade) – related to obesity and PCOS (polycystic ovary syndrome)

Type two (high grade) – genetic mutations?

14

Endometrial cancer: sx

Sx

Post menopausal bleeding/discharge (1 year after last period)

15

Endometrial cancer: clinial assessment

Clinical assessment

Often nothing to find as at early stage

16

Endometrial cancer:  diagnosis

Diagnosis

USS

Endometrial biopsy

MRI for invasion

17

Endometrial cancer: management

Management

Surgery: removak of uterus, ovaries, LNs

Post op radiotherapy if bad

18

Endometrial cancer: prognosis.

Prognosis

Good if early stage type 1

19

Vuval cancer: epidemiology

Epidemiology

  • Rare 1800 cases a year

 

20

Vuval cancer: aetiology

Aetiology

Premalignant vulval disease, intraepithelial neoplasm

Lichen sclerosis (autoimmune)

21

Vuval cancer: sx

Sx

Vulval pain

Bleeding

Feeling of a lump

22

Vuval cancer: clinical assessment

Clinical assessment

Vulval mass

Groin node enlargement at advanced stage

23

Vuval cancer: diagnosis

Diagnosis

Biopsy

USS

24

Vuval cancer: management 

Management

Surgical removal

If LNs involved radoitherapy and chemo

25

Vuval cancer: prognosis.

Prognosis

Stage 1 no LN 90% 5yr

Stage 3 w/ LN 50% 5yr

26

Ovarian cancer: epidemiology

Epidemiology

  • Second commonest gynae cancer

 

27

Ovarian cancer: aetiology

Aetiology

Disease of menopause

Type 1 (low grade)

Type 2 (high grade) ?genetic mutation BRACA1

28

Ovarian cancer: sx

Sx

Persistent Bloating

Abdominal pain

Eating trouble (feeling full after a meal)

Trouble with the bladder (Urinary frequency)

29

Ovarian cancer:clinical assessment

Clinical assessment

Clinically challenging

Abdopelvic mass

Ascites

30

Ovarian cancer:  diagnosis

Diagnosis

USS

Bloods for tumour marker

CT to assess spead

31

Ovarian cancer: management

Management

Surgery - remove uterus, ovaries, LNs and debulk

Chemo

32

Ovarian cancer: prognosis

Prognosis

Good if early type 1

Most present at late stage and die from reoccurence in 5 yrs