Gynae Cancer

Question 1

What is the best treatment for a carcinoma of the cervix?

Answer 1

In younger women, preservation of ovarian function is important so radiotherapy would not be the best option. Surgery is the best option, like a radical hysterectomy- (before stage 3)

Question 2

What is the best treatment for a cervical carcinoma beyond stage 3?

Answer 2

Radiotherapy (if it has spread to the pelvic side walls it is too advanced for surgery).

Question 3

What does stage 4 ovarian carcinoma include and what is the best treatment for this?

Answer 3

It includes parenchymal liver metastases and the best treatment is chemotherapy. Ovarian cancer is chemo-sensitive and responds well to platinum-based and alkylating agents and to taxoids.

Question 4

How should you treat a well differentiated adenocarcinoma?

Answer 4

TAH and BSO- the need for adjuvent therapy depends largely on the depth of myometrial invasion and the grade of the tumour.

Question 5

What are the risk factors for cervical carcinoma?

Answer 5

Long term use of the pill without barrier

Question 6

Cervical cancer

Answer 6

1: Wertheim’s hysterectomy involves pelvic node clearance, hysterectomy, removal of parametrium and upper third of the vagina.
2: In high stage disease, platinum-based chemotherapy has been shown to increase survival and decrease recurrence.
3: Palliative radiotherapy is used for haemorrhage.
4. Cone biopsy alone can be used in very early stage disease.
5. Simple hysterectomy is the preferred treatment of choice for post-menopausal women.