L70 Flashcards
Does too much or too little E put you at risk for risk for endometrial cancer?
Excess E - endo prolif
- Tamoxifen
- Obesity
- Diabetes
- No preg/early periods/late menopause
TESTQ: presenting symptom of endometrial cancer + follow up
Post-meno bleeding
Do biopsy, possible followed by D&C if need more tissue
What are the 2 types of endometrial hyperplasia?
Non-atypical = benign Atypical = pre-cancerous
Is endometrial cancer surgically or clinically staged?
Surg
What is an endometrioid cancer?
Endometrial hyperplasia that still resembles the tissue of origin
Treat endometrial cancer for post-meno pt
Surgery - likely partial/full hysterectomy
Adj therapy of some kind
Treat endometrial cancer for a woman who still wants to have kids
+ Progesterone (PO or IUD) - only for low grade/stage cancers
What are some of the different types of uterine sarcomas?
MMMT = carcinosarcoma
Leio-myo-sarcoma
Overall sarcomas = rarer = more aggressive
Anti-step: is grade of stage the most important prognostic factor for endometrial cancer?
Grade… lol its actually stage for step
You know what strains of HPV go in the cervical cancer vaccine, but what part of the virus is used to make it?
Empty viral capsid - makes sense! You just need to recognize the outside
What are the 2 parts of cervical cancer screening?
- Pap smear
2. If see, ASC-US do HPV testing
What are the next steps if an HPV test comes back positive?
Colposcopy determines abnormal areas for biopsy
TESTQ: presentation of invasive cervical carcinoma
Bleeding after sex
Most common types of invasive cervical cancer
SCC - from exocervix
Adenocarcinoma - from endocervix
Is cervical cancer staged surgically or clinically?
Clinically
Look for LOCAL spread: involved the vagina? Pelvic side walls? Bladder/ureters?
Treat cervical cancer
Based on stage
Surg + rad +/- chemo
What are the 3 categories of endometrial cancers?
- Epithelial cell cancer - most
- Stromal cell cancer = granulosa or Leydig/Sertoli cells
- Germ cell tumors
How does ovulation play into your risk of ovarian cancer?
More ovulation cycles = higher risk
Preg, PO birth control, breast feeding all protective
2 genetic risk factors for ovarian cancer
BRCA 1/2
HNPCC (Lynch syndrome)
Ovarian cancer presenting symptoms
Non-specific!!!
Bloating + fuller ab size
Marker for endometrial cancer that you can test for
CA-125 - not screening
For treatment response and recurrance
What might ovarian mets look like
Seed the abdomen
- Ascities
- Omental caking = thickening of omental fat
Is ovarian cancer staged clinically or surgically?
Surg - examine regional LN specimens
Treat high vs low stage ovarian cancer
Low - surg only
High - surg + adj chemo
Chemo = intraperitoneal carboplatin/taxol
Are you worried about ovarian cancer recurrence?
YEP - even if you go into remission, you’ll relapse at some point
Where does endo vs cervical vs ovarian cancer met
Endo to LNs
Cervix locally
Ovarian into peritoneum
What is the tumor marker for a dysgerminoma? (ovarian germ cell tumor)
LDH
What is the tumor marker for a yolk sac tumor? (ovarian germ cell tumor)
AFP
What is the tumor marker for choriocarcinoma? (ovarian germ cell tumor)
HCG
