cervical cancer

Question 1

many risk factors of cervical Ca are related to HPV infection

Answer 1

multiple sexual partners
early age first intercourse - immaturity of cervix - transformation zone more susceptible
older age of partner - more likely to have infection
cigarette smoking - effect on cell mediated immunity

Question 2

cervical cancer symptoms

Answer 2

abnormal vaginal bleeding
post-coital bleeding
intermenstrual bleeding/PMB
discharge - brown blood, smell

unusual for patient to present with pain, would be very advanced Ca

Question 3

diagnosis of cervical Ca

Answer 3

clinical - seeing what looks like cancer

screen detected - cervical smear

biopsy - this is crucial

Question 4

cervical cancer histology

Answer 4

tumour cells from epithelium invade into underlying stroma

majority squamous carcinoma (80%)
adenocarcinoma (endocervical)

Question 5

stage IA

Answer 5

invasive cancer only identified microscopically

Question 6

stage IB

Answer 6

clinical tumours confined to cervix

Question 7

local spread of cervical cancer

Answer 7

stage 2: upper 2/3 vagina
stage 3: lower vagina, pelvis
stage 4: bladder, rectum

Question 8

cervical cancer metastases

Answer 8

lymphatic: pelvic nodes
blood: liver, lungs, bone

Question 9

staging cervical cancer

Answer 9

PET-CT

MRI

Question 10

cervical cancer treatment: stage 1A1

Answer 10

type 3 excision of the cervical TZ or (simple) hysterectomy if not planning on kids

Question 11

cervical cancer treatment: stage 1B - 2A

Answer 11

radical hysterectomy or chemo-radiotherapy

Question 12

cervical cancer treatment: stage 2B - 1V

Answer 12

chemo-radiotherapy

Question 13

radical hysterectomy

Answer 13

exploration of pelvic and para-aortic space

removal of: uterus, cervix, upper vagina, parametria, pelvic lymph nodes

ovaries conserved in pre-menopausal women