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Reproductive System > Endometrial, Cervical, Vulval and Ovarian Cancer > Flashcards

Endometrial, Cervical, Vulval and Ovarian Cancer Flashcards

1
Q

why is the prognosis of ovarian cancer often poor?

A

because it has vague symptoms so often presents late

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2
Q

what investigations are carried out to diagnose ovarian cancer?

A
  • abdo/pelvic ultrasound
  • abdo/chest/pelvic CT
  • marker: CA 125
  • laparotomy
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3
Q

what marker can be raised in ovarian cancer that can also be found in other cancer and benign conditions?

A

CA 125

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4
Q

what are the stages of ovarian cancer?

A

1 - ovaries only
2 - pelvic involvement
3 - peritoneal/nodal involvement
3 - distant metastases

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5
Q

how is ovarian cancer managed?

A
  • surgery (biopsy/staging/resection/debulking)

- chemotherapy

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6
Q

which genetic condition can cause higher risk of developing ovarian cancer?

A
  • HNPCC/Lynch syndrome

- BRCA gene mutation

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7
Q

what is BRCA gene?

A

a tumor suppressor gene

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8
Q

name a few symptoms that women with ovarian cancer may present with

A
  • abdominal discomfort
  • indigestion/early satiety
  • constipation
  • bloating/weight gain
  • ascites
  • pelvic mass
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9
Q

which type of contraception provides some protection against ovarian cancer?

A

oral combined pill

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10
Q

what type of surgery is carried out for ovarian cancer?

A

laparotomy

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11
Q

how is the risk of malignancy (RMI) identified for ovarian cancer?

A
  • Ultrasound
  • Menopausal status
  • CA 125
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12
Q

what is the average age for ovarian cancer to develop?

A

50-60

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13
Q

what are the risk factors for developing vulval cancer?

A
  • lichen sclerosus
  • vulval intraepithelial neoplasia (VIN)
  • smoking
  • immunosuppression
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14
Q

name a few symptoms of VIN/vulval cancer

A
  • itch
  • pain
  • burning
  • bleeding from site
  • lump/ulcer
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15
Q

how is vulval cancer diagnosed?

A

punch biopsy or excision biopsy

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16
Q

how is vulval cancer treated?

A
  • excision of lesion
  • excision of lymph nodes
  • chemotherapy/radiotherapy
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17
Q

how is vulval cancer staged?

A
  1. <2cm in size
  2. > 2cm in size
  3. inguinal/femoral lymph node involvement
  4. pelvic lymph node involvement
18
Q

what type of cancer is vulval cancer?

A

squamous cell carcinoma

19
Q

what are the subtypes of vulval intraepithelial neoplasia (VIN), and what is the usual population presenting with each?

A
  • usual type VIN: HPV infection related, commonly younger women
  • differentiated VIN: not HPV related, common in older women
20
Q

what red flag symptom indicates potential cervical cancer?

A

post-coital bleeding

21
Q

name a few symptoms of cervical cancer

A 
abnormal bleeding:
- post-coital bleeding
- heavy menstrual bleeding
- intermenstrual bleeding
discharge
pain
22
Q

what is the cause of cervical cancer?

A

HPV infection

23
Q

what are the two strains of HPV that cause cervical cancer?

A

HPV 16 and HPV 18

24
Q

what type of cancer is the majority of cervical cancers?

A

squamous cell carcinoma

25
Q

what staging is used for cancers of the female reproductive tract?

A

FIGO staging

26
Q

what are the FIGO stages?

A 
0 - carcinoma in situ
1 - larger area of same tissue
2 - spread to adjacent organs
3 - spread to pelvic organs
4 - distant metastases
27
Q

how is cervical cancer staged?

A

biopsy
PET-CT scan
MRI scan

28
Q

which area of the cervix is most likely to develop cancer?

A

transformation zone

29
Q

what are the management options for cervical treatment?

A
  • excision of transformation zone
  • radical hysterectomy + chemo/radiotherapy
  • chemo/radiotherapy
  • brachytherapy
30
Q

what is the most effective way to prevent cervical cancer?

A

cervical cancer screening program - smear test

31
Q

what are the subsets of Stage 1 cervical cancer?

A

Stage 1A - cancer only visible microscopically

Stage 1B - cancer visible on examination of cervix

32
Q

what chemotherapy treatment is used for cervical cancer among others?

A

cisplatin

33
Q

what are the main symptoms of endometrial cancer?

A

abnormal vaginal bleeding

post-menopausal bleeding

34
Q

what are the risk factors for endometrial cancer?

A
  • post-menopause
  • increase/unopposed levels of oestrogen (early menarche, late menopause, low parity, OCP, PCOS)
  • obesity
  • smoking
  • atypical endometrial hyperplasia
  • Lynch syndrome
35
Q

what are the main investigations carried out to diagnose endometrial cancer?

A
  • transvaginal ultrasound
  • endometrial biopsy
  • hysteroscopy
  • MRI for staging
36
Q

what is the cut off for normal endometrial thickness in post-menopausal women?

A

4mm`

37
Q

why is measuring endometrial thickness not a reliable diagnostic tool for endometrial cancer in pre-menopausal women?

A

because during normal cycle endometrium thickness varies a lot

38
Q

histologically, what are the two types of endometrial carcinoma?

A
  • endometrioid adenocarcinoma: commonest type, younger women, fairly good prognosis if caught early
  • uterine serous/clear cell carcinoma: older women, rapidly aggressive, can be fatal
39
Q

what is the management of endometrial cancer?

A
  • total hysterectomy + bilateral salpingo-oophorectomy
  • chemotherapy
  • radiotherapy
  • progesterone (palliative)
40
Q

what staging method is used for endometrial cancer?

A

FIGO staging

Reproductive System (7 decks)

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