35 terms

female genital tract cancer

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