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Yr 3 - Reproduction > Cancers of Lower Genital Tract > Flashcards

Cancers of Lower Genital Tract Flashcards

1
Q

How does vulval cancer present?

A

Vulval itch/irritation not eased with treatment
Pain and burning
Bleeding
Lump/ulcer

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2
Q

What is the the typical age of vulval cancer patients?

A

> 60years

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3
Q

What are the risk factors for vulval cancer?

A

Neoplasia/cancer at other lower genital site
Lichen sclerosus
Smoking
Immunosuppression

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4
Q

How is Vulval cancer staged?

A

Size of legion

Lymph node involvement

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5
Q

Which lymph nodes are involved in vulval cancer?

A

Inguinal and upper femoral

Pelvic

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6
Q

What vulval intraepithelial neoplasia is associated with HPV?

A

Usual type VIN
Younger women
Multifocal/zonal

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7
Q

What vulval intraepithelial neoplasia is not associated with HPV?

A

Differentiated VIN

Older women

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8
Q

Differentiated VIN is associated with what?

A

Non-HPV
Lichen Sclerous
Older women
Cancer at first diagnosis

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9
Q

Usual type VIN is associated with what?

A

HPV infection
Younger women
Immunosuppression
Hx Intraepithelial neoplasia

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10
Q

What is stage 1 vulval cancer?

A

<2cm size

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11
Q

What is stage 2 vulval cancer?

A

> 2cm size

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12
Q

What is stage 3 vulval cancer?

A

Local spread

Unilateral nodes

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13
Q

What is stage 4 vulval cancer?

A

Distant spread
Advanced local spread
Pelvic nodes

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14
Q

How is vulval cancer treated?

A

Surgery
- Local excision
- Unilateral/bilateral node dissection
RT/Chemo

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15
Q

Which nodes are removed in groin node dissection?

A

Iguinal + upper femoral

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16
Q

Groin node dissection is associated with what?

A

Morbidity:

  • Wound infection
  • Lymphocysts
  • Nerve damage
17
Q

What is the role of groin node dissection?

A

Remove nodal disease

Staging

18
Q

Cervical cancer is associated with what?

A 
Age 45-55
HPV 16 + 18
Multiple partners
Early first intercourse
Older age partner
Cigarette smoking
19
Q

Cervical cancer symptoms?

A 
Abnormal vaginal bleeding
Post-coital bleeding
Intermenstrual bleeding
Discharge
Pain
20
Q

How is cervical cancer diagnosed?

A

Examination
Biopsy (LLETZ) Transformation zone
Screening

21
Q

What are the most common cancers of the cervix?

A 
Squamous carcinoma (80%)
Adenocarcinoma
22
Q

How is stage 1A cervical cancer identified?

A

Microscopically

23
Q

What is stage 2 cervical cancer?

A

Contained to vagina

24
Q

What lymphatic nodes do cervical cancer spread to?

A

Pelvic nodes

25
Q

To what does cervical cancer metastasise?

A

Liver
Lungs
Bone

26
Q

What is stage 3 cervical cancer?

A

Contained to lower vagina, pelvis

27
Q

How is cervical cancer examined for staging?

A

PET-CT

MRI

28
Q

How is cervical cancer stage 1a treated?

A

Excision of cervical transformation zone

29
Q

How is cervical cancer stage 1b-2a treated?

A

Radical hysterectomy

Chemo-radiotherapy

30
Q

What is removed in radical hysterectomy?

A

Uterus, cervix, upper vagina
Parametria
Pelvic nodes
Ovaries conserved

31
Q

What is the non-surgical management of cervical cancer?

A

Radiotherapy - External beam x20
Chemotherapy - 5 cycles of Cisplatin
Caesium Insertion

32
Q

What is FIGO stage 1A1?

A

Depth <3mm, <7mm wide

33
Q

What is FIGO stage 1A2?

A

Depth <5mm. width <7mm

34
Q

Why is radiotherapy not indicated in cervical cancer for young women?

A

Radiation effect on ovaries may trigger menopause

35
Q

What staging is used for cervical/vulval cancer?

A

FIGO staging (NOT TNM)§

36
Q

What is Lichen Sclerosus?

A

Inflammatory skin condition which can pre-dispose to cancer

37
Q

Differentiated type VIN is always what grade?

A

Always high grade

Yr 3 - Reproduction (37 decks)

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