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JG Year 2 > 220 Gynea cancers > Flashcards

220 Gynea cancers Flashcards

1
Q

Which cell type is involved in carcinoma?

A

Epithelial cells

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2
Q

Which tissue type is involved in adenocarcinoma?

A

Glandular epithelial tissue

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3
Q

What is dysplasia?

A

Disordered growth with cells showing abnormalities

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4
Q

What is pleomorphism?

A

2 or more species existing at the same time which suggests rapid growth

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5
Q

What is neoplasia?

A

Abnormal, uncontrolled cell growth

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6
Q

In which group of patients is endometrial cancer most common in?

A

Post menopausal women

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7
Q

Name 4 risk factors for endometrial cancer (7 listed)

A 
Obesity
Nulliparous
Long fertile period
Unopposed oestrogen
Hx of other Ca
HNPCC gene carriers
Tamoxifen / oestrogen only OCP
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8
Q

How does increased exposure to oestrogen and decreased progesterone cause endometrial Ca?

A

Oestrogen causes proliferation of the endometrium while progesterone softens the endometrium for implantation & withdrawal and causes shedding - unopposed oestrogen therefore causes uncontrolled proliferation and increased risk of cancerous mutation

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9
Q

Why is obesity a risk factor for endometial cancer?

A

Fat converts steroids to oestrogen leading to increased oestrogen

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10
Q

Name 3 types of endometrial cancer

A
  1. Endometrioid carcinoma
  2. Papillary serous & clear cell carcinomas
  3. Secretory carcinomas
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11
Q

What is the most common type of endometrial cancer?

A

Endometrioid carcinoma - contains glands which resemble normal endometrium

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12
Q

Why is the presentation of endometrial cancer normally quite early?

A

Post menopausal bleeding = symptom

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13
Q

What percentage of post menopausal bleeding is due to endometrial Ca?

A

20%

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14
Q

What is the PC in pre menopausal women with endometrial cancer?

A

Irregular or heavy bleeding

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15
Q

Name 3 Ddx for post menopausal bleeding

4 listed

A

HRT
Atrophic vaginitis
Endometrial hyperplasia
Cervical Ca

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16
Q

What investigations should be performed in post menopausal bleeding? (3 listed)

A

Trans-vaginal USS
Endometrial Bx
MRI for staging

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17
Q

What is the treatment for endometrial Ca?

A

TAH with bilateral salpingoophrectomy

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18
Q

What should be added in to the treatment of high grade endometrial Ca along with TAH?

A

Chemo and RTx

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19
Q

What is the 5 year survival rate in limited endometrioid adenocarcinoma?

A

94%

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20
Q

What is the 5 year survival rate in endometrioid andenocarcinoma grade 4?

A

25%

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21
Q

What type of ovarian cancer makes up >90% of primary tumours?

A

Epithelial ovarian carcinoma

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22
Q

Which gynea cancer causes the highest rates of mortality in the UK?

A

Ovarian Ca

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23
Q

Which genes are related to an increased risk of developing ovarian Ca?

A

BRCA 1
BRCA 2
HNPCC

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24
Q

What is HNPCC?

A

Hereditary non-polyposis colorectal cancer

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25
Q

Which cancers does HNPCC cause?

3 listed

A

Ovarian
Edometrial
Colorectal

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26
Q

Name 4 risk factors for the development of ovarian cancer

5 listed

A 
Oestrogen only HRT
Tamoxifen
Nulliparity
Obesity
Endometriosis
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27
Q

Name 3 protective factors for ovarian cancer

A

OCP
Sterilisation
Breast feeding

28
Q

What is the mechanism of spread of ovarian epithelial carcinoma?

A

Intraperitoneal dissemination ? cells floating in ascites

29
Q

Where does ovarian cancer tend to spread to first?

A

Greater omentum creating an omental cake

30
Q

What causes ascites in ovarian cancer?

A

Breakdown of the peritoneal barrier to ECF, lymph blockage and protein loss into ascites causing increased oncotoc pressure

31
Q

At which stage does ovarian cancer commonly present and why?

A

Stage 3 - this is when the Ca has spread to abdominal organs

32
Q

What may cause an early presentation of ovarian Ca?

A

Ovarian torsion

33
Q

What are the symptoms of ovarian Ca?

A

Abdo/pelvic pain (organ involvelment)
Bloating and feeling full (due to pressure of ascites)
Urinary - frequency/urgency (ascites pressure on bladder)
Fatigue
W/L

34
Q

What are the signs of ovarian Ca?

4 listed

A

Abdo distension
Palpable mass
Shifting dullness
Pleural effusion (ascits passing into pleural cavity/pleural mets)

35
Q

Which tumour marker is useful for tracking the progression of ovarian Ca?

A

CA-125

36
Q

What is the treatment of ovarian Ca?

A

Surgery - of benefit even if disease is not fully resectable

+ chemo (carboplatin)

37
Q

Why is cervical Ca the most common gynea Ca in the world but only 3rd most common in the UK?

A

Screening

38
Q

What are the risk factors for cervical Ca? (4 listed)

A

No of sexual partners due to HPV
Smoking
OCP
Immunosuppression

39
Q

What is the cervical transformation zone?

A

Where the (stratified squamous) epithelium of the ectocervix meets the (columnar) epithelium of the endocervix

40
Q

What is ectropion?

A

Where the transfromational zone is visible surrounding the cervical os

41
Q

When does part of the external os evert outwards onto the cervical surface?

A

Puberty

42
Q

What happens to the part of the external cervical os during puberty?

A

Squamous metaplasia

43
Q

Which HPV viruses are thought to cause 70% of cervical cancers?

A

16 + 18

44
Q

What is CIN?

A

Cervical intraepithelial neoplasia

45
Q

What is Stage 1 cervical dysplasia?

A

Mild dysplasia (may exist for 20 years before progressing)

46
Q

What is Stage 3 cervical dysplasia?

A

Severe dysplasia/carcinoma in situ - i.e. the neoplasia is developing but not yet invasive

47
Q

Which type of cervical cancer is the most common?

A

Squamous cell carcinoma (80%)

48
Q

What is the presentation of cervical cancer which has not been picked up by screening?

A

Irregular bleeding - intermenstrual or post coital in pre menopausal or post menopausal bleeding
Vaginal discharge
Cervical lesion

49
Q

What investigation/treatment should be performed for CIS?

A

Colposcopy +/- loop excision

50
Q

What is the treatment for a resectable cervical tumour?

A

TAH +/- vaginal excision

51
Q

What is the treatment for a non resectable cervical tumour?

A

Chemotherapy
RTx
Brachytherapy

52
Q

What is FIGO used for?

A

International federation of obs and gynea - staging of cervical cancer

53
Q

What is FIGO stage 0 cervical cancer?

A

CIS - carcinoma confined to the epithelial lining of the cervix

54
Q

What is FIGO stage 1 cervical cancer?

A

Cancer has spread further into the cervix

55
Q

What is FIGO stage 2 cervical cancer?

A

Cancer has spread into the upper 2/3rds of vagina and or part of the uterus

56
Q

What is FIGO stage 3 cervical cancer?

A

Cancer spread into lower third of vagina and into ureter causing one non-functioning kidney

57
Q

What is FIGO stage 4 cervical cancer?

A

Cancer spread into the true pelvis involving multiple surrounding organs +/- mets

58
Q

What is the 5 year survival for cervical cancer?

A

67%

59
Q

Which 2 gynea cancers are the most rare?

A

Vulval and vaginal

60
Q

What type of cancer causes 90% of vulval Ca?

A

Squamous cell

61
Q

Which cancer causes 5% of vulval Ca and has a high risk of mets?

A

Melanoma

62
Q

Which type of vulval cancer rarely invades deeply or metastases?

A

Basal cell

63
Q

Which HPV virus is present in the majority of vaginal cancers?

A

HPV 16

64
Q

In which group of patients is squamous cell carcinoma of the vagina most common?

A

> 65 yr olds

65
Q

In which group of patients is adenocarcinoma of the vagina most common?

A

Children/young women

JG Year 2 (28 decks)

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