1. Risk factor
1.1. Ovarian cancer
1.1.1. Age (increases risk over 50) Family history of breast or bowel cancer Changes in the BRCA1 or BRCA2 gene Being Ashkenzai Jewish decent Early onset of periods (before 12 years) and late menopause If you had you’re first child over 35 Estrogen only hormone replacement therapy long term use of Oral contraceptive pill Fallopian tubes removed
1.2. Cervical
1.2.1. Vaginal bleeding between periods Bleeding after intercourse Weakened immune system Unusual vaginal discharge Excessive tiredness Leg pain Lower back pain If you mother was prescribed DES (diethylstilbestrol) between 1939-1971
2. Physical exam
2.1. Ovarian cancer
2.1.1. - check vital signs - check abdomen for any lumps, bumps, rashes - check for discolouration in the skin - internal vagina examination
2.2. Cervical
2.2.1. Internal vagina examination Vital signs checked Doctor will view you cervix and vagina
3. Common medical treatment
3.1. Ovarian cancer
3.1.1. Surgery
3.1.1.1. Used to determine the extent of the malgingnancy and remove as much as possible, if localised this will be the main treatment
3.1.2. Chemotherapy
3.1.2.1. Uses anti cancer drugs to destroy cancer cells. Will usually happen after surgery
3.1.2.1.1. However some women will have this treatment before surgery in an attempt to shrink growth to increase a successful removal
3.1.3. Radiation therapy
3.1.3.1. May be used after chemotherapy
3.1.4. Palliative care
3.1.4.1. Aims to improve quality of life by alleviating cancer symptoms
3.2. Cervical
3.2.1. Staging
3.2.1.1. Cancer will be staged from stage 0 ( abnormal cells found) to stage IV ( cancer has spread to nearby organs)
3.2.2. Surgery
3.2.2.1. For early detection and growth is less then 4cm
3.2.3. Radiation therapy
3.2.4. Chemotherapy
3.2.5. Palliative care
4. Pathophysiology
4.1. Ovarian cancer
4.1.1. Malignant tumour in one of both overlies
4.1.2. Eitology of ovarian cancers is not fully understood
4.1.2.1. Investigations have suggested that genetic predisposition and benign inflammatory diseases may be involved
4.1.3. Three different types
4.1.3.1. EPITHELIAL (90% of cases)
4.1.3.1.1. Arises form the cell outside the ovary
4.1.3.2. GERM CELL (4%)
4.1.3.2.1. Arises from cells that produce eggs
4.1.3.3. RARE STROMAL
4.1.3.3.1. Arising from supporting tissues within the ovary
4.2. Cervical cancer
4.2.1. Growth of abnormal cells in the lining of the cervix
4.2.2. Types
4.2.2.1. Squamous cell carcinoma (70%)
4.2.2.2. Adenocarcinoma
4.2.2.2.1. Less common and more difficult to diagnose as higher in the cervix
5. History / progression
5.1. Ovarian cancer
5.1.1. This depends on the type and stage of cancer as well as their age and general health
5.1.1.1. Survival rate is 45.7%
5.1.2. 6th most common cancer type in women
5.2. Cervical cancer
5.2.1. Depends on individual patient
5.2.1.1. Effectively treated when found early
5.2.2. 5 year survival rate is 73%
6. Current testing
6.1. Ovarian cancer
6.1.1. Blood test
6.1.1.1. To detect a common tumour marker CA125 is present
6.1.2. Pelvic ultrasound
6.1.2.1. Provides a rough “picture” of what the ovaries and uterus look like
6.1.2.1.1. In an attempt to locate any abnormal lumps / growth
6.1.3. CT scan
6.1.3.1. Uses x radiation to take images inside the body and detect if cancer / growths have spread
6.1.4. PET scan
6.1.4.1. Highlights abnormal tissue in body
6.1.5. Colonoscopy
6.1.5.1. Bowel examination to rule out these symptoms aren’t caused by a bowel issue. A biopsy will be conducted in this process
6.2. Cervical
6.2.1. Screening Pap smear test
6.2.2. Colposcopy
6.2.2.1. Identifies where the abnormal cells are located in the cervix and what they look like.
6.2.2.1.1. Use of a colposcopy is needed to allows the doctor to view the vagina and cervix
6.2.3. Biopsy
6.2.3.1. Doctors will remove tissue from the surface of the cervix and test for cancer
6.2.3.1.1. LLETZ is the most common method to remove cervical tissue