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19 Cards in this Set
- Front
- Back
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What types of cancers are included in "Gynecological Oncology"?
Which is the most common? |
cancers of the vulva, vagina, cervix, uterus, fallopian tubes, ovaries
-- most common = Endometrial Cancer |
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Etiology of Endometrial Cancer?
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estrogen stimulates growth of endometrium
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Etiology of Ovarian Cancer?
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unknown.... several theories:
- cyclic injury to surface of ovary by ovulation - direct communication between external environ and peritoneal cavity (via endometrial canal and fall tubes) has some relation - genetics (5-10%) - e.g., BRCA mutation |
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Etiology of Cervical Cancer?
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HPV
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Endometrial Cancer
- Risk factors? - Protective factors? |
Risk Factors:
- nulliparity - infertility - anovulation - early menarchy; late menopause - ERT (HRT) - Tamoxifen - Obesity - Granulose Cell Tumors - HTN - Diabetes - Gall Bladder Disease - Thyroid Disease Protective Factors: - Combo: OC pills and pregnancy - smoking |
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Ovarian Cancer
- Risk Factors? - Protective Factors? |
Risk Factors:
- early menarche; late menopause - nulliparity - infertility - ovulation - induction medications - family hx Protective Factors - OC pills - pregnancy - breast feeding - tubal ligation - hysterectomy - oophorectomy (esp if BRCA mutation) |
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For what cancer is SMOKING a PROTECTIVE factor??
Risk factor? |
Endometrial Cancer (protective)
(risk for cervical cancer) |
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For what cancer is Breastfeeding a PROTECTIVE FACTOR?
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Ovarian Cancer
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Cervical Cancer
- Risk Factors? - Protective Factors? |
Risk Factors:
- Number of sexual partners - Age at first coitus - OC pills - multiparity - age at first pregnancy - hx STIs - HPV, HIV - long-term steroid use - immunosuppression (and meds) - smoking - low SES, education - non-white race - nationality - screening noncompliance Protective Factors: - Barrier methods of contraception help - Gardasil |
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For what gyn cancers are there screening tests? Explain...
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Only CERVICAL CANCER
= PAP smear (prior to pap smears, cervical cancer was #1 cancer killer in women) |
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Signs/symptoms of Endometrial Cancer?
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Early Sign: peri- or post-menopausal bleeding = 80% patients diagnosed with endometrial cancer
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Signs/symptoms of Ovarian Cancer?
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No early signs
Late signs: - abdominopelvic masses - in GI tract, urinary tract, respiratory tract - massive ascites - increased abdominal girth and pelvic pressure |
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Signs/symptoms of Cervical Cancer?
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... most detected early by PAP smear...
Late Signs: - postcoital or intramenstraul bleeding - vaginal hemorrhage - flank pain due to ureteral obstruction - leg pain due to sciatic nerve involvement - cachexia |
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What are the diagnostic tests for:
- Endometrial Cancer - Ovarian Cancer - Cervical Cancer |
ENDOMETRIAL CANCER
- Ultrasound - measure endometrial thickness - Biopsy - D&C (outpatient under anesthesia) with Hysteroscopy during D&C to visualize endometrial cavity OVARIAN CANCER - Laparotomy or laparoscopy ONLY CERVICAL CANCER - serial tests: PAP --> colposcopy --> colposcopically guided biopsy --> cervical conization (cone biopsy) |
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What are the Staging Procedures for Endometrial Cancer?
- At what stage are most women diagnosed? %? Why? |
- Chest x-ray
- Exploratory Laparotomy - Peritoneal washings for cytology - Total abdominal hysterectomy - Bilateral salpingo-oophorectomy - Bilateral pelvic and paraaortic lymph node dissection ***80% diagnosed with Stage I disease due to early sx of bleeding |
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What are the Staging Procedures for Ovarian Cancer?
- At what stage are most women diagnosed? %? |
- Chest x-ray
- Exploratory Laparotomy - Peritoneal washings for cytology - Total abdominal hysterectomy - Bilateral salpingo-oophorectomy - Bilateral pelvic and paraaortic lymph node dissection - Omentectomy **70% diagnosed with Stage III disease **15% diagnosed with Stage IV disease |
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What are the Staging Procedures for Cervial Cancer?
- At what stage are most women diagnosed? %? Why? |
Staged Clinically...
- Chest x-ray - IVP (contrast radiograph of GU system) - pelvic exam under anesthesia - cytoscopy - proctoscopy/barium enema **85% diagnosed at stage I due to PAP smear (BUT in underdeveloped countries, detection usually late and one of most common cancer-related deaths) |
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Therapy:
- endometrial cancer - ovarian cancer - cervical cancer |
Endometrial Cancer: surgery +/- radiation
Ovarian Cancer: surgery +/- chemotherapy Cervical Cancer: surgery +/- chemo-radiation |
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Prognosis:
- Endometrial Cancer - Ovarian Cancer - Cervical Cancer |
Endometrial Cancer
- 5 year survival rate = 85% due to early detection due to bleeding Ovarian Cancer - 5 year survival rate = 40% due to late diagnosis - recurrent/persistent disease almost inevitable - can have extended lives and decent QOL with surgery and chemo Cervical Cancer - developed countries: survival = 90% due to early detection with PAP smears - underdeveloped countries: a leading cause of mortality for women ... vaccines show promise for the future |
