L5: Cancer Cervix Flashcards
(79 cards)
1
Q
Def of Cancer Cervix
A
- It is malignant tumors arising from the cervical epithelium mainly the ectocervix
2
Q
Incidence of Cancer Cervix
A
- The second most common female cancer after endometrial carcinoma.
3
Q
Predisposing factors for Cancer Cervix
A
4
Q
Predisposing factors for Cancer Cervix
- Age
A
- Median age of diagnosis is 45-60 years (usually in HPV infected females).
- There may be ff risk at ≥ 80 years (ITcancer incidence è age).
5
Q
Predisposing factors for Cancer Cervix
- Race
A
Increased in blacks & Christians.
6
Q
Predisposing factors for Cancer Cervix
- SES
A
Low (high parity & early marriage).
7
Q
Predisposing factors for Cancer Cervix
- Parity
A
Multiparity
8
Q
Predisposing factors for Cancer Cervix
- Special
A
9
Q
Predisposing factors for Cancer Cervix
- Familial
A
+ve family history
10
Q
Precancerous lesions for Cancer Cervix
A
Cervical intraepithelial neoplasia (CIN)
- Up to 30% of CIN-3 can develop to cancer in about 10-15 years.
11
Q
Pathology of Cancer Cervix
A
12
Q
Pathology of Cancer Cervix
- NE
A
13
Q
Ectocervical “portiovaginalis” carcinoma
- %
- Origin
- Shape
A
14
Q
Endocervical “Supravaginal” carcinoma
- %
- Origin
- Shape
A
15
Q
Malignant Ulcer Is Characterized By ……
A
16
Q
Pathology of Cancer Cervix
- ME
A
17
Q
ME of Cancer cervix
- SCC
A
18
Q
ME of Cancer cervix
- Adenocarcinoma
A
19
Q
ME of Cancer cervix
- rare Types
A
20
Q
Spread of Cancer cervix
A
21
Q
Spread of Cancer cervix
- Local
A
22
Q
Spread of Cancer cervix
- Lymphatic
A
23
Q
Spread of Cancer cervix
- Blood
A
Very Rare
24
Q
Spread of Cancer cervix
- Implantation
A
Implantation “Seedling”:
- To retroperitoneal space during Wertheim’s operation.
- To vaginal fornices, lower vagina and vulva
25
Staging of **Cancer cervix**
26
Staging of **Cancer cervix**
- Stage I
27
Staging of **Cancer cervix**
- Stage IA
28
Staging of **Cancer cervix**
- Stage IB
29
Staging of **Cancer cervix**
- Stage II
30
Staging of **Cancer cervix**
- Stage III
31
Staging of **Cancer cervix**
- Stage IV
32
Complications of **Cancer cervix**
33
Symptoms of **Cancer cervix**
34
Symptoms of **Cancer cervix**
- Asymptomatic
- In early stages in early pre and micro-invasive stages.
35
Symptoms of **Cancer cervix**
- Bleeding
**Commonest symptom**
- Contact bleeding after intercourse, douching or examination (1st symptom).
- Irregular or intermittent bleeding.
- Heavy Postmenopausal bleeding especially in ulcerative type.
36
Symptoms of **Cancer cervix**
- Cachexia & symptoms of distant metastasis.
....
37
Symptoms of **Cancer cervix**
- Discharge
Serous then serosanguineous then offensive (due to infection).
38
Symptoms of **Cancer cervix**
- Enlargement of abdomen (pelviabdominal mass)
in pyometra
39
Symptoms of **Cancer cervix**
- Pain
40
Symptoms of **Cancer cervix**
- Pressure Symptoms
....
41
Signs of **Cancer cervix**
42
Signs of **Cancer cervix**
- general
Signs of renal failure, cachexia or anemia.
43
Signs of **Cancer cervix**
- Abdominal
- The uterus is palpable if there is pyometra.
- Palpale kidney in hydronephrosis.
44
Signs of **Cancer cervix**
- Local
45
Local Signs of **Cancer cervix**
- Inspection & Palpation
As scheme + Cervical N/E criteria.
46
Local Signs of **Cancer cervix**
- Bimanual Ex
As scheme.
47
Local Signs of **Cancer cervix**
- Uterine Sound
48
Local Signs of **Cancer cervix**
- PR
As scheme.
49
INVx for **Cancer cervix**
50
INVx for **Cancer cervix**
- Dx
51
INVx for Dx of **Cancer cervix**
- Labs
As scheme + Renal function tests
52
INVx for Dx of **Cancer cervix**
- Rads
As Scheme
53
INVx for Dx of **Cancer cervix**
- Endoscopy
scheme + colposcopy
54
INVx for Dx of **Cancer cervix**
- Biopsy
Histopathology as mentioned in M/E.
55
INVx for **Cancer cervix**
- Detect Mets
Scheme
56
INVx for **Cancer cervix**
- Pre-Operative
Scheme
57
TTT of **Cancer cervix**
58
TTT of **Cancer cervix**
- Prophylactic
59
TTT of **Cancer cervix**
- Active
60
Active TTT of **Cancer cervix**
- Correction of general condition
By tonics, blood transfusion, vitamins...
61
Active TTT of **Cancer cervix**
- Lines of TTT
62
Lines of TTT of **Cancer cervix**
- Radiotherapy
The main line and can be used in all stages.
63
Lines of TTT of **Cancer cervix**
- Surgery
Limited to stages I and lla.
64
Lines of TTT of **Cancer cervix**
- Combined Surgery & Radio
- As postoperative radiotherapy for patients with L.N metastasis and para-cervical spread.
65
Lines of TTT of **Cancer cervix**
- Adjuvant
66
Lines of TTT of **Cancer cervix**
- Palliative
67
Surgical Management of **Cancer cervix**
68
Surgical Management of **Cancer cervix**
- Indications
69
Surgical Management of **Cancer cervix**
- Modalities
70
Modalities of Surgical TTT of **Cancer cervix**
- Conservative Surgery
71
Modalities of Surgical TTT of **Cancer cervix**
- Radical Surgery
72
Importance of **Wertheim's hysterectomy**
It is the standard surgical procedure and indicated in stages I and lIA.
73
Technique of **Wertheim's hysterectomy**
74
Complications of Wertheim's hysterectomy
75
TTT of **Cancer Cervix** Acc to Stage
76
Radiotherapy in TTT of **Cancer Cervix**
- Modalities
77
Radiotherapy in TTT of **Cancer Cervix**
- Lethal Dose
5000-8000 rads.
78
Radiotherapy in TTT of **Cancer Cervix**
- Complications
79
TTT of **Cancer Cervix**
- Combined RT and surgery
