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Reproductive > Ovarian cancer > Flashcards

Ovarian cancer Flashcards

1
Q

What medication can reduce the risk of ovarian cancer?

A

Oral contraceptive pill (OCP)

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2
Q

What age group is ovarian cancer rare in?

A

<30yrs

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3
Q

What genetics/high risk families can be high risk of developing ovarian cancer?

A

HNPCC/Lynch syndrome
BRAC1
BRAC2

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4
Q

What is the incessant ovulation theory in ovarian cancer?

A

Suggests that the risk of ovarian carcinoma increases as a result of the recurrent minor trauma to the ovarian surface epithelium that occurs during ovulation

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5
Q

What are the signs/symptoms of ovarian cancer?

A 
Often vague
Indigestion/early satiety/poor appetite
Altered bowel habit/pain
Bloating/discomfort/weight gain
Pelvic mass (pressure symptoms or asymptomatic)
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6
Q

What are the diagnostic techniques for ovarian cancer?

A

Surgical/pathological
US abdomen/pelvis
CT
CA125

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7
Q

What is a tumour marker for ovarian cancer?

A

CA 125

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8
Q

What is CA 125

A

Glyco-protein antigen

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9
Q

What benign conditions can CA 125 be raised in?

A 
Menstruation
Endometriosis
PID
Liver disease
Recent surgery
Effusions
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10
Q

What cancers can CA 125 be raised in?

A

Ovarian
Colon/pancreas
Breast

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11
Q

What percentage of women with ovarian cancer have raised CA 125?

A

80%

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12
Q

What is the RMI score?

A

Risk malignancy index

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13
Q

What is the RMI for ovarian cancer?

A

RMI = U x M x CA 125

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14
Q

What is the U and M in the RMI for ovarian cancer?

A 
U = ultrasound evaluation
M = menopausal status
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15
Q

What are ultrasound features you would look for when doing an RMI for ovarian cancer?

A 
Multi-lobular
Solid areas
Bilateral
Ascites
Intra-abdominal
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16
Q

What is the staging for ovarian cancer?

A

Stage 1-4

17
Q

What is stage 1 ovarian cancer?

A

Limited to ovaries with capsule intact

18
Q

What is stage 2 ovarian cancer?

A

One or both ovaries with pelvic extension

19
Q

What is stage 3 ovarian cancer?

A

One or both ovaries with peritoneal implants outside pelvis or + nodes

20
Q

What is stage 4 ovarian cancer?

A

Distant metastasis

21
Q

What are the two main options for treatment for ovarian cancer?

A

Surgery

Chemotherapy

22
Q

What are the surgery options for ovarian cancer?

A

Laparotomy
Total abdominal hysterectomy (TAH)
Bilateral salpingo-oophorectomy (BSO)

23
Q

What happens during a laparotomy for ovarian cancer?

A

Obtain tissue diagnosis
Stage disease
Disease clearance
Debulk disease

24
Q

What is the first line chemotherapy for ovarian cancer?

A

Platinum and taxane (Taxol)

25
Q

When is chemotherapy given for ovarian cancer?

A

Within 8 weeks of surgery
Complete/partial response
Cure unlikely
Average response 2yrs

26
Q

What is the management if there is recurrence of ovarian cancer?

A 
Chemotherapy
Palliation
Platinum >6mo
?Surgery
Tamoxifen
27
Q

Why tamoxifen in ovarian cancer?

A

Keep any estrogens circulating in the woman’s body from stimulating cancer cell growth

28
Q

Who is screened for ovarian cancer?

A

High risk women: cancer gene mutation carriers, 2+ relatives

29
Q

What can be screened for ovarian cancer?

A

Pelvic examination
US ovaries
CA 125

30
Q

What surgery can be recommended for women at high risk of ovarian cancer?

A

Prophylactic oophorectomy

31
Q

At what stage does ovarian cancer usually present?

A

Stage 3/4 disease

32
Q

What are the normal values of CA 125?

A

<46 U/mL

33
Q

What is the main type of ovarian cancer?

A

Epithelial

34
Q

What is the main type of epithelial ovarian cancer?

A

Serous

35
Q

What are the risk factors for ovarian cancer?

A 
Low parity/infertility
Early menarche
Late menopause
HRT
Obesity
Smoking
Previous IBD
Breast/bowel cancer
Endometriosis
Genetic
Developed world
36
Q

What are protective factors for ovarian cancer?

A

OCP
Childbearing
Breast feeding
Hysterectomy

37
Q

What is not present in ovarian cancer which you’d expect of a gynaecological cancer?

A

Vaginal discharge and blood

38
Q

What are some DD for ovarian cancer?

A 
Benign ovarian tumours/cysts
Fibroids
Pelvic malignancies
Endometriosis
IBS/IBD
Constipation
Coeliac
Gastroenteritis
Diverticulitis
39
Q

Where does ovarian cancer typically spread to?

A 
*Greater omentum
Liver
Lungs
Bone
Cerebrum
Lymph nodes

Reproductive (20 decks)

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