Mindmaps for medicals students - cancer Flashcards
What is cervical cancer?
- Uncontolled differentiation and proliferation of cells lining the cervix
- It may be categorised into two different cell types:
- Squamous cell carcinoma (80%)
- Adenocarcinoma (20%)
Risk factors for cervical cancer
- HPV - types 16, 18 and 33
- most prominant
- HIV
- Multiple pregnancies
- Multiple sexual partners
- Early age of first sexual intercourse
- Comined oral contraceptive pill
- Increasing age
- Low socioeconomic status
- Smoking
Symptoms of cervial cancer
- Intermenstrual bleeding
- Post-coital bleeding
- Post-menopausal bleeding
- Abnormal vaginal discharge
- General symptoms of malignancy
- Asymptomatic - picked up by the national screening programme
How often does screening for cervical cancer take place?
- 3 yearly aged 25-49
- 5 yearly aged 50-64
Investigations for cervical cancer
- General blood tests: FBC, U&E, LFT, TFT
- Colposcopy with biopsy of cervix
- Radiology
- MRI of pelvis
What staging system is used for cervical cancer?
FIGO (Fédération Internationale de Gynécologie et d’Obstétrique) system
How can cervical cancer be prevented?
HPV vaccination offered to school girls aged 12
Treatment for cervical cancer
- Medication
- Chemotherapy and radiotherapy may be required
- Surgical
- Cone biopsy
- Hysterectomy
Complications of cervical cancer
- Psychological implications
- General and specific complications of chemotherapy and radiotherapy
- Lymphodema if lymph nodes removed
- Fistula formation
- Metastases
- Death
What is vaginal cancer?
- Uncontrolled differentiation and proliferation of cells lining the vagina. It may be categorised into different cell types:
- Squamous cell carcinoma (most common)
- Adenocarcinoma
- Clear cell carcinoma
- Germ cell tumours (eg teratomas)
- Melanoma
Risk factors for vaginal cancer
VAGINA
- Viruses (eg HPV, HIV)
- increasing Age
- General factors such as smoking and alcohol
- chronic Irriation (eg from prolonged pessary use)
- Neoplasms (eg having cervical cancer increases the risk of vaginal squamous cell carcinoma)
- vaginal Adenosis
Symptoms of vaginal cancer
- Asymptomatic
- Intermenstrual bleeding
- Post-coital bleeding
- Post-menopausal bleeding
- Abnormal vaginal discharge
- Dyspareunia
- General symptoms of malignancy
Vaginal cancer investigations
- General blood tests: FBC, U&E, LFT, TFT
- Colposcopy with biopsy
- Radiology
- MRI pelvis
Treatment of vaginal cancer
- Chemotherapy and radiation may be required
- Surgical
- Partial or radical vaginectomy
- Radical vaginectomy plus radical hysterectomy
- Pelvic exenteration
Complications of vaginal cancer
- Psychological implications
- Depression and anxiety
- General and specific complications of chemotherapy and radiotherapy
- Lymphoedema if lymph nodes are removed
- Fistula formation
- Metastases
- Death
What is endometrial cancer?
Uncontrolled differentiation and proliferation of the endometrium. It mat be categorised into different cell types, most of which are adenocarcinomas.
Causes of endometrial cancer
It is due to unopposed action of oestrogen on the endometrium.
Risk factors for endometrial cancer
ENDOMETRIUM
- Early menarche
- Nulliparity
- Diabetes mellitus
- polycystic Ovary syndrome
- Menopause
- E
- Tamoxifen
- HRT
- Increased risk with other cancers (eg breast and ovarian)
- Unopposed oestrogen (eg anovulation, HRT)
- Menstrual irregularity
Symptoms of endometrial cancer
- A woman with post menopausal bleeding is considered to have endometrial cancer until proven otherwise
- Premenopausal women: intermenstrual bleeding, post coital bleeding
- General symptoms of malignancy
Investigations for endometrial cancer
- General blood tests: FBC, U&Es, LFTs, TFTs
- Radiology: first line - transvaginal ultrasound scan (<4mm = normal)
- this may be followed by histeroscopy with endometrial biopsy
- MRI of pelvis - for staging and metastases
- Stage using FIGO system of the TNM system
Treatment for endometrial cancer
- Chemotherapy and radiotherapy may be required
- Total abdominal hysterectomy with bilateral salpingecto-oophrectomy +/- lymphadenopathy
Complications for endometrial cancer
- Psychological implications
- Depression and anxiety
- General and specific complications of chemotherapy and radiotherapy
- Lymphoedema if lymph nodes are removed
- Fistula formation
- Metastases
- Death
Risk factors for ovarian cancer
A - increasing Age
B - BRCA1 and BRCA2 genes
C - COCP is protective
D - Duration of ovulation (ie nulliparity, early menarche and late menopause)
E - Endometriosis
Symptoms of ovarian cancer
(Vague)
- Abdominal pain
- Abdominal bloating
- Intermenstrual bleeding
- Post-coital bleeding
- Early satiety
- Symptoms of bladder dysfunction or irritation such as frequency or urgency
- General symptoms of malignancy (eg fatigue, cachexia, weight loss)
Investiagations for ovarian cancer
- General blood tests: FBC, U&Es, LFTs, TFTs
- Tumour marker: CA 125 (diagnosis and follow up)
- Radiology: transvaginal USS
- CT or MRI of pelvis - for staging and metastasis
- Surgery: diagnostic laparotomy with biopsy
- Stage using FIGO system of the TNM system
- Risk of malignancy index
How is risk of malignancy index (RMI) calculated?
RMI is used to calculate risk of having a malignant ovarian tumour.
ultrasound score x menopausal score x CA 125 measurement
Treatment for ovarian cancer
- Chemotherapy usually required and radiotherapy may be required
- Depends on the individual case and may include oophrectomy, salpingectomy, hysterectomy and omentectomy
Complications of ovarian cancer
- Psychological implications
- Depression and anxiety
- General and specific complications of chemotherapy and radiotherapy
- Lymphoedema if lymph nodes are removed
- Fistula formation
- Metastases
- Death
