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Additional CSO Cards > Chapter 23: Gynecological cancers > Flashcards

Chapter 23: Gynecological cancers Flashcards

1
Q

The HPV vaccine has reduced incidence of ______ cancer in women in the US, but remains a bigger threat in other countries

A

Cervical__

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2
Q

_______ cancer is the leading cause of gynecological cancer deaths in the US

A

Ovarian

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3
Q

Unlike _______ cancer, ovarian cancer presents with few symptoms making early detection difficult

A

Endometrial

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4
Q

Risk for _______ gyn cancer is increased w/ obesity & Mediterranean diet, while there is little evidence to support metabolic syndrome or diet quality to _________ gyn cancer

A

Endometrial
Ovarian

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5
Q

Calcium/dairy and ovarian cancer

A

Some studies showed inverse relationship but very conflicting/inconclusive

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6
Q

Factors increasing risk for endometrial cancer (6)

A

-Exposure to estrogen (birth control pills, total number of menstrual cycles)
-Tamoxifen
-PCOS
-Obesity
-Older age
-Hyperglycemia/DM/metabolic syndrome

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7
Q

Protective factors for endometrial cancer (4)

A

-Coffee
-Fruit & non-starchy vegetables
-Mediterranean diet
-physical activity

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8
Q

Risk factors for uterine sarcoma (3)

A

-Radiation to pelvis
-Family hx of retinoblastoma (abnormal copy of RB gene_
-Black women

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9
Q

Oral contraceptives increase risk for ________ gyn cancer, but decrease risk for _______ gyn cancer

A

Endometrial
Ovarian
(think that the ovaries produce estrogen so they like it)

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10
Q

Factors that increase risk for ovarian cancer (4)

A

Age
Growth/height in adulthood
Obesity
Gene mutations (BRCA)

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11
Q

Factors that decrease risk for ovarian cancer (5)

A

Giving birth
Birth control
Breastfeeding
Increased hip circumference
Prophylactic oophrectomy

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12
Q

What is the word for removal of the ovaries?

A

Oophrectomy

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13
Q

Which 2 types of HPV are most linked to cervical cancer

A

HPV 16 & HPV 18

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14
Q

Endometrial cancer is the most common type of uterine cancer, while uterine _________ is rare

A

Sarcoma

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15
Q

The most common type of ovarian cancer is of the ________ cells

A

Epithelial

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16
Q

These are the 2 types of cervical cancer, based on the type of cell they originate from

A

squamous cell
adenocarcinoma

17
Q

Signs of endometrial cancer

A

Unusual bleeding/pelvic pain after menopause, unintentional weight loss

18
Q

Signs of late ovarian cancer

A

GI issues (gas, bloating, constipation)
Early satiety
Abdominal pain/swelling/bloating

19
Q

_______ cancer is usual detected by regular exams or pain during sex

A

Cervical

20
Q

Treatment of endometrial cancer

A

Surgery + observation

Vaginal brachytherapy, EBRT, systemic chemo, or hormone therapy may be considered

21
Q

Surgery for ovarian cancer is the primary treatment and involves removal of (4)

A

Ovaries
Uterus (hysterectomy)
Lymph nodes
Omentum

“hysterectomy with bilateral salpingo-oophrectomy with lymph node dissection and omentectomy”

*fertility sparing surgery may be an option

*Instestinal surgery may also be needed

22
Q

________ > is preferred to _______ when ovarian cancer is detected to reduce the risk for mets

A

Tissue removal
Biopsy

23
Q

Intestinal surgery is needed in ______ - _____% cases of advanced ovarian cancer

A

30-50%

24
Q

Adjuvant recommendations for ovarian cancer

A

Platinum-based chemotherapy, may include intraperitoneal. Targeted therapy may also be an option.

Radiation is NOT standard, this was done historically

25
Q

Treatment for cervical cancer

A

Varies on the stage - advanced will require hysterectomy while cryotherapy or laser surgery may be used for early stages

EBRT, brachytherapy, and chemotherapy are also options

26
Q

Mets to the ________ or ______ systems are possible with GYN cancers d/t close proximity

A

GI
Urinary

27
Q

_________ during gyn surgery can contribute to ascites and mask true wt loss

A

Lypmh node removal

28
Q

The prognostic nutritional index may be used as a screening tool, often for breast & gyn cancers. It is calculated by ___________ + __________

A

Albumin + total lymphocytes

29
Q

Malnutrition is approximately ____________% in ovarian cancer

A

70%

30
Q

4 supplements/medical management for radiation-induced diarrhea (gyn cancer category)

A
  1. Psyllium - 2 teaspoons daily
  2. Probiotics - need more research on specifics
  3. Loperamide & diphenoxylate - standard of practice for mild symptoms
  4. Octreotide - studied specifically w/ rectal cancer (may be difficult to get insurance coverage d/t newer research)
31
Q

Traditional versus non-traditional nutrition progression post-op of GYN cancers

A

Witholding intake until bowel sounds, flatus, or stool or noted

ERAS - early PO, enteral, or immune-enhanced formulas. Associated with fewer complications and LOS
**may contribute to more nausea

32
Q

________ is a preterminal event to ovarian cancer and make it very difficult to tolerate oral intake d/t pain, N/V, ascites

A

Malignant bowel obstruction

33
Q

Survival length of surgical versus non-surgical malignant bowel obstruction

A

Non-surgical: 4-5 weeks
Surgical: 6 months but most of the time spent in the hospital d/t various complications

34
Q

T/F: PN is recommended for inoperable cases of MBO

A

False. Use palliative measures

35
Q

_______ & ______ are tools used to relieve symptoms of MBO for non-surgical candidates

A

Venting G tubes
Stents

Reduce nausea, vomiting, improves PO intake thus QOL

36
Q

Some RDs recommend a __________ diet for MBO, but need clinical judgement

A

low fiber

37
Q

Factors to consider w/ PN in advanced gynelogical cancers w/ MBO d/t discomfort w/ PN and only mild increase on life span

A

Performance status (karnofsky >/= 50), if you’ll die from malnutrition before the cancer

38
Q

Long-term survivors of ovarian cancer will experience early menopause, thus risks for ______ & ______ increase

A

Osteoporosis
Heart disease

Additional CSO Cards (26 decks)

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