Cervical Cancer Flashcards
1
Q
cervical cancer risk factors
A
- peak age 45-55 years
- HPV related (16&18)
- multiple sexual partners
- early age at first intercourse
- older age of parter
- cigarette smoking
2
Q
cervical cancer symptoms
A
- abnormal vaginal bleeding
- post-coital bleeding
- intermenstrual bleeding/PMB
- discharge
- (pain)
3
Q
cervical cancer - diagnostic investigations
A
- clinical
- screening detected, remember screening aims to detect pre-cancerous disease NOT cancer
- ## biopsy
4
Q
what will a biopsy of cervical cancer show?
A
- darkly-staining dysplastic tumour cells from epithelium invade into underlying stroma
- unable to identify basement membrane
- majority squamous carcinoma (80%)
- adenocarcinoma (endocervical) rising in relative incidence
5
Q
what are the stages of local spread of cervical cancer?
A
- stage 2: vagina (upper 2/3)
- stage 3: lower vagina, pelvis
- stage 4: bladder, rectum
6
Q
what are the routes of metastases of cervical cancer?
A
- lymphatic > pelvic nodes
- blood > liver, lungs, bone
7
Q
what imaging is used to stage cervical cancer?
A
- PET-CT
- MRI
8
Q
what is the treatment of cervical cancer depending on stage?
A
- stage 1a1: type 3 excision of the cervical TZ or hysterectomy
- stage 1b - 2a: radical hysterectomy or chemo-radiotherapy
- stage 2b-4: chemo-radiotherapy
- radiotherapy - external beam
- chemotherapy - once weekly during radiotherapy
- brachytherapy - caesium insertion (24hrs)
9
Q
what does a radical hysterectomy involve?
A
- exploration of pelvic and para-aortic space
- removal of: uterus, cervix, upper vagina, parametria, pelvic nodes
- ovaries conserved in pre-menopausal women
