Gynae Oncology Flashcards
Most common cell type of endometrial cancer
Adenocarcioma
Risk factors for endometrial cancer
Nulliparity Late menopause Oestrogen treatment Obesity Diabetes Corpus cancer syndrome PCOS Fibroids DUB High fat diet Endometrial hyperplasia Familial history
Progression from normal cervical epithelium to invasive carcinoma takes at least how long?
On average 15 years
In what cancers is alpha-feto protein raised
Ovary Testis Liver Pancreas Lung Stomach Colon
Common symptoms of ovarian cancer
Abdominal distension and pain
Ascites
What is Ca 125 a marker for?
Ovarian cancer
Presentation of endometrial carcinoma
Postmenopausal bleeding
Premenopausal menstrual irregularity
When CIN is found in the deeper layers of the cervical epithelium (lower 1/3) what grade of CIN would this be?
CIN 1
Undifferentiated cells confined to lower 1/3
When CIN is found in the lower 2/3 of the cervical epithelium what grade of CIN would this be?
CIN 2
More marked nuclear abnormalities than CIN 1
When CIN is found throughout the thickness of the cervical epithelium what grade of CIN would this be?
CIN 3
Which HPV viruses are most associated with cervical cancer
16 and 18 (33, 31)
Risk factors for female genital tract neoplasia
Increased number of sexual partners Persistent HPV infection Immune compromise Cigarette smoking Low socioeconomic status Prolonged use of the OCP Higher number of pregnancies
What are the most common symptoms of cervical cancer
Abnormal vaginal bleeding / discharge
Discomfort during intercourse
How is high dose brachytherapy for cervical cancer delivered?
Applicators are put in the cervix and connected to an afterloading machine which delivers radiation at a high dose rate for a few minutes.
Often repeated several times, a few days apart, on an outpatient basis
What is topotecan used to treat
Advanced cervical cancer
Ovarian cancer
Small cell lung cancer
How does topotecan chemotherapy work
Prevents DNA replication in cancer cells by inhibiting the enzyme topoisomerase I.
What is DySIS?
digital video colposcope using dynamic spectral imaging to evaluate the blanching effect of applying acetic acid to the epithelium. It measures the rate, extent and duration of the acetowhitening.
What is the annual incidence of cervical cancer in the UK
The annual incidence of cervical cancer in the UK is estimated to be 9.7 per 100,000 population.
What is the annual mortality rate for cervical cancer in the UK?
The annual mortality rate for cervical cancer in the UK is 3.9 per 100,000 population (2001)
How is liquid based cytology carried out
Samples collected using a brush.
The head is rinsed / broken off in a vial of preservative.
Samples mixed to disperse the cells.
Cellular debris/ blood/ mucus is removed.
A thin layer of cervical cells put on a slide and stained.
What does a Radical hysterectomy involve
Surgical removal of the uterus, supporting ligaments, upper vagina and pelvic lymph nodes +/- para-aortic lymph nodes.
What approaches are possible for a radical hysterectomy
standard approach = abdominal incision. Laparoscopic radical hysterectomy
What is the extent of stage 1 cervical cancer
stage I cervical cancer is confined to the cervix
What is the extent of stage 2 cervical cancer
Stage IIA - tumour invades the cervix with endocervical glandular involvement only.
Stage IIB - Tumour has spread upward into tissues around the cervix but not into the pelvic wall.
