Cervical cancer

Question 1

Cervical cancer is 99% caused by what virus?

Answer 1

HPV

Question 2

High rates of anal HPV infection have been reported in men who ?

Answer 2

have sex with men, resulting in an increased risk of HPV-related anal cancer.

Question 3

CIN1 infections may progress to?

Answer 3

squamous cell carcinoma

Question 4

as a result of the lack of sensitivity of the Pap smear test, what is not picked up on?

Answer 4

glandular lesions, the earlier stages of this disease are often not observed in the patient.

Question 5

CERVICAL CANCER - what is the peak age?

Answer 5

45-55

Question 6

HPV related cervical cancer is athwart key ages ?

Answer 6

16 and 18

Question 7

risks for cervical cancer (4)

Answer 7

• Multiple sexual partners
• Early age at first intercourse
• Older age of partner
• Cigarette smoking

Question 8

typical cancer presentation - does not have post coital bleeding

• does not have a regular partner and because of the bleeding she does not have sex
• no screen test since 2005
• smokes 25 a day
• what Is you next step?

Answer 8

• Refer as urgent suspected cancer to Gynaecology

Question 9

CERVICAL CANCER: SYMPTOMS (5)

Answer 9

• Abnormal vaginal bleeding
• Post coital bleeding
• Intermenstrual bleeding/PMB
• Discharge
• (Pain)

Question 10

CERVICAL CANCER: DIAGNOSIS - (3)

Answer 10

Clinical
Screen detected
Biopsy

Remember screening aims to detect pre-cancerous disease NOT cancer

Question 11

tumour cells invade what?

Answer 11

• from epithelium = underlying stroma

Question 12

the majority of cervical cancers are 80%

Answer 12

squamous carcinoma

Question 13

what cancer is on rise in incidence?

Answer 13

Adenocarcinoma (endocervical)

Question 14

Stage 1A cancer is only identified by? - what mm values show it is micro invasive

1A2 values?

Answer 14

microscopically

• ≤ 3 mm depth and ≤7 mm diam
• ≤ 5 mm x7 mm

Question 15

stage 1B are ?

Answer 15

clinical tumours confined to the cervix

Question 16

spread of cervical cancer - local - stage 2, 3 and 4

Answer 16

2: Vagina (upper 2/3)
3: lower vagina, pelvis
4: bladder, rectum

Question 17

spread of cervical cancer - metastases

Answer 17

Lymphatic – pelvic nodes

Blood – liver, lungs, bone

Question 18

Cervical Cancer Staging - what 2 scans do you do?

Answer 18

PET-CT

MRI

Question 19

CERVICAL CANCER TREATMENT - type 1a1

Answer 19

Type 3 Excision of the cervical TZ or hysterectomy

Question 20

CERVICAL CANCER TREATMENT- stage 1b -11a

Answer 20

Radical hysterectomy or chemo-radiotherapy

Question 21

CERVICAL CANCER TREATMENT - Stage 11b - 1V

Answer 21

Chemo-Radiotherapy

Question 22

RADICAL HYSTERECTOMY is the removal of ?

• what is conserved in pre- menopausal women?

Answer 22

• Uterus, cervix, upper vagina
• Parametria
• Pelvic nodes
• Ovaries conserved

Question 23

Radiotherapy is given by a?

Answer 23

external beam

Question 24

Chemotherapy is given?

Answer 24

once weekly during radiotherapy

Question 25

What is Brachytherapy?

Answer 25

Caesium Insertion (24 hours)

Question 26

what does screening detect?

Answer 26

• detects pre-invasive changes which are asymptomatic

Question 27

cervical cancer causes abnormal?

Answer 27

vaginal bleeding