Gynaecological Cancer Flashcards
What investigations would you do for someone with Cervical Cancer?
1) Vaginal exam
2) Colposcopy
3) HPV test
4) Biopsy
What are some protective factors for cervical cancer?
1) COCP
2) Pregnancy
3) Breast feeding
How does Rb work?
Acts as a TSG, controlling cell division by altering activity of transcription factors
What happens if malfunctioning in Rb or p53?
If a mutation occurs in these genes a patient may have uncontrolled cell growth -> cancer.
What is an example and the roles of Oncogenes?
Example: HER2
- Oncogenes stimulate excessive cell growth and cell division –> Chance of cancer development
What is the most common type of Gynaecological cancer and it’s PP?
Endometrial Cancer
PP: Unopposed oestrogen -> Endometrial Hyperplasia -> Increased risk of endometrial adenocarcinoma
What are the main RF for developing endometrial cancer?
1) Obesity
2) Diabetes
3) Nulliparity
4) Late menopause
5) Pelvic Irradiation
6) HRT
Endometrial Cancer: Most common type and main red flag?
Most Common: Adenocarcinoma
Red Flag: Post-menopausal bleeding
Endometrial Cancer: Staging system and main investigations
SS: FIGO staging
Investigations: Pevlic/Abdo exam, Transvaginal USS, Endometrial biopsy, Hysteroscopy,
Endometrial Cancer: Main treatment
1) Hysterectomy +/- Pelvic Lymph Node removal
2) Adjuvant radiotherapy and progesterone therapy
What oncoproteins are associated with HPV?
1) E6 - blocks p53
2) E7 - blocks Rb
Why is the incidence of cervical cancer decreasing?
- Screening - cervical smears.
- HPV vaccine.
Give 5 risk factors for HPV and so cervical cancer.
Early age intercourse (<16).
Multiple sexual partners.
STI’s.
Smoking.
Multiparity.
OCP.
Cervical Cancer: Most common type and staging system
CT: Squamous
SS: FIGO
Cervical Cancer: Red flag symptom?
Post-coital bleeding
Describe the treatment for cervical cancer.
<2cm - loop removal, just removing part of the uterus.
> 2cm - radical hysterectomy.
> 4cm - radiotherapy, chemotherapy, palliative care.
CONSIDER FERTILITY
Give 3 potential risks of performing a radical hysterectomy.
Bowel problems.
Sexual problems.
Bladder problems.
Lymphoedema.
How is ovarian cancer treated?
Surgery and chemotherapy should be offered.
Describe the epidemiology of ovarian cancer.
More common in women >50; post-menopausal. Often people present late and so it is advanced at presentation.
What are the commonest types of ovarian cancer?
Epithelial (85%).
Sex cord.
Germ cell.
Give the main symptoms of ovarian cancer.
Bloating.
Abdominal pain.
Change in bowel habit.
Urinary frequency.
Bowel obstruction.
Can often be asymptomatic.
What investigations might you do in a patient who you suspect has ovarian cancer?
Measure CA125.
Trans-vaginal USS.
Calculate the RMI (risk of malignancy index) - if this is >250 the patient should be referred under the 2 week wait system.
What are the RF for developing ovarian cancer?
Early menarche.
Late menopause.
Nulliparity.
Genetics e.g. BRCA1/2.
What is the most common type of Vulval cancer?
Squamous
