Gynaecological Cancers Flashcards

1
Q

How is ovarian cancer classified?

A

Histolologically:

  1. high grade serous (most common)
  2. clear cell
  3. endometroid
  4. mucinous invasive
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2
Q

What genetic testing should be perfomed in patients with high grade serous ovarian cancer?

A

BRCA1/2

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3
Q

What is the primary treatment of ovarian cancer?

A

debulking surgery, primary chemothapy (6 x carbo/taxol Q3W)

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4
Q

What percentage of patients with ovarian cancer get recurrence after treatment?

A

80%

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5
Q

What is the managment for patients with ovarian cancer who are suboptimally debulked or have stage IV disease?

A

carbo/taxol plus bevacizumab

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6
Q

What is the management for patients with ovarian cancer who have a BRCA1/2 mutations?

A

carbo/taxol plus maintenance olaparib (PARP inhibitor)

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7
Q

What is the tumour marker for ovarian cancer?

A

CA125

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8
Q

What is the difference in management between patients who have a recurrence of disease less than 6 months from initial treatment versus more than 6 months?

A

if less than 6 months they are platinum resistant so need to be treated with a non platinum agent

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9
Q

Is there are role for neoadjuvant chemothearpy, dose dense chemotherapy or intraperitoneal chemotherapy in ovarian cancer?

A

yes

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10
Q

What novel treatments are available for ovarian cancer?

A

anti-angiogenic agents, PARP inhibitors, immune check point inhibitors

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11
Q

What is the most common gynaecological cancer?

A

endometrial cancer

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12
Q

Why is there increasing incidence of endometrial cancer?

A

increased prevalence of obesity and metabolic syndrome

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13
Q

What is the mortality rate of endometrial cancer?

A

2 per 100,000

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14
Q

What are the risk factors for endometrial cancer?

A

unopposed oestrogen, age, lynch syndrome

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15
Q

What are protective factors for endometrial cancer?

A

OCP

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16
Q

What are the types of endometrial cancers?

A

Type I - oestrogen dependent, good prognosis

Type II - oestrogen independent, less good prognosis

17
Q

What is the usual presentation of endometrial cancer?

A

PV bleeding, abdo pain, bloating, nausea, fatigue, LOA, LOW

18
Q

How is endometrial cancer invetigated?

A

US +/- pipelle, may require hysteroscopy/D+C, pre-operative MRI to determine local invasion/potential nodal involvement

19
Q

What is the treatment for endometrial cancer?

A

total hysterecotmy and bilateral salpingo-oophrectomy

20
Q

Should patients with endometrial cancer have adjuvant chemotherapy?

A

depends on risk

21
Q

What is the management for advanced endometrial cancer?

A

depends on patient factors, tumour factors and biomarker factors
can consider surgery
can consider chemo/radiotherapy

22
Q

What are the risk factors for cervical cancer?

A

HPV, smoking, immunosupression

23
Q

What percentage of cervical cancer does HPV account for?

A

95%

24
Q

Which are the most common types of HPV associated with cervical cancer?

A

HPV 16 and HPV 18

25
Q

What is the median survival of advanced cervical ca?

A

12-13 months

26
Q

What is the management for early stage cervical cancer?

A

surgery +/- adjuvant chemoRT

27
Q

What is the management for locally advanced cervical cancer?

A

definitive chemo-RT

28
Q

What is the management for recurrent/metastatic cervical ca?

A

carbo/taxol +/- bevacizumab