Ovarian cancer (full lecture) Flashcards
(23 cards)
T/F: Ovarian cancer is less common than endometrial cancer but more fatal.
True.
It is fatal because 60% have metastatic disease at presentation!!
What is the mainstay of treatment for ovarian cancer?
surgery + chemo (before, after or both)
T/F: progress has been made in the cure rate for ovarian cancer over the last 30 years.
False. Very little progress (different from other cancers)
How is ovarian cancer staged?
surgically
How does ovarian cancer spread?
- intraperitoneally.
- doesn’t spread through blood or lymph very often.
most common type of ovarian cancer
EOC - epithelial ovarian cancer - 80% - serous variety is the most common (out of 6 types)
followed by germ cell, and then sex cord stromal
median age of presentation for ovarian cancer.
65 yo
T/F - All types of ovarian cancer tend to occur in old age (past 6th decade)
FALSE.
-Germ cell tumors, and sex cord stromal tumors, the second and third most common tumors, are both tumors of young women.
T/F - the three types of ovarian cancer all have relatively equal mortality.
false. Germ cell tumor has significantly better prognosis.
Presentation of sex cord-stromal ovarian tumors
EXCESS ESTROGEN
- precocious puberty
- vaginal bleeding (postmenopausal women)
- adenomatous hyperplasia
2 most important (major) Risk factors for epithelial ovarian cancer.
Family history & age
4 minor risk factors for ovarian cancer
- nulliparity
- late childbirth
- endometriosis
- early menarche, late menopause
- Think; high estrogen + endometriosis
3 manners of risk reduction for ovarian cancer
- OCP - oral contraception - reduce risk of endometrial AND ovarian cancer!!
- breastfeeding
- tubal ligation
common presenting symptoms of ovarian caancer
Overall, non-specific and vague (hard to recognize - hence late stage presentation!!)
- abdominal bloating (clothes don’t fit)
- fatigue
- abdominal pain, back pain, pain with sex
- early satiety
- indigestion
- constipation
- urinary frequency/incontinence
T/F - Hereditary syndromes make up nearly half of all Epithelial ovarian cancer (EOC)
False - they only account for about 10%
- BRCA
- HNPCC
- Lynch 2
3 family syndromes which cause epithelial ovarian cancer
- BRCA
- HNPCC
- Lynch 2
-also cause colorectal, breast, endometrial, and others - ask about family history of these cancers, not just ovarian cancer!!
lifetime risk of ovary cancer with familial syndromes
- BRCA1 - 40%, BRCA2 = 20%
- HNPCC - 10-15% (much smaller than colon/endometrial cancer risk)
You are screening for ovarian cancer with transvaginal ultrasound. What characteristics indicate a malignancy vs. a benign mass?
Indicate malignancy
- solid or solid/cystic combo
- multiple septations
- bilateral masses
- strong blood flow
- irregular borders
these all indicate malignancy!!
T/F CA125 is a sensitive but non-specific test for ovarian cancer
FALSE. neither.
CA125 - features as a screening test.
- very non specific test, (elevated in any case of malignancy / inflammation in the abdomen.)
- normal value in 50% of stage 1 tumors
- better in post-menopausal pt’s
T/F - ovarian screening with CA125 and TVUS is recommended in pt’s over 60
FALSE. screening can cause harm in asymptomatic women (false positive –> unnecessary surgeries)
-If patients have high risk for ovarian cancer, screening can be useful
5 conditions which, if found in a POST-menopausal woman, along with pelvic mass, should prompt referral to a high volume ovarian cancer center. (important!!)
- Elevated CA125 ( >35)
- ascites
- nodular or fixed pelvic mass
- evidence of distant metastasis
- family history of breast or ovarian cancer.
4 conditions which, if found in a PRE-menopausal woman, along with pelvic mass, should prompt referral to a high volume ovarian cancer center. (important!!)
- -Elevated CA125 ( >200)
- ascites
- evidence of distant metastasis
- family history of breast or ovarian cancer.
