Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
62 Cards in this Set
- Front
- Back
|
#1 Gynecologic cancer |
Endometrial/Uterine |
|
|
What is the triad of obesity? |
50+ lbs overweight High blood pressure Diabetic |
|
|
Risk factors for uterine cancer: |
Triad of obesity Hormonal factors |
|
|
Most common histology of uterine cancer: |
Adenocarcinoma |
|
|
Symptoms of uterine cancer: |
Post menopausal bleeding Smelling vaginal discharge Pelvic pain or pressure |
|
|
Primary treatment option for uterine cancer: |
Surgery- hysterectomy |
|
|
When is radiation used for uterine cancer? |
Tumor extends beyond 1/2 of the myometrium or beyond the uterus |
|
|
Most common histology of ovarian cancer: |
Epithelial |
|
|
Most ovarian cancers present in what stage |
Stage 3, 80% with abdominal cavity involvement |
|
|
Risk factors for ovarian cancer: |
-Age -Nulliparity -Late menopause -Lack of oral contraceptive use -Family history -Personal history of breast, colon, or endometrial cancer -History of endometriosis |
|
|
Symptoms of ovarian cancer: |
No early symptoms Late symptoms: -Pelvic or abdominal pain -Back pain -Bloating or distension -Nonspecific GI symptoms -Change in bowel/bladder habits -Abnormal vaginal discharge or bleeding |
|
|
Initial treatment option for ovarian treatment: |
Surgery |
|
|
Standard post op treatment for ovarian cancer: |
Chemo |
|
|
What treatment was used historically for ovarian cancer? |
Whole abdomen radiation |
|
|
What may be used to treat the peritoneal cavity in high risk patients? |
Phosphorus 32 |
|
|
Specific type of ovarian tumor, often bilateral, which is commonly secondary to a GI malignancy |
Krukenberg Tumor |
|
|
Most common location of cervical cancer: |
Squamo-columnar junction |
|
|
Opening of cervix |
Endocervical canal or external os |
|
|
Risk factors for cervical cancer: |
Smoking Low socio economic status Early onset sexual activity Multiple partners Exposure to STDs Oral contraceptives |
|
|
Symptoms of cervical cancer: |
May not be any for early disease Irregular bleeding Foul odor Pelvic pain Back pain Dysuria |
|
|
Most common histology for cervical cancer: |
Squamous cell or epidermois carcinoma |
|
|
Most common cervical cancer histology with DES exposure: |
Clear cell |
|
|
Screening guidelines for cervical cancer: |
-Begin at 21 years of age - 21-29 years should have pap every 3 years -30-65 years should have PAP and HPV every 5 years or PAP every 3 - >65 with normal regular screenings do not need continued screening |
|
|
Common external radiation dose for cervical cancer |
40-50 Gy |
|
|
Intracavitary doses for cervical cancer: |
80-85 cGy to point A |
|
|
Lymph nodes of interest for cervical cancer: |
Parametrial, common iliac, inernal iliacs, external iliacs, obturator, periaortics, supraclav |
|
|
Periaortic involvement in cervical cancer leads to 35% chance of spread to where? |
Suprclavicular |
|
|
Common distant metastatic sites for cervical cancer: |
Lung and liver |
|
|
Cervical cancer treatment fields |
Superior L4-5 Vaginal s.w. 1.5-2 cm <1 cm margin of vagina included |
|
|
LDR DoseHDR Dose |
LDR .4-2 Gy/hr HDR >12 Gy/hr |
|
|
Advantages of remote afterloaders: |
-Increased patient treatment capacity -Consistent and reproducible treatment delivery -Reduced radiation exposure of staff |
|
|
Advantages of HDR over LDR: |
- Optimization of dose distribution - Outpatient treatments - Elimination of staff radiation exposure |
|
|
Cervical Brachytherapy Point A location |
2 cm superior/ 2 cm lateral to cervical os - Crossover of the ureter and uterine artery, located in the paracervical triangle |
|
|
Cervical Brachytherapy Point B location |
3 cm lateral to point A or 2 cm superior & 5 cm lateral to cervical os - 1 cm lateral to the medial aspect of the pelvic side wall |
|
|
What is vulvar cancer associated with? |
STDs and diabetes |
|
|
Most common histology of vulvar cancer: |
Squamous cell carcinoma |
|
|
Symptoms of vulvar cancer: |
Subcutaneous mass Pelvic pressure/pain Itching Skin/color changes |
|
|
Most common location of vulvar cancer |
Labia majora |
|
|
Lymphatics of interest for vulvar cancer |
Inguinal nodes, deep femoral nodes, pelvic notes (internal, external, obturators) |
|
|
Most common histology of vaginal cancer: |
Squamous cell cancer |
|
|
Symptoms of vaginal cancer: |
Painful intercourse, vaginal bleeding |
|
|
#1 location of vaginal cancer |
Upper posterior 1/3 |
|
|
Lymphatic drainage of vaginal cancer: |
Inguinal nodes if middle or lower third of vagina included |
|
|
Treatment of choice for vaginal cancer: |
Radiation 45-50 Gy whole pelvis Boost 65-80 Gy
Surgery for recurrent disease and to tx clear cell cancer to young patients |
|
|
Acute side effects of pelvic irradiation: |
Fatigue Diarrhea Dermatitis Erythema Dysuria Moist desquamation |
|
|
Chronic side effects of pelvic irradiation: |
Menopause Vaginal dryness Vaginal shrinking Chronic cystitis Enteritis Bowel obstruction |
|
|
What to do for diarrhea: |
-Low fiber diet -Sucralfate-bowel coating agent -Lomotil -Loperamid (immodium) |
|
|
What to do for Nausea: |
Compazine, Kytril, H2 blockers like togamet, zantac, pepcid, axid |
|
|
What to do for dysuria: |
Pyridium, Urised, Ditropam, Levisin, Hyrin |
|
|
What to do for dermatitis: |
Domboros soak, aquaphor, natural care gels |
|
|
Tolerance dose for rectum/bladder when treating the pelvis: |
No more than 55% above 47 Gy |
|
|
Tolerance dose for femoral heads when treating the pelvis: |
No more than 50% above 30 Gy |
|
|
Tolerance dose for spinal cord when treating the pelvis: |
Maximum less than or equal to 45 Gy |
|
|
Tolerance dose for kidneys when treating the pelvis: |
Mean dose to bilateral kidneys should be 18 Gy |
|
|
Application of a brachytherapy implant directly into the tissues via devices such as needles, ribbons, or seeds placed in the at risk tissues
|
Interstitial implant |
|
|
Brachytherapy device placed through the cervical os into the uterus and subsequently afterloaded to give the dose application directly to the cervix, uterus, and upper vagina
|
Intrauterine tandem
|
|
|
Shielding block used to eliminate dose to centrally located anatomy
|
Midline block
|
|
|
Tissues lateral to and around the uterus
|
Parametrium
|
|
|
Dilation of the surface blood vessels caused by the loss of capillary tone, resulting in a fine spider vein appearance on the skin surface
|
Telangiectasia
|
|
|
Paired brachytherapy devices that allow insertion into the lateral vaginal fornices or apex of the vagina for intracavitary treatment. These are usually shielded anteriorly and posteriorly for greater lateral throw of the dose
|
Vaginal colpostats
|
|
|
Small rim of vaginal tissue at the apex of the vagina around the cervix.
|
Vaginal cuff
|
|
|
Domed ended tubular brachytherapy device used to give even dose distribution to the apex or entire vaginal surface
|
Vaginal cylinder
|
