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Yr 3 - Cancer > Ovarian Cancer > Flashcards

Ovarian Cancer Flashcards

1
Q

Why is it that ovarian cancer typically presents late?

A

It has very non-specific symptoms

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2
Q

What are the three types of ovarian tumours?

A
  1. epithelial cell tumours
  2. Germ cell tumours
  3. Sex cord stromal tumours
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3
Q

What is the most common type of ovarian tumour?

A

Epithelial cell tumours

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4
Q

What are the 5 subtypes of ovarian cancer?

A
  1. Serous tumours
  2. Endometrial tumours
  3. Clear cell tumours
  4. Mucinous tumours
  5. Undifferentiated tumours
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5
Q

Are ovarian germ cell tumours benign or malignant?

A

Benign

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6
Q

What is another name given to ovarian germ cell tumours?

A

Dermoid tumours / Teratoma

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7
Q

Describe the composition of ovarian germ cell tumours:

A

teratomas contain various tissue types such as skin, teeth, hair and bone

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8
Q

What two blood markers are ovarian germ cell tumours associated with?

A

1) alpha fetoprotein
2) human gonadotropin (hCG)

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9
Q

Are sex cord stromal tumours benign or malignant?

A

either

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10
Q

What are sex cord stromal tumours?

A

rare ovarian tumours that arise from connective tissue or sex cords

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11
Q

What are sex cords?

A

embryonic structures associated with follicles

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12
Q

Give two examples of sex cord stromal tumour subtypes:

A

1) Sertoli-Leydig cell tumours
2) granulosa cell tumours

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13
Q

What percent of ovarian tumours are epithelial?

A

85-90%

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14
Q

What percent of ovarian cancer are germ cell tumours?

A

5-7%

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15
Q

What percent of ovarian cancers are Sex-cord stromal?

A

5-7%

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16
Q

What is the breakdown of the epidemiology of epithelial tumours?

A

Serous – most common – about 50% of cases
Endometroid – 20%
Clear cell tumours – 6%
Mucinous – 10%
Brenner – rare
Undifferentiated

17
Q

What are hormone factors that increase the risk of epithelial ovarian cancer?

A
  1. increased risk with low fertility
  2. Early menarche
  3. LAte menopause
  4. Use of HRT
18
Q

What are lifestyle factors that increase the risk of epithelial ovarian cancer?

A
  1. Obesity
  2. Smoking
  3. Lack of exercise
  4. Talc powder used pre 1975
  5. Exposure to asbestos
19
Q

What are previous medical history factors that increase the risk of epithelial ovarian cancer?

A
  1. pelvic inflammatory disease
  2. cancer of breast or bowel
  3. Increasing age
  4. endometriosis
20
Q

What are genetic factors that increase the risk of epithelial ovarian cancer?

A
  1. Family history
  2. BRCA1, BRCA 2, HPNCC
21
Q

What is a protective factor against ovarian cancer?

A
  1. Use of oestrogen containing contraceptives
22
Q

What are some symptoms of ovarian cancer?

A
  1. Vague abdominal distention
  2. Urinary frequency
  3. Dysuria
  4. Fever
  5. Weight Loss
  6. Pelvic mass
  7. Acites
  8. Abnormal uterine bleeding
  9. Rupture/local peritonism
23
Q

What is the name given to secondary tumours in the ovary?

A

Krukenberg tumours

24
Q

Which primary tumours commonly give rise to ovarian cancer?

A

GI cancer (stomach)

25
Q

What is the characteristic sign of a Krukenberg tumour on histology?

A

Signet ring

26
Q

Give 6 risk factors for ovarian cancer:

A

1) age (peak incidence at 60)
2) BRCA1 and BRCA2
3) increased number of ovulation
4) obesity
5) smoking
6) repeat use of clomifene (infertility treatment)

27
Q

Give 3 ovarian cancer red flag symptoms that warrant an immediate 2WW referral:

A

1) ascites
2) pelvic mass
3) abdominal mass

28
Q

Give 6 symptoms that indicate the need for a CA125 blood test:

A

1) new symptoms of IBS
2) bloating
3) early satiety
4) pelvic pain
5) urinary frequency and urgency
6) weight loss

29
Q

CA125 is not specific to ovarian cancer - give 6 other conditions where it may be raised:

A

1) fibroids
2) endometriosis
3) adenomyosis
4) pelvic infection
5) liver disease
6) pregnancy

30
Q

What criteria is used to estimate risk of ovarian cancer?

A

Risk of Malignancy Index

31
Q

What three factors does the Risk of Malignancy Index take into account when assessing risk of ovarian cancer?

A

1) menopausal status
2) ultrasound findings
3) CA125 level

32
Q

In what instance would alpha-fetoprotein and HCG testing be indicated in the context of ovarian cancer?

A

if the patient is under 40 with a complex ovarian mass (this points towards a germ cell tumour which would produce alpha-FP and HCG)

33
Q

What is the name of the ovarian cancer staging system?

A

FIGO staging

34
Q

Summarise FIGO staging for ovarian cancer:

A

1) stage 1 - confined to the ovary
2) stage 2 - spread outside of ovary but inside pelvis
3) stage 3 - spread outside pelvis but inside abdomen
4) stage 4 - spread outside of the abdomen (distant metastases)

35
Q

What is the typically treatment plan for ovarian cancer?

A

a combination of surgery and chemotherapy

36
Q

what is the epidemiology of ovarian cancer?

A

60yrs

37
Q

what is the prognosis of ovarian cancer?

A

poor

  • usually advanced disease at presentation

Yr 3 - Cancer (8 decks)

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