cervical cancer Flashcards
what is the radical tx for stage 1a cervical cancer
simple hysterectomy = removal of uterus + cervix - for small / localised tumors
what is the radical tx for stage 1b cervical cancer
radical hysterectomy =. removal of uterus, fallopian tubes, overies, upper vagina and pelvic LNs
* if LN are positive then post-op chemorad is required * = EBRT+BT to upper 1/3 vagina and chemo to improve outcome
what are the 2 radical EBRT txs for stage 2-4 cervical cancer
EBRT as chemorad = VMAT 45gy 25# or 20Gy 28# for LN involvement and chemo of weekly IV cisplatin
EBRT as brachy boost = HDR 28Gy in 4# followed by adjuvant EBRT no later than 7 days - whole thing should not exceed 56 days.
when is palliative tx given for cervical cancer
EBRT given if distant mets or significant bladder/bowel involvement
what is the EMBRACE trail for cervical cancer
Brachytherapy trial looking at the use of the applicator and needles to improve local control without additional toxicities
name the 8 FIGO stages for cervical cancer
1a= confined to cervix
1b= confined to cervix
2a= vaginal mucosa involved but to lower 1/3
2b= parametric involved but not pelvic side wall
3a=invaded lower 1/3 vagina
3b=invade pelvic side wall
4a=bladder and rectal involvement
4b=metastatic spread
give 4 aetiological risk factors for cervical cancer
HPV
smoking
sexual activity from a young age
miscarriage
oral contraceptives
STDs
HIV
name the 2 main tumour types for cervical cancer
75% squamous cell carcinoma
25% adenocarcinoma
give 4 signs of cervical cancer
vaginal bleeding
vaginal discharge
haematuria
rectal bleeding
weightloss
3 investigations for cervical cancer
cervical cytology - smear test - identifying cells within cervix
Biopsy = determine stage/grade
CT/MRI= anatomical extent of disease.
spread of cervical cancer
local - most common = lateral ANT/POST to bladder and rectum
lymph = paracervical and internal/external iliac
blood = lung/liver/bone
