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Sexual and Reproductive Health > Cancer > Flashcards

Cancer Flashcards

1
Q

What type of cancer makes up the majority of cervical cancers?

A

Squamous cell carcinoma

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2
Q

What is HPV?

A

Human papilloma virus

DNA virus

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3
Q

What is a persons lifetime risk of coming into contact with HPV?

A

80%

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4
Q

What strains of HPV cause cervical cancer?

A

16/18

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5
Q

CIN is the precursor lesion of invasive cancer, how is it graded?

A

Via biopsy:

CIN1: dyskaryosis in basal 1/3rd
CIN2: dyskaryosis in 2/3rds of epithelium
CIN3: full thickness dyskaryosis

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6
Q

Why is CIN so important?

A

progresses to cancer but begins young

can take 20 years for CIN3 to develop into an invasive cancer

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7
Q

When does cervical screening start?

A

age 25+

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8
Q

How often do people have smear tests?

A

age 25-49; every 3 years
age 50-64: every 5 years
HIV, transplant patients: annual

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9
Q

Based on results of smear (cytology), women may be asked to return for repeat smear/testing. If inflammation is seen when will they be seen again?

A

3 months

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10
Q

Based on results of smear (cytology), women may be asked to return for repeat smear/testing. If mild dyskaryosis is seen when will they be seen again?

A

6 months

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11
Q

Based on results of smear (cytology), women may be asked to return for repeat smear/testing. If moderate dyskaryosis is seen when will they be seen again?

A

refer to colposcopy

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12
Q

Based on results of smear (cytology), women may be asked to return for repeat smear/testing. If severe dyskaryosis is seen when will they be seen again?

A

refer to colposcopy (4 weeks)

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13
Q

Based on results of smear (cytology), women may be asked to return for repeat smear/testing. If invasive CIS is seen when will they be seen again?

A

urgent referral to colposcopy (2 weeks)

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14
Q

What is colposcopy?

A

looking at cervix, with speculum and microscope

allows for diagnosis, biopsy and management

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15
Q

Lesions are identified how in colposcopy?

A

Stains -
acetic acid - turns abnormal areas white
iodine - normal areas turn brown

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16
Q

When do we intervene in management of CIN?

A

CIN2/3

17
Q

What management do we offer for CIN 2/3?

A

cold coagulation

LLETZ: large loop excision biopsy

18
Q

When do we use LLETZ?

A

when woman has no intention of further pregnancy

as risk of cervical incompetence and preterm labour/miscarriage

19
Q

If CIN 1 identified on colposcopy what do we do?

A

Repeat smear in 12 months

20
Q

If smear found a glandular abnormality (gCIN) what do we do?

A

Send them directly for LLETZ

as possible risk of adenocarcinoma of the endocervix

21
Q

After treatment how do we test to see if its been effective?

A

repeat smear at 6 months

oncogenic HPV tested for too

22
Q

If cervical cancer is diagnosed what is the management?

A

Stage 1a: cone biopsy
Stage 1a2 - 2a: radical hysterectomy with bilateral pelvic node dissection
Stage 2b-4: radiotherapy +/- chemotherapy

23
Q

How can we prevent cervical cancer?

A

HPV vaccine

regular smear tests (screening)

24
Q

What are the 3 types of endometrial hyperplasia?

A

simple (0% risk of ca)
complex (1-2% risk of ca)
atypical (20% risk of ca)

25
Q

What type of tumour are endometrial cancers?

A

majority adenocarcinoma
80% arise from hyperplasia - endometriod
20% dont arise from hyperplasia - squamous and clear cell

other types:
stromal sarcoma, carcinocarcinoma, leiomyosarcoma

26
Q

How may someone with endometrial cancer present?

A

PMB
abnormal intermenstrual bleeding
menorrhagia

27
Q

How do we assess suspected endometrial cancer?

A 
PV + speculum 
TVU 
endometrial biopsy (pipelle)
hysteroscopy
staging (MRI)
CTCAP
28
Q

On TVU what thickness of endometrium is suspicious for endometrial cancer?

A

post menopausal >4mm

pre menopausal >16mm

29
Q

How might someone with ovarian cancer present?

A

often vague symptoms for a few months:

SoB
Fatigue, weight loss
Urinary freq/urgency 
irregular bleeding/pelvic pain 
abdo pain, bloating, early satiety, reduced appetite 
change in BO 
ascited
30
Q

How do we investigate for ovarian cancer?

A 
Blood: tumour markers 
CA125
Imaging: 1st line TVUS
Tissue sampling: ascetic tap (cytology)
laparotomy/laparoscopy for biopsy

Sexual and Reproductive Health (9 decks)

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