Flashcards in Gynaecological Cancers Deck (9):
1
What are some protective factors for ovarian cancer?
Oral contraceptive pill
Tubal ligation
Breast feeding
Ovulation suppression
2
What are some genetic mutations pre-disposing to ovarian cancer?
BRCA 1- 15-45% risk of ovarian
BRCA 2- 10-20% risk of ovarian
HNPCC
3
What are some pathological types of ovarian cancer?
Serous (80%)
Endometrioid (10%)
Clear cell (5%)
4
Symptoms of ovarian cancer?
Asymptomatic until late stage
Abdo pain, constipation, diarrhoea, urinary freq, vaginal bleeding, ascites
5
Stage of ovarian cancer?
Stage 1 - confined to ovaries
Stage 2 - extension into pelvis
Stage 3 - extension into peritoneum
Stage 4 - distant metastases
Ascites = stage c
Stage 1-2 = early
Stage 2-3 = advanced
6
Management of early stage ovarian cancer?
Surgical resection to remove all visible disease
- BSO + TAH, omenectomy, appendectomy, lymphadenectomy
Adjuvant chemotherapy recommended in high risk disease (greater then 1a - confined to 1 ovary, grade 3, clear cell)
Carboplatin and paclitaxel
7
Management of advanced ovarian cancer?
Cytoreductive surgery cornerstone of management
- better cytoreduction = correlates with better survival
Can consider neo adjuvant or adjuvant chemotherapy with carbo/paclitaxel
Aiming for 6 cycles
8
Management of relapsed disease?
Depends on progression free interval
Platinum refractory - relapse on treatment or within 4 weeks
Platinum resistant - within 6 months
Platinum sensitive - more then 12 months
Retrial platinum if sensitive
Otherwise use single sequential single agent chemotherapy
9