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reproductive system > ovarian cancer > Flashcards

ovarian cancer Flashcards

1
Q

What is the epidemiology of ovarian cancer?

A
  • 600 cases per year in Scotland
  • 400 deaths per year in Scotland
  • 5year survival all stages 40-45%
  • Most present with advanced disease
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2
Q

What is the origin of ovarian cancer?

A
  • Most cases originate from the fallopian tube

- Some from pre-existing benign ovarian cysts (often low grade cancers)

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3
Q

What medication is protective in ovarian cancer?

A

OCP

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4
Q

In what age group is ovarian cancer rare?

A

<30 years

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5
Q

What families are at high risk?

A

Account for 5-10% of cases and include:

  • HNPCC/Lynch type II familial cancer syndrome
  • BRCA1
  • BRCA2
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6
Q

What is the inheritance of BRCA genes?

A

Autosomal dominant

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7
Q

What are BRCA genes?

A

Tumour suppressor genes involved in DNA repair and cell cycle control

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8
Q

What are the symptoms of ovarian cancer?

A

VERY VAGUE

  • Indigestion/early satiety/ poor appetite
  • Altered bowel habit/pain
  • Bloating/discomfort/weight gain
  • Pelvic mass (asymptomatic or pressure symptoms)
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9
Q

How is ovarian cancer diagnosed?

A
  • Surgical/Pathological
  • US Scan abdomen and pelvis
  • CT Scan
  • CA 125
  • Surgery
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10
Q

What is CA 125?

A

A glyco-protein antigen

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11
Q

What malignancies is CA 125 associated with?

A
  • Ovarian
  • Colon/pancreas
  • Breast
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12
Q

What benign conditions is CA 125 associated with?

A
  • Menstruation/endometriosis/PID

- Liver disease/recent surgery/effusions

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13
Q

What is the association between CA 125 and ovarian cancer?

A
  • 80% of women with ovarian cancer have a raised CA 125

- 50% of women with stage 1 disease

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14
Q

What role does CA 125 play in ovarian cancer?

A

Used to detect and monitor epithelial ovarian tumour

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15
Q

What is used to determine risk of ovarian cancer?

A

Risk of malignancy index

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16
Q

What are the components of the risk of malignancy index?

A
  • Ultrasound features
  • Menopausal status
  • CA 125 levels
17
Q

What are the ultrasound features used in the RMI?

A
  • Multi-locular
  • Solid areas
  • Bilateral
  • Ascites
  • Intra-abdominal
18
Q

How is RMI calculated?

A

UxMxCA125

1 US feature= 1
2-5 US feature= 3

Pre-menopausal=1
Post-menopausal=3

19
Q

How is ovarian cancer treated?

A
  • Surgery

- Chemotherapy (adjuvant/neoadjuvant)

20
Q

What is the gold standard treatment for ovarian cancer?

A

Surgery

21
Q

What are the aims of laparotomy?

A
  • Obtain tissue diagnosis
  • Stage disease
  • Disease clearance
  • Debulk disease
22
Q

How is chemotherapy used in ovarian cancer?

A
  • First line Platinum and taxane (Taxol)
  • Within 8 weeks of surgery
  • Complete/partial response
  • Cure unlikely
  • Average response 2 years
23
Q

What are the cure rate relevant to stage for ovarian cancer?

A
  • Stage 1= 85%
  • Stage 2= 47%
  • Stage 3= 15%
  • Stage 4= 10%
24
Q

How can ovarian cancer recurrence be managed?

A
  • Chemotherapy
  • Palliation for symptomatic recurrence
  • Platinum if > 6months
  • ?Surgery
  • Tamoxifen
25
Q

Who is screened for ovarian cancer?

A

High risk women

  • Cancer gene mutation carriers
  • 2 or more relatives
26
Q

How is ovarian cancer screened for?

A
  • Pelvic examination
  • US scanning of ovaries
  • CA 125
27
Q

Why is ovarian cancer not screened for in the general population?

A
  • Not recommended
  • Limited sensitivity and specificity
  • Cannot pick up pre-cancerous changes
28
Q

What can at risk women be offered?

A

Prophylactic oophorectomy and salpingectomy

29
Q

What stage does it often present in?

A

Presents late at satge 3 or 4

30
Q

What is the normal range of CA 125?

A

0-35

31
Q

What RMI is highly suggestive of malignancy

A

> 200

32
Q

What system is used for staging ovarian cancer?

A

FIGO staging

33
Q

What are the FIGO stages of ovarian cancer?

A
  • Stage 0: carcinoma in situ (common in cervical, vaginal, and vulval cancer)
  • Stage I: confined to the organ of origin
  • Stage II: invasion of surrounding organs or tissue
  • Stage III: spread to distant nodes or tissue within the pelvis
  • Stage IV: distant metastasis

reproductive system (31 decks)

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