ovarian, vulval & vaginal cancer

Question 1

name the 3 radical tx options for ovarian cancer

Answer 1

surgery - removal of both ovaries, uterus and omentum - if full resectable surgery not achievable then debunking surgery can be used

Chemotherapy - ADJUVANT to surgery to prevent relapse - paclitaxel and carboplatin

EBRT - sometimes used for clear cell carcinomas but otherwise only role is palliative

Question 2

name two rare ovarian cancers

Answer 2

germ cell tumours
sex-chord tumours

Question 3

name 3 txs for sex-chord

Answer 3

surgery - predominant option removing both ovaries or conserving 1 to preserve fertility
chemo - cisplatin used for palliation
rt- only palliative

Question 4

name 3 txs for germ cell tumours

Answer 4

surgery - removal of one ovary to preserve fertility
chemo - very chemo sensitive so good and if pts relapse
rt- quite radiosensitive an given as 20in10# or 40in20# but not as conservative as chemo

Question 5

what are the 2 desired tx of vagina cancer

Answer 5

rt- whole vagina and pelvic LNs with concurrent chemo - then followed by BT if in upper 1/2 or EBRT BOOST if in lower 1/2 vagina
Chemo - if fit enough concurrent chemo as cisplatin improves outcome

Question 6

what are the 2 main tx options for vulval cancer

Answer 6

surgery - triple incision technique, a bilateral groin node dissection and radical vulvectomy (GOLD STANDRAD)
chemorad - cisplatin concurrent with rt can shrink inoperable tumours but difficulty with rt effectiveness due to skin folds and severe reactions in tx area