cervical cancer Flashcards

1
Q

around 50% of cervical CA occur in women…

A

under age of 45 years

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2
Q

which age group has the highest incidence rates of cervical CA?

A

25-29 year olds

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3
Q

what can cervical CA be divided into?

A
  • squamous cell cancer (80%)

- adenocarcinoma (20%)

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4
Q

what are the features of cervical CA?

A
  • may be detected during routine cervical CA screening
  • abnormal vaginal bleeding: PCB / IMB / PostMB
  • vaginal d/c
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5
Q

what is the most important factor in the development of cervical CA?

A
Human PapillomaVirus (HPV)
serotypes 16, 18 and 33
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6
Q

what are the other risk factors in developing cervical CA?

A
  • smoking
  • HIV
  • early 1st intercourse, many sexual partners
  • high parity
  • lower socioeconomic status
  • COCP
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7
Q

what is the mechanism of HPV causing cervical CA?

A

HPV 16 and 18 produces oncogenes E6 and E7 respectively
→ E6 inhibits p53 tumour suppressor gene
→ E7 inhibits RB suppressor gene

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8
Q

what is the mx of cervical CA determined by?

A

FIGO staging and wishes of the pt to maintain fertility

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9
Q

what are the FIGO stages?

A

IA, IB, II, III and IV

*prognosis also depends on FIGO staging

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10
Q

what is meant by FIGO stage IA?

A

confined to cervix, only visible by microscopy and <7mm wide

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11
Q

what is meant by FIGO stage IB?

A

confined to cervix, clinically visible / >7mm wide

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12
Q

what is meant by FIGO stage II?

A

extension of tumour beyond cervix but not to pelvic wall

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13
Q

what is meant by FIGO stage III?

A

extension of tumour beyond cervix and to pelvic wall

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14
Q

what is meant by FIGO stage IV?

A

extension of tumour beyond pelvis / involvement of bladder/rectum

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15
Q

how do you manage stage IA tumours?

A

gold standard: hysterectomy +/- lymph node clearance

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16
Q

how do you manage stage IA tumours in pts who wish to maintain fertility?

A

cone biopsy with negative margins

17
Q

how do you manage stage IB tumours?

A

radiotherapy with concurrent chemotherapy

radiation: brachytherapy/external beam
chemotherapeutic agent: cisplatin

18
Q

how do you manage stage II and III tumours?

A

radiotherapy with concurrent chemotherapy

if hydronephrosis, consider nephrostomy

19
Q

how do you manage stage IV tumours?

A

radiation +/- chemo

stage IVB - palliative chemo