Cervical Cancer Flashcards
Pathophysiology:
Where does it develop?
What is dysplasia (dyskaryosis)? What may trigger this?
How is dysplasia classified?
Squamo-coumnar junction (SCJ) - the transitional zone between the squamous epithelium of the vagina and the columnar epithelium of the endocervix.
Metaplasia of columnar > squamous epithelium
HPV infection - human papilloma virus
CIN 1-3
HPV:
Which HPV viruses causes most of the dyskaryosis?
16 and 18
31 and 33 do the rest
Presentation:
How may it present?
What MUST be done for PERSISTENT PCB?
How are most cases picked up?
Non-menstrual bleeding including PCB
2WW
At screening
Risk factors:
3P’s and 3S’s
Parity - higher parity increases risk
Partners > 4 sexual partners - HPV transmission
Pill - long pill use
Sex - the early loss of virginity
STDs including HIV
Smoking
CIN:
What does it stand for?
What does it look at?
How many stages?
Cervical Intra-epithelial neoplasia
Degree of dysplasia
3 CIN1, CIN2 and CIN3
Investigations:
What procedure is done to have a detailed look at the cervix?
What needs to be to confirm the cancer?
What needs to be ruled out?
What imaging is used for staging?
Colposcopy - look up
Biopsy
Pregnancy with urine test
Infection with vaginal swabs
CT/MRI
FIGO staging:
What has happened in:
- Stage 1
- Stage 2
- Stage 3
- Stage 4
Cervix only
Upper 2/3 of the vagina
Lower 1/3 of the vagina
Bladder or rectum
Management:
How is it prevented?
Surgery:
- Stage 1A1 - what is done?
- Stage 1A2+1B1 - what is done?
Chemoradiotherapy is used for stages 1B2 to 4A. Why is surgery not used beyond 1B1?
What is done if there are distant mets? What stage is this?
How is it followed up annually?
HPV vaccine for girls 12-13 yrs old
Radical abdo hysterectomy - removing the uterus, ovaries, broad ligaments, upper vagina and pelvic lymphadenectomy
Surgery risks leaving positive margins
Chemo - using cisplatin - stage 4B
LBC - liquid-based cytology
Complications:
Why is sex encouraged within 2 months of Rx?
Radiotherapy can lead to vaginal stenosis
