Cervical Cancer Flashcards
Describe the prevalence of cervical cancer
2500 cases per year in the UK
1200 deaths
10th most common cancer in women in Scotland
What are the risk factors for cervical cancer?
Peak age us 45-55 years
HPV related (16 and 18)
Multiple sexual partners
Early age at first intercourse
Older age of partner
Cigarette smoking
What are the cervical cancer symptoms?
Abnormal vaginal bleeding
Post coital bleeding
Intermenstrual bleeding/ PMB
Discharge and pain
How is cervical cancer diagnosed?
Clinical
Screen detected
Biopsy
Describe the histology of cervical cancer
Tumour cells from epithelium invade into underlying stroma
Majority squamous carcinoma
Adenocarcinoma rising in incidence
What is stage 1A?
Invasive cancer identified only microscopically
IA1 - less than 3mm depth and 7mm diameter
IA2 - under 5mm x 7mm
What is stage IB?
Clinical tumours confined to the cervix
What is the local spread of cervical cancer?
Stage 2 - vagina (upper 2/3rds)
Stage 3 - lower vagina and pelvis
Stage 4 - bladder and rectum
What is the sites for metastases in cervical cancer?
Lymphatic - pelvic nodes
Blood - liver, lungs and bone
How is cervical cancer staged?
PET-CT
MRI
What is the treatment for stage 1a1?
Type 3 excision of the cervical TZ or hysterectomy
What is the treatment for stage 1b-11a?
Radical hysterectomy or chemo-radiotherapy
What is the treatment for stage 11b - 1V?
Chemo-radiotherapy
What is a radical hysterectomy?
Exploration of pelvic and para-aortic space
Removal of uterus, cervix, upper vagina, parametria, pelvic nodes and ovaries are conserved
What is the treatment for cervical cancer?
Radiotherapy - external beam
Chemotherapy - once weekly during radiotherapy
Brachytherapy - caesium insertion (24hrs)
