Cancer Flashcards
Cervical cancer screening - how often, what is assessed
3 yearly 25-50 5 yearly 50-64 Swept over transformation zone - assessing dyskaryosis
Assessment of dyskaryosis - what are the histological findings
Nuclear enlargement, variation in size + shape of nuclei, hyperchromasia, reduction in cytoplasm
CIN appears white when stained with 5% acetic acid
CIN - causes
Cervical intraepithelial neoplasia Needs infection with HPV 16, 18, 31, 33
RF for CIN
Persistent HPV infection Multiple partners Smoking Immunocompromise COCP
S+S cervical cancer
PCB PMB Vaginal discharge Advanced: heavy bleeding, ureteric obstruction, weight loss, bowel disturbance, swollen legs, fistulas
Cervical cancer investigations + management (stage 1a1, 1a2-1b1, 1b2 + >1b2)
Colposcopy, histology, MRI for staging
Stage 1a1: local excision (cone biopsy)
Stage 1a2 - 1b1: lymphadectomy + Wertheims hysterectomy
Stage 1b2: RT + lymphadectomy + Wertheims hysterectomy
>1B2: RT
Endometrial cancer causes
Unopposed oestrogen leads to hyperplasia Oestrogen comes from: Peripheral conversion in adipose tissue Granulosa cell tumour PCOS Oestrogen only HRT Tamoxifen
RF for endometrial cancer
Obesity Nulliparity PCOS Early menarche/ late menopause HNPCC Breast cancer - tamoxifen use
S+S endometrial cancer
PMB Menstrual disturbance PV discharge
Diagnosis of endometrial cancer
TVUSS (endometrial thickness) MRI pelvis CXR (for staging) Endometrial biopsy if >4mm
Endometrial cancer staging
I = confined to uterus II = involving cervix III = spread outside the uterus IV = bowel, bladder or distant organ involvement
Management of endometrial cancer
Total abdominal hysterectomy with bilateral salpingo-oophrectomy
Types of ovarian tumours
Epithelial - from Mullerian epithelium Sex cord Germ cell
Causes/RF of ovarian cancer
Irritation of ovarian epithelium, due to damage during ovulation RF: multiple ovulations Nulliparity, endometriosis, early menarche, late menopause, HRT BRCA 1 (39% chance of developing ovarian cancer) BRCA 2 (11%) HNPCC (12%)
S+S ovarian cancer
Abdo distension, pain Pressure effects on bladder + rectum SOB, GI upset Abnormal vaginal bleeding Ascites Presents late