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oncology > Cervical Cancer > Flashcards

Cervical Cancer Flashcards

1
Q

what is the most important risk factor for developing cervical cancer?

A

human papilloma virus (HPV)

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2
Q

what HPV types are carcinogenic?

A
  • 16
  • 18
  • 33
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3
Q

what HPV subtypes are associated with genital warts and are non-carcinogenic?

A
  • 6
  • 11
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4
Q

how does HPV affect cervical cells?

A

infected endocervical cells undergo changes resulting in the development of koliocytes

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5
Q

what are the characteristics of koilocytes?

A
  • enlarged nucleus
  • irregular nuclear membrane contour
  • nucleus stains darker than normal (hyperchromasia)
  • perinuclear halo may be seen
normal cervical cells on left and koliocytes on right
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6
Q

what is the most common types of cervical cancer?

A
  • squamous cell carcinoma (80%)
  • adenocarcinoma
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7
Q

how does HPV increase the risk of developing cancer?

A
  1. HPV produces E6 and E7 proteins
  2. these proteins inhibit tumour suppressor genes (p53 and pRb)
  3. promotes the development of cancer
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8
Q

are are the risk factors for catching HPV?

A
  • early sexual activity
  • increased number of sexual partners
  • sexual partners who have had more partners
  • not using condoms
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9
Q

other than HPV, what are the risk factors for developing cervical cancer?

A
  • smoking
  • HIV
  • COCP
  • pregnancy
  • family history
  • exposure to diethylstilbestrol during foetal development
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10
Q

what symptoms can cervical cancer present with?

A
  • abnormal vaginal bleeding
  • pelvic pain
  • dyspareunia
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11
Q

what can be seen on cervical examination which raises the suspicion of cancer?

A
  • ulceration
  • inflammation
  • bleeding
  • visible tumour
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12
Q

what is CIN I?

cervical intraepithelial neoplasia

A
  • mild dysplasia
  • 1/3 thickness of the epithelial layer
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13
Q

what is CIN II?

cervical intraepithelial neoplasia

A
  • moderate dysplasia
  • 2/3 thickness of the epithelial layer
  • likely to become cancerous is not treated
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14
Q

what is CIN III?

cervical intraepithelial neoplasia / cervical carcinoma in situ

A
  • severe dysplasia
  • very likely to become cancerous
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15
Q

what ages is the cervical screening undertaken?

A
  • 25-49 every 3 years
  • 50-64 every 5 years
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16
Q

what are the exceptions to the cervical screening program?

A
  • HIV screened annually
  • previous CIN
  • immunocompromised
  • wait until 12 weeks post-partum
17
Q

why is acetic acid used in colposcope?

A
  • causes abnormal cells to appear white
  • acetowhite
18
Q

why is iodine solution used in colposcope?

schiller’s iodine test

A
  • stain health cells a brown colour
  • abnormal will not stain
19
Q

what is large loop excision of the transformation zone (LLETZ)?

A
  • performed under local
  • diatheramy used to remove abnormal cells
20
Q

what are possible complications following LLETZ?

A
  • bleeding
  • abnormal discharge
  • infection
  • preterm labour
21
Q

what is a cone biopsy?

A
  • treatment for CIN
  • general anaesthetic
22
Q

what are the main risks of a cone biopsy?

A
  • pain
  • bleeding
  • infection
  • scar formation with stenosis of the cervix
  • increased risk of miscarriage and premature labour
23
Q

what are stage IA cervical cancer tumours managed?

A
  • hysterectomy +/- lymph node clearance
  • maintain fertility = cone biopsy
24
Q

how is stage IB-IIA cervical cancer managed?

A
  • B1 tumours = radiotherapy + chemotherapy
  • B2 tumours = radical hysterectomy + pelvic node dissection
25
Q

how is stage IIB-IVA cervical cancer managed?

A
  • chemotherapy
  • radiotherapy
26
Q

how is stage IVB cervical cancer managed?

A
  • surgery
  • radiothrapy
  • chemotherapy
  • palliative care
27
Q

what is stage IA FIGO cervical cancer?

A

confined to cervix + <7mm wide
* A1 = <3mm deep
* A2 = 3-5 mm deep

28
Q

what is stage IB FIGO cervical cancer?

A

confined to cervix + >7mm wide
* B1 = < 4 cm diameter
* B2 = > 4 cm diameter

29
Q

what is stage II FIGO cervical cancer?

A

extension of tumour beyong cervix
* A = upper 2/3rds of vagina
* B = parametrial involvement

30
Q

what is stage III FIGO cervical cancer?

A

extension of tumour beyond the cervix and to the pelvic wall
* A = lower 1/3rd of vagina
* B = pelvic side wall

31
Q

what stage of cervical cancer is a tumour causing hydronephrosis or a non-functioning kidney?

A

stage III

32
Q

what is stage IV FIGO cervical cancer?

A

extension of tumour beyond the pelvis or involvement of bladder or rectum
* A = involvement of bladder or rectum
* B = involvement of distant sites outside the pelvis

32
Q

what is stage IV FIGO cervical cancer?

A

extension of tumour beyond the pelvis or involvement of bladder or rectum
* A = involvement of bladder or rectum
* B = involvement of distant sites outside the pelvis

33
Q

what is the chemotherapy agent of choice in cervical cancer?

A

cisplatin

oncology (14 decks)

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