Cervical cancer Flashcards
what is the incidence of cervical cancer
500,000 new cases per year
2nd most common cause of cancer in women
risk groups for cervical cancer
Young (immature TZ)
Early age of first sexual intercourse
Multiple partners
Promiscuous male partners
History of sexually transmitted diseases
Smoking
Type of contraception
Screening history
Screening intervals for 21-25
first invite
Screening intervals for 25-30 year olds
ever 3 years
Screening intervals50-64 year olds
every 5 years
Screening intervals for 65 olds and above
if they haven’t been screened since 50.
if a recent smear showed abnormal findings
what is a pap smear
Examination of exfoliating cells from the
transformation zone of the cervix microscopically for detection of
cancerous or precancerous lesions.
what is Liquid-based cytology.
sample is collected, by a small brush, in the same
way as for a conventional smear test,
the sample is then
deposited into a small bottle of preservative liquid.
liquid is treated to remove other elements such
as mucus before a layer of cells is placed on a slide.
CIN RANKING
benign
benign atypia
CIN 1 = low grade intraepithelial lesion/ betheda syst
CIN 2 = HIL
CIN 3 = HIL
CIS
INVASIVE CARCINOMA
benign
w/in normal limits
return for yearly checkup
benign atypia
unusual cells
usually d/2 infection
antibiotics
3 month check up
CIN 1
low grade intraepithelial lesion
small amount of cancerous cells
colposcopy
cryosurgery
cauterization
conization
CIN 2
high grade intraepithelial lesion
large amount of cancerous cells CONFINED to cervical surface
colposcopy
cryosurgery
cauterization
conization
CIN 3
high grade intraepithelial lesion
large amount of cancerous cells CONFINED to cervical surface but more than CIN2
colposcopy
cryosurgery
cauterization
conization
CIS
carcinoma in situ
high grade intraepithelial lesion
large amount of cancerous cells CONFINED to cervical surface but more than CIN2
colposcopy
cryosurgery
cauterization
conization
invasive carcinoma
adenocarcinoma/ squamous cell carcinoma
cancer has spread deep into the cervix and potential metastasis
etiology of cervical cancer
HPV
Low: 6, 11, 58, 59
High 16, 18, 31, 45
most common cause of CIN3 and 70% of cervical cancer
HPV 16
causes invasive squamous carcinoma
type pf cervical cancer caused by HPV 18
invasive adenocarcinoma
sx ov CC
Blood spots or light bleeding between or following
periods
MENORHAGIA Menstrual bleeding that is longer and heavier than
usual
Bleeding after intercourse, douching, or a pelvic
examination
Increased vaginal discharge
Pain during sexual intercourse
Bleeding after menopause
Unexplained, persistent pelvic and/or back pain
dg of CC
pap smear
pelvic rectal exam
colposcopy and biopsy
conization of cervic
CBC
chest xray. CT . MRI for metasteses
what is a colposcopy
device used to look into the vagina
how are abnormal cells detected on colposcopy
lugol’s soltn causes normal squamous cells to turn brown d/2 glycogen w/in their cells.
biopsy’s are taken from sites that dont stain
CC findings in colposcopy
lekuoplakia
acetowhite area w/ sharp border
mosaicism
punctation
types of cervical cancer presentation
endo vs exophytic
endo vs exocervical
how does CC spread?
Direct extention – uterine body, vagina, parametria, bladder, rectum
Lymphatic spread
Hematogenous dissemination-
lungs, liver, bones
how what dg methods are used for staging
PELVIC MRI
ABDOMINAL AND CXR
rx of cervical cancer
Surgery
Cone biopsy
Radical trachylectomy = cervicectomy,
Radical hysterectomy
Neoadjuvant chemotherapy combined with
radical surgery
exenteration- removal of organs in pelvic cavity
when is radiotherapy used in cervical cancer
pre op
post op in cases of poor prognosis
alternative to surgery
palliative care
when is chemotherapy used in cervical cancer
palliative care
type of radiation therapy used in cervical cancer
external beam from a machine
internal radiation therapy w. radioactive implants
chemotherapeutic agents in cervical cancer
CISPLATIN
PACLITAXEL
TOPOTECAN
AVASTATIN
SURGERY COMplications in cervical cancer
Acute complications
Fistula
Bladder dysfunction
Body image
CHEMO and RADIO COM in cervical cancer
alopecia
radiation burns
vaginal stenosuis and inflamm
cystitis and colitis
fistuala betw/ bladder and bowel
outcome of cervical cancer
Stage and 5 year survival 1 80% 2 60% 3 20% 4 5%
