Gyn Ovarian cancer

Question 1

What are the necessary investigation of ovarian cancer/suspicion

Answer 1

for any IBS sx in an elderly woman never forget CA125

Ix of choice is TVUSS
(can refer with just CA125 if >35
--but ideally can calculate RMI -
CA125x USS x menopause (>250 bad)
CT best for extrapelvic disease, MRI 

bad part is often presents late

Question 2

What are the types of ovarian tumours/cancers

Answer 2

Epiethial are most common - especially low grade serous
Endometroid, mucinous, clear cell
and high grade serous

Then germ cell- teratomas
and sex cord- fibroma, thecoma

Question 3

Managment of ovaian cancer

Answer 3

Main treatment is surgery + chemo
laporotomy- Total hysterctomy, ovary , tubes + as much debulking as possible (even mets)

and chemo added if advanced ovarian cancer (which most often is)
Platinium ciompouds (carboplatin)

can offer chemo alone if doesnt want surgery
Fertility sparing surgery exists but not as good

Prog- stage 1 -90% 5 year survival
stage 3 - 30%
but 75% present in satage 3

Question 4

RF for ovarian cancer

Answer 4

Age, Fhx, BRCA1, Lynch, Obesity, HRT, endometriosis, smoking