Ovarian Cancer Flashcards

1
Q

What increases chance of getting ovarian canceR?

A

no. of times u have ovulated increases risk

FHx of tumour marker

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2
Q

What are RF

A

− Nulliparity
− Early menarche/late menopause
− BRCA 1 and 2
HNPCC (commonest form of hereditary colorectal cancer)

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3
Q

What are protective factors

A

− Pregnancy
− Breastfeeding
− COCP
− Tubal ligation

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4
Q

What cells are most ovarian cancers made up of

A

epithelial cells

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5
Q

What is presentation

A

Often vague sx which can look like IBS or diverticular disease
• Bloating / ‘IBS’ like symptoms
• Weight loss, loss of appetite, early satiety
• Abdominal/pelvic pain
• Fatigue
• Change in bowel habit
• Urinary frequency
• Bowel obstruction
• Cachexia (weakness and wasting of body)

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6
Q

What can be found on examination

A
→	Fixed abdo/pelvic mass  
→	Ascites
→	Omental mass
→	Pleural effusion 
→	Supraclavicular node enlargement
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7
Q

What are ix

A
  • CA125 - w bloating or new IBS symptoms >55
  • They have a USS related to symptoms and age
  • Referral based on risk of malignancy index
  • CXR
  • CT abdo/pelvis
  • CEA (tumour marker) raised in colorectal cancers but not ovarian
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8
Q

Explain RMI

A

Risk of malignancy index
RMI = U x M x CA125
U = US score (0, 1 or 3)
M = menopausal status (1 = premenopausal, 3 = postmenopausal)

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9
Q

What is low risk score of RMI

A

<25

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10
Q

What is mod risk of RMI

A

25-250

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11
Q

What is high risk of RMI

A

> 250

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12
Q

Explain FIGO staging of ovarian cancer

A
I
One or both ovaries 
II
Limited to pelvis
III
Limited to abdomen, including regional LN
IV
Distant metastases outside abdo cavity
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13
Q

What is treatment

A

Surgery (full stage laparotomy) + neoadjuvant chemo

platinum therapy - carboplatin or paclitaxel

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14
Q

What is involved in full stage laparatomy

A

i. Midline laparotomy
ii. Hysterectomy
iii. Bilateral salpingo-oophorectomy
iv. Omentectomy
v. Para-aortic and pelvic LN sampling
vi. Peritoneal washings and biopsies

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