Menopause & Cancer

Question 1

What is average menopause age?

Answer 1

45-50

Question 2

What causes changes in temperature regulation during menopause?

Answer 2

Decrease in estrogen levels lead to vasodilation

Question 3

Decrease in estrogen levels can lead to ____.

Answer 3

Bone loss (osteoporosis)

Question 4

What are the most common complaints during menopause?

Answer 4

Hot flashes/flushes, vaginal dryness, depression, mood swings, irritability

Question 5

What is osteoporosis?

Answer 5

Decreased bone density due to decrease in estrogen. Makes bones susceptible to fractures. Body breaks down bones for calcium.

Question 6

What are some risk factors for osteoporosis?

Answer 6

Small-boned, thin-build. Low body weight. Family history, lack of wt. bearing exercise. Never pregnant. Early menopause. Drinking, smoking. Euro-American, Asian.

Question 7

How do we diagnose osteoporosis?

Answer 7

Bone mineral density test (DEXA / DXA scan). All woman over 65, men over 70

Question 8

When should a woman begin therapy for osteoporosis?

Answer 8

T-score of -2.5 or lower should begin therapy.

Question 9

What are some treatments for osteoporosis?

Answer 9

Calcium & vitamin D supplements. Hormone therapy. Bisphosphonates (antiresorptive drugs). Biologics (Q6 injection). Anabolic agents (build bone)

Question 10

What is hormone replacement therapy (HRT)?

Answer 10

Therapy for menopause. Not required, should be short-term usually. Oral pills, patches, creams, gels, etc.

Question 11

When is both estrogen and progesterone given as HRT?

Answer 11

When the woman still has her uterus

Question 12

When is ONLY estrogen given as HRT?

Answer 12

If woman has no uterus (for non-cancer reasons I.e. fibroids)

Question 13

What are symptoms of vulvo-vaginal atrophy?

Answer 13

Itching, burning, sexual discomfort

Question 14

What are some treatments for vulvo-vaginal atrophy?

Answer 14

Water soluble lubricants or estrogen.

Question 15

What are some risk factors for breast cancer?

Answer 15

Female, older than 55, white, early period start, never pregnant or pregnant > 30, genetics, long-term HRT use, overweight

Question 16

What genetic mutation increases risk for breast cancer?

Answer 16

BRCA1 or BRCA2

Question 17

Who is at risk for the BRCA mutation?

Answer 17

Family hx of breast cancer <50. Other cancers in family. Ashkenazi Jewish. African American with breast cancer <35.

Question 18

What are some S&S of breast cancer?

Answer 18

• A palpable lump
• Skin discoloration, thickening, Peau d’orange
• Itching, redness, scaling of nipple
• Large axillary lymph node
• Focal pain

Question 19

When is hormonal therapy good for breast cancer?

Answer 19

When the specific breast cancer is sensitive to hormones.

Question 20

Why has the cervical cancer death rate dropped?

Answer 20

Increased people getting pap tests!

Question 21

What can low-risk HPV cause?

Answer 21

A few genital, anal, mouth warts. Generally harmless.

Question 22

What can high-risk HPVs cause?

Answer 22

Cancer

Question 23

How is HPV transmitted?

Answer 23

Intercourse, anal, oral sex.

Question 24

What increases risk for ovarian cancer?

Answer 24

Family history, genetic mutations, post-menopausal, increased age

Question 25

What decreases risk for ovarian cancer?

Answer 25

Pregnancy, breastfeeding, oral contraceptives

Question 26

Treatment for ovarian cancer?

Answer 26

Surgery then chemotherapy. 5 year survival rate dependent on stage at diagnosis and response to chemo.

Question 27

What is the primary symptom of endometrial cancer?

Answer 27

Abnormal vaginal bleeding near or after menopause.

Question 28

What is the highest cure rate with endometrial cancer?

Answer 28

Surgery (hysterectomy and salpingo oophorectomy)… chemo and radiation can be used in poor surgical candidates