HPV and premlaignant disease of the cervix and Endometrial Ca Flashcards
When does cervical cancer occur?
Between the 5th and 6th decades, average age is 51 years.
What are the risk factors for cervical cancer?
Early coitarche (= 16 years), Multiple male sexual partners, Early age at first birth, Multiparity, Smoking, Low socioeconomic status, Immunosuppressive state.
What is Cervical Intraepithelial Neoplasia (CIN)?
A premalignant disordered growth of the cervical epithelium, most commonly detected in women in their 20s.
How is CIN classified?
CIN 1: Lower 1/3 of cervical epithelium (Low grade),
CIN 2: Lower 2/3 (High grade),
CIN 3: Full-thickness disordered growth (High grade),
Carcinoma in situ: Full-thickness disordered growth.
What are the diagnostic methods for CIN?
Pap smear, Liquid-based cytology, HPV testing, Colposcopy.
How is CIN treated?
Low-grade may regress spontaneously, follow-up with colposcopy and cytology. High-grade treated with excision and ablation.
What HPV vaccines are available, and what do they protect against?
Cervarix (HPV 16, 18), Gardasil (HPV 16, 18, 6, 11).
What are the stages of cervical cancer?
Stage 0: Carcinoma in situ,
Stage I: Confined to cervix,
Stage II: Spread beyond cervix,
Stage III: Spread to lower vagina or pelvic sidewall,
Stage IVa: Spread to nearby organs,
Stage IVb: Distant metastasis.
What are the histological types of cervical cancer?
Squamous cell carcinoma (70-95%), Adenocarcinoma (20-25%), Adenosquamous carcinoma (3-5%).
What are the symptoms of cervical cancer?
Abnormal vaginal bleeding(post-coital, inter-menstrual, post-menopausal)
Foul-smelling vaginal discharge
Pelvic pain
Leg edema
, Leg pain or swelling, Urinary symptoms, Weight loss, Fatigue.
What investigations are done for cervical cancer?
Pap smear, Biopsy, HPV testing, Tumor markers, VIA, Ultrasound, CT scan, MRI, PET scan.
What are the surgical treatments for cervical cancer?
Conization, Hysterectomy (Radical/Simple), Pelvic exenteration.
What types of radiation therapy are used in cervical cancer?
External Beam Radiation Therapy (EBRT), Brachytherapy.
What is the role of chemotherapy in cervical cancer treatment?
Used in advanced cases, often combined with radiation (chemoradiation), palliative chemotherapy in later stages.
What targeted therapy is used for cervical cancer?
Bevacizumab (Avastin) - Inhibits blood vessel growth in tumors.
What immunotherapy is used for cervical cancer?
Pembrolizumab (Keytruda) - Used for recurrent/advanced cases.
What is endometrial cancer?
Cancer that arises from the glandular tissue within the uterine lining.
What is the lifetime risk of developing endometrial cancer?
1 in 46 pregnancies.
What is the mean age at diagnosis of endometrial cancer?
62 years.
In which racial group is endometrial cancer more common?
More common in white women than in black women.
What are the two main causes of endometrial cancer?
High circulating estrogen levels, Hereditary Non-Polyposis Colon Cancer (HNPCC).
What are the types of endometrial cancer?
Endometrial adenocarcinoma (Type 1), Serous papillary carcinoma (Type 2), Clear cell carcinoma (Type 2).
What are the differences between Type 1 and Type 2 endometrial cancer?
Type 1: Common, younger women, estrogen-dependent, arises from endometrial hyperplasia, good prognosis. Type 2: Less common, older women, estrogen-independent, arises from atrophic endometrium, poor prognosis.
What are the clinical features of endometrial cancer?
Menorrhagia, Metrorrhagia, Post-menopausal bleeding, Foul-smelling vaginal discharge, Abdominal swelling, Pain, Dyspareunia.
What investigations are done for endometrial cancer?
Ultrasound (Endometrial thickness >5mm is suspicious), Cytology of vaginal aspirates, Endometrial curettage, CXR, CT scan, MRI, LFT, Cystoscopy, Sigmoidoscopy, Full blood count.
What is the FIGO staging of endometrial cancer?
Stage 1: Tumor confined to uterus, Stage 2: Tumor invades cervical stroma, Stage 3: Local/regional spread, Stage 4: Invasion of bladder, bowel, distant metastases.
How is endometrial cancer treated at different stages?
Stage 1: TAH + BSO, � radiotherapy.
Stage 2: TAH + BSO + radiotherapy.
Stage 3 & 4: Radiotherapy, chemotherapy (Adriamycin, Cisplatin, Cyclophosphamide), progesterone therapy.
What are the poor prognostic factors for endometrial cancer?
Age >70 years, High BMI, Grade 3 tumor, Serous papillary tumor, Clear cell adenocarcinoma.
