female genital tract cancer

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cancers of the female genital tract

ovarian, cervical, endometrial (uterus), vaginal and vulvar

the most fatal genital tract cancer

ovarian cancer

ovarian cancer

4th leading cause of cancer death in women, incidence increases with age, majority have advanced disease

median age of ovarian cancer

55 y/o

ovarian cancer development

multiple foci within the abdomen since carcinomatosis can develop after the removal of normal ovaries

risk factors for ovarian cancer

family history, persons with family or personal history of ovarian, breast, colon cancer, BRCA 1 gene

positive risk factors that reduce the number of ovulations/ovarian cancer

oral contraceptives, pregnancy and breastfeeding, tubal-ligation, hysterectomy, removal of ovaries

risk factors that increase ovarian cancer

null parity, age of menarche, late menopause, ovulatory stimulation, history of breast cancer, genetics, caucasian

screening for ovarian cancer

no sensitive and specific screening tests, ACOG recommends annual pap, pelvic and rectal exams

screening for high risk ovarian cancer

pelvic exam, CA-125, transvaginal ultrasound

signs and symptoms of ovarian cancer

persistent abdominal pain or bleeding, urinary symptoms, change in bowel habits may herald onset, palpable abdominal mass in 70-80% of patients, abdominal distention, indigestion, early satiety, loss of appetite

diagnostic work-up for ovarian cancer

identification of adnexal mass (tubes and ovaries), surgery for staging

prognosis of ovarian cancer

stage of disease, residual disease status, histology, tumor differentiation, nodal metastases, peritoneal cytology

treatment of ovarian cancer

surgery-curative in early stage of disease, radiation therapy- limited application, chemotherapy, hormone therapy

cervical cancer incidence

most common malignancy in both incidence and mortality

cervical cancer etiology

HPV status, viral exposure, underserved populations, smoking, multiple sex partners, partner's sexual practices, immunosuppression

screening for cervical cancer

annual pap tests, annual pelvic exams for sexually active women

presentation of symptoms for cervical cancer

abnormal pap smear, primary symptoms (post-coital bleeding or abnormal vaginal bleeding), foul smelling vaginal discharge, pain lymphedema

diagnostic evaluation of cervical cancer

abnormalities on a cytological smear or tissue biopsy of the cervix represent alterations in the degree of differentiation of cervical epithelial cells

prevalence of cervical cancer

order of highest prevalence- american indian/ alaskan native, african american, white women, hispanic, asians or pacific islanders

risk factors for cervical cancer

sexual activity, sexual activity at an early age, history of sexually transmitted infection, multiple sex partners, or engaging in sexual activity with promiscuous men, HPV infection, smoking, multiparity, exogenous or endogenous immunodeficiency, long term OCP's and dietary factors (low vitamin C and carotene)

Diagnosis of cervical cancer

patient and family history, physical/ pelvic examination, biopsy

treatment of cervical cancer

for limited disease: hysterectomy/LND or radiation therapy. for more advanced disease: definitive radiation therapy. chemotherapy with cisplatin currently standard of care

cervical cancer prognosis

stage of disease, histology, tumor differentiation, nodal metastases

Endometrial cancer (Uterine cancer) incidence

predominant form of cancer of the female genital tract, fourth leading cause of cancer in women

screening for endometrial cancer

pap smear occasionally reveals endometrial cancer/ no specific or sensitive screening tests

endometrial cancer presenting symptoms

primary symptom- abnormal uterine bleeding, premenopausal onset of heavy or irregular menses, pelvic pressure or pain

diagnosis of endometrial cancer

patient and family history, physical/pelvic exam, endometrial biopsy is the initial diagnostic test to rule out endometrial cancer

endometrial cancer treatment

treatment is individualized, medical treatment is based on the extent of the disease, usually a hysterectomy is preformed to remove the site of the cancer

endometrial cancer prognosis

stage of disease, histology/tumor differentiation, depth of myometrial invasion, nodal metastates, peritoneal cytology (ascites)

vaginal cancer etiology

tumors are squamous cell carcinomas, but melanoma, sarcoma, adenocarcinoma and other histological types also occur, the majority of these malignancies are metastatic.

vaginal cancer risk factors

multiple lifetime sexual partners, early age at first intercourse, smoking, infection with HPV is a common association, HIV is a risk factors

presenting symptoms for vaginal cancer

vaginal bleeding either postmenopausal or postcoital, watery discharge, blood tinged or malodorous charge, vaginal mass, urinary symptoms (urgency, frequency, dysuria, hematuria), gastrointestinal complaints, pelvic pain

screening and early detection of vaginal cancer

pap test may detect maligant cells, lesions are difficult to see, biopsy, posterior wall of the upper 1/3 of the vagina

vaginal cancer treatment

no consensus as the appropriate treatment of the vaginal cancer, surgery, radiation, chemotherapy are the options

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