GYN Cancer Flashcards
Is cervical carcinoma more prevalent among old or younger women?
younger women
What are some etiological factors contributing to gynecological cancers? (6 answers)
Poor, early sexual activity, multiple partners, pelvic lesions (HPV & HSII), Smoking, Nulliparity
What had helped to increase the early detection of cervical cancer?
Pap smears
what portion of cervical cancer is caught in the early non-invasive stage?
2/3
What is a gynecologic cancer risk factor specific to married women? (1 answer)
Those with husbands that have penile cancer
What does the effect of DES (Diethylstilbestrol) have on the risk for gynecological cancer?
Those that were exposed to DES before birth have a higher risk to develop Clear Cell Cervical and Vaginal cancer
What is attributing to the increase in endometrial cancer? (2 answers)
An aging population, Diets high in fats and calories
What is the peak incidence age for gynecological cancer?
58
What are two other health conditions that contribute to the occurrence of gynecological cancer?
Diabetes and hypertension
Those that are 50 lbs heavier are likelier to develop gynecological cancer. True or False?
True, 9x more likely
What are the nodes involved in the gynecological cancer region? ( 5 answers) “Physicians Commonly Intervene Extra Objectively”
Periaortic, Common Iliac, Internal Iliac, External Iliac, and Obturator Nodes
What is the outermost portion of the Gyn tract?
Vulva
What are the three sections of the vulva?
Labia majora, Labia Minora, and Clitoris
Where is the perineum located in female anatomy?
Between the vulvovaginal complex and anal verge
Explain the vagina. Characteristics? Dimensions? Location? ( 4 answers)
Muscular tube, 6-8 inch sup from the vulva, Ant to rectum, and Post to Bladder
What is the most inferior portion of the uterus that extends into the apex of the vagina?
The cervix
Explain the cervix. Characteristics? ( 3 answers)
Firm/round structure, 1.5 cm to 3 cm diameter, protrudes into the vagina creating spaces called fornices
Explain the Cervical Os. (1 answer)
canal the extends into the vagina through the cervix into the uterine cavity
Explain the Uterus. Characteristics? Dimensions? Location? (4 answers)
Hollow muscular structure, Overlays the bladder, extend laterally to fallopian tubes (transfer tube for eggs into the uterus), and Parametrium is tissue lateral to the uterine cervix
What are three important structures to consider in gynecological cancer?
Bladder, rectum and Small Bowel
What portion of the anatomy should be considered in the treatment design for gynecological cancer? ( 2 answers)
Primary lesions and draining lymphatics (inguinal, Pelvic and Para-aortic)
What is the most common malignant female genital carcinoma?
Endometrium Cancer
Endometrium cancer is ___ most common in women.
4th
What is the mucous membrane lining the uterus called?
Endometrium
What is the smooth muscle portion of the uterus called?
Myometrium
What is the outer portion of the uterus called?
Perimetrium
What two factors are contributing to the increase in endometrial cancer?
Hormone exposure w/o progesterone and obesity (3-5x more likely)
What does endometrium cancer present as? (2 answers)
Postmenopausal bleeding (1/3 of experience is cancer) and sometimes putrid discharge
What percentage of gynecological diagnosis are early stage?
80%
What are some prognostic factors for endometrial cancer? (4 answers)
Grade, Depth of Invasion, Nodal involvement, Tumor size
What is the gold standard for the detection of endometrial cancer?
Fractional dilation and curettage
What are some technologies used for diagnostics of endometrial cancer? (4 answers)
CT/MRI, Cystoscopy, Proctoscopy, and CA-125 levels
What is the staging system used for endometrium cancer?
FIGO staging, (only difference is FIGO staging indicates the depth of invasion)
What is the relative 5-year survival rate for endometrium cancer?
15-90% depending on staging
What is the most common histology of endometrial cancer?
Adenocarcinoma
What is the method of spread for endometrial cancer? (2 answers)
Pelvic and Para-aortic nodes
What are the treatment options for endometrium cancer? (3 answers)
Surgery, RT, and Chemo ( all depend on stage, grade, and status)
What does TAH stand for in gynecological cancer situations?
Total Abdominal hysterectomy
What is the radiotherapy regime used for endometrial cancer?
EBRT with 50 Gy boost to 75 Gy brachytherapy
What is the name of the devices used to aid in the treatment of the vaginal cuff? (2 answers)
Vaginal Cylinders and Colpostats
What type of imaging is used for treatment planning?
Orthogs
Describe the simulation/set-up for endometrial cancer. ( 3 answers)
Pt flat, pillow for comfort, immobilize feet,
What other devices are utilized in simulation to add image clarification? (2 asnwers)
Rectal and Vaginal markers
What are the critical structures to consider when treating endometrium cancer?
Endometrial cavity (75-90 Gy), Bladder/Rectum (65-75 Gy), Small bowel (below 50 Gy), Nodes (45-50 Gy)
What age group does ovarian cancer mostly affect?
50-70 yo
Ovarian cancer is the ____ leading cause of cancer deaths in women.
5th
What are some of the risk factors for Ovarian Cancer? ( 6 answers)
Older age, Family History, Late/Few pregnancies, Late menopause, Other cancer history, Diets high in meats and fats.
What is the most deadly of the Gyn Cancers?
Ovarian Cancer
Why is ovarian cancer so deadly?
Symptoms don’t present until widely disseminated
What are the common symptoms of Ovarian Cancer? (4 answers)
Abdominal, Pelvic Pain, Nausea, and Constipation
What is the route of spread for ovarian cancer?
into the abdominal cavity lymph nodes through pelvic nodes
What percentage of Ovarian Cancers are epithelial?
90%
What staging system is used for ovarian cancer?
FIGO
What is the treatment of choice for early-stage ovarian cancer?
TAH with bilateral salpinhoopherectomy
What is the treatment of choice for epithelial ovarian tumors?
Debulking and surgical evaluation
What is true about early-stage ovarian cancer?
Usually have good outcomes
In the case of ovarian cancer, XRT is often given pre or post-op?
Post-op
The entire peritoneal cavity is included in the treatment field for ovarian cancer. True or False?
True
Cervical carcinoma is more prevalent among what demographics?
Younger women 20-50, Poor women and early sexual active women
What two viruses are found in 99% of cervical cancers?
HPV 16 and 18
What two lifestyle factors influence the risk of cervical cancer?
Nulliparity and Smoking
What does cervical cancer present as?
Bleeding, Slow growing, Hematuria and discharge
At what age are routine pap smears recommend for women?
21
What are diagnostics taken for cervical cancer?
Colposcopy with biopsy for abnormal pap smear
What are some imaging diagnostics utilized for Cervical cancer?
PET/CT, MRI. Cytoscopy, and Proctoscopy
What are some of the lymph nodes involved in cervical cancers?
Parametrial, Pelvic, Common iliacs and paraaortics.
In the case of Cervical cancer, increased invasion means?
Poor outcome
What is the most common histology of cervical cancer?
Squamous Cell Carcinoma
What staging system is used for cervical cancer?
FIGO
What is the treatment of choice for early-stage cervical cancer?
TAH with a small vaginal cuff dissection
Whats a hysterectomy?
Removal of uteres
What is the difference between a total and radical hysterectomy
Total involves the removal of the cervix and radical involved the removal the vagi
what is the advantage of brachytherapy?
high does to tumor with little exposure to critical structures
What is the advantage,e of placing the patient prone for cervical cancer?
Allows the bowel to be placed outside the field
What are some devices used for the cervix during the process of radiotherapy?
Rectal/vagina markers, rectal barium
Where is point A for cervical cancer?
2 cm superior to cervical os and 2 cm lateral to the endometrial cancer
Where is point B for cervical cancer?
3 cm lateral from Point A
What does vuvla cancer present as?
suspicious lump, exophytic, labia majora (most common)
What age group does ovarian cancer mostly affect?
Women less than 50
What is the predictable vulvar cancer lymphatics spread?
Superficial inguinal, Deep femoral and then eventually pelvic nodes
What are diagnostics taken for vulva cancer?
CT and cystourethroscopy
What is the often used treatment for vuvlar cancer?
vulectomy with node dissection
What are some symptoms of vulva cancer?
Most desquamation and smaller tissue thickness, which can be resolved with bolus
What is the 5-year survival rate for Vulva cancer?
70%
Why is it important to have a vuvla cancer patient set-up uniquely? (pt frog legged and bolus)
Patients need to physically widen the field being treatment and also bolus is used to bring the dose higher on the skin
What is the most common location of vulva cance?
posterior third fo vagina
What is the dose limit for endometrial cancer?
45-50 Gy, boost to 10-15 Gy
What is the dose limit for vuvla cancer?
50 Gy, boot to 15-20 Gy
What is the dose limit for cervical cancer?
45 Gy, boost to 10-15 Gy
What is the dose limit for vaginal cancer?
45-50 Gy
