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Reproductive > Cancers of the Ovary, Uterus, Vulva > Flashcards

Cancers of the Ovary, Uterus, Vulva Flashcards

1
Q

Which genetic syndromes increase the risk of ovarian cancer?

A
  • HNPCC
  • BRAC1
  • BRCA2
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2
Q

What are the symptoms of ovarian cancer?

A
  • Indigestion, early satiety and poor appetite
  • Altered bowel habit and pain
  • Bloating, discomfort and weight gain
  • Pelvic mass
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3
Q

How can ovarian cancer be diagnosed?

A
  • Surgical/pathological
  • USS abdo and pelvis
  • CT scan
  • CA 125 test (blood marker)
  • Surgery
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4
Q

Which conditions can have a raised CA 125?

A
  • Malignancy: ovarian, colon, pancreatic and breast
  • Menstruation/endometriosis/ PID
  • Liver disease, recent surgery and effusions
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5
Q

Describe the staging of ovarian cancer

A

Stage 1: limited to ovaries with capsule intact
Stage 2: one or both ovaries with pelvic extension
Stage 3: one or both ovaries with peritoneal implants outside the pelvis or nodes
Stage 4: distant metastasis

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6
Q

How can ovarian cancer be treated?

A
  • Surgery

- Chemo: adjuvant and neo-adjuvant (platinum and taxane)

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7
Q

How can recurrence of ovarian cancer be treated?

A
  • Chemo
  • Palliation: symptomatic recurrence
  • Platinum if > 6 months
  • ? surgery
  • Tamoxifen
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8
Q

What are the symptoms of endometrial cancer?

A

-Vaginal bleeding in between periods or after menopause

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9
Q

How is post menopausal bleeding investigated?

A
  • Pelvic and speculum exam
  • Transvaginal USS
  • Endometrial biopsy
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10
Q

How can endometrial cancer be staged?

A
  • Pathology

- MRI

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11
Q

Describe the staging of endometrial cancer

A
  • 1A: inner half of myometrium
  • 1B: outer half of myometrium
  • 2: Invades cervix
  • 3A: serosa/adnexa
  • 3B: vagina/parametrium
  • 3C: pelvic or para-aortic nodes
  • 4: bladder/bowel/intra-abdominal/inguinal nodes
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12
Q

Describe the features of type 1 endometrial cancer

A
  • Endometriol adenocarcinoma
  • Commonest
  • Unopposed oestrogen
  • Hyperplasia with atypia precursor
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13
Q

Describe the features of type 2 endometrial cancer

A
  • Uterine serous and clear cell carcinoma
  • High grade, more aggressive
  • Generally older women
  • Serous intraepithelial carcinoma precursor
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14
Q

How can endometrial cancer be treated?

A
  • Early stage: TAH/BSO/washings
  • High risk: chemo
  • Advanced: radiotherapy
  • Palliation: progesterone
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15
Q

What are the risk factors for endometrial cancer?

A
  • Post menopause
  • High circulating oestrogen levels: obesity, unopposed E2 therapy, PCOS and early menarche/ late menopause
  • Atypical endometrial hyperplasia
  • HNPCC/Lynch syndrome
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16
Q

What are the causes of post menopausal bleeding?

A
  • Endometrial cancer
  • HRT
  • Perimenopausal bleeding
  • Atrophic vaginitis
  • Polyps: cervical and endometrial
  • Other cancers: cervical, vulval, bladder, anal etc.
17
Q

What are the symptoms of vulval cancer

A
  • Pain
  • Itching
  • Bleeding
  • Lump/ulcer
18
Q

What are the risk factors for vulvar cancer?

A
  • Intraepithelial neoplasia or cancer at another site
  • Lichen sclerosus
  • Smoking
  • Immunosuppression
19
Q

Is HPV implicated in vulvar cancer?

A

Yes - mainly in younger females

20
Q

How can vulvar cancer be investigated?

A

-Punch/excisional biopsy

21
Q

What are the two types of vulvar intraepithelial neoplasia?

A
  • Usual type: HPV associated

- Differentiated type: older women, not HPV related

22
Q

What type of cancer is vulvar cancer?

A

Sqaumous cell carcinoma

23
Q

How can vulvar cancer be managed?

A
  • Surgery
  • Radiotherapy
  • Chemotherapy
24
Q

Which nodes can need to be removed when treating vulvar cancer?

A
  • Inguinal

- Upper femoral

25
Q

What are the symptoms of cervical cancer?

A
  • Abnormal vaginal bleeding
  • Post coital bleeding
  • Intermenstrual bleeding/PMB
  • Discharge
  • Pain
26
Q

How is cervical cancer diagnosed?

A
  • Clinical
  • Screen detected
  • Biopsy
27
Q

Describe the staging of cervical cancer

A
  • 1A1: depth <3mm and width < 7mm
  • 1A2: depth < 5mm and width < 7mm
  • 1B: clinically visible tumour or greater than 1A
28
Q

Where do cervical cancers spread to?

A
  • Upper vagina (stage 2)
  • Lower vagina and pelvis (stage 3)
  • Bladder and rectum (stage 4)
  • Metastases: pelvic nodes, liver, lungs and bone
29
Q

How is cervical cancer staged?

A
  • PET CT

- MRI

30
Q

How can cervical cancer be treated?

A
  • Stage 1A1: excision of the transition zone or hysterectomy
  • Stage 1b-11a: radical hysterectomy or chemo-radiotherapy
  • Stage 11b-1V: chemo-radiotherapy
31
Q

What is removed in a radical hysterectomy?

A
  • Uterus, cervix and upper vagina
  • Parametria
  • Pelvic nodes
  • Ovaries are conserved

Reproductive (26 decks)

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