Gynae cancer Flashcards Preview

Oncology + Palliative > Gynae cancer > Flashcards

Flashcards in Gynae cancer Deck (22):
1

Cervical cancer screening - how often, what is assessed

3 yearly 25-50 5 yearly 50-64 Swept over transformation zone - assessing dyskaryosis

2

Assessment of dyskaryosis - what are the histological findings

Nuclear enlargement, variation in size + shape of nuclei, hyperchromasia, reduction in cytoplasm

CIN appears white when stained with 5% acetic acid 

3

CIN - causes

Cervical intraepithelial neoplasia Needs infection with HPV 16, 18, 31, 33

4

RF for CIN

Persistent HPV infection Multiple partners Smoking Immunocompromise COCP

5

S+S cervical cancer

PCB PMB Vaginal discharge Advanced: heavy bleeding, ureteric obstruction, weight loss, bowel disturbance, swollen legs, fistulas

6

Cervical cancer investigations + management (stage 1a1, 1a2-1b1, 1b2 + >1b2)

Colposcopy, histology, MRI for staging

Stage 1a1: local excision (cone biopsy) 

Stage 1a2 - 1b1: lymphadectomy + Wertheims hysterectomy 

Stage 1b2: RT + lymphadectomy + Wertheims hysterectomy 

>1B2: RT

7

Endometrial cancer causes

Unopposed oestrogen leads to hyperplasia Oestrogen comes from: Peripheral conversion in adipose tissue Granulosa cell tumour PCOS Oestrogen only HRT Tamoxifen

8

RF for endometrial cancer

Obesity Nulliparity PCOS Early menarche/ late menopause HNPCC Breast cancer - tamoxifen use

9

S+S endometrial cancer

PMB Menstrual disturbance PV discharge

10

Diagnosis of endometrial cancer

TVUSS (endometrial thickness) MRI pelvis CXR (for staging) Endometrial biopsy if >4mm

11

Endometrial cancer staging

I = confined to uterus II = involving cervix III = spread outside the uterus IV = bowel, bladder or distant organ involvement

12

Management of endometrial cancer

Total abdominal hysterectomy with bilateral salpingo-oophrectomy

13

Types of ovarian tumours

Epithelial - from Mullerian epithelium Sex cord Germ cell

14

Causes/RF of ovarian cancer

Irritation of ovarian epithelium, due to damage during ovulation RF: multiple ovulations Nulliparity, endometriosis, early menarche, late menopause, HRT BRCA 1 (39% chance of developing ovarian cancer) BRCA 2 (11%) HNPCC (12%)

15

S+S ovarian cancer

Abdo distension, pain Pressure effects on bladder + rectum SOB, GI upset Abnormal vaginal bleeding Ascites Presents late

16

Ovarian cancer investigations

CA125, Pelvic USS, CXR

17

Ovarian cancer management

Laparotomy, hysterectomy, BSO Adjuvant chemo

18

Vulval carcinoma

90% squamous cell Commonly arise on a background of lichen sclerosus or VIN VIN = associated with HPV (16) S+S: lump, pain, irritation, bleeding Surgery + groin lymphadenopathy

Ulcer with indurated base + everted margins 

19

Classification of CIN

lower 1/3 of epithelium, CIN 2 = lower 2/3 epithelium, CIN 3 – full thickness of endothelium

20

management of CIN 2-3

treat with excision to depth of 8mm via LLETZ (large loop excision of transformation zone) – increases risk of preterm labour

21

Follow up after CIN findings 

Cytology at 6 months

22

Staging of ovarian cancer

1 = limited to ovaries, 2 = pelvic implantation, 3 = peritoneal implants/ small bowel/ omentum 4 = distant mets