1 / 9

Cancer of the Cervix

Cancer of the Cervix. Max Brinsmead PhD FRANZCOG May 2011. Ca Cx – Symptoms. Watery PV discharge Becomes bloody Intermenstrual bleeding (postcoital) Pain =Parametrial tissue involvement Bowel or Bladder symptoms = a late sign Fistula Urine or feculent material

moe
Download Presentation

Cancer of the Cervix

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Cancer of the Cervix Max Brinsmead PhD FRANZCOG May 2011

  2. Ca Cx – Symptoms • Watery PV discharge • Becomes bloody • Intermenstrual bleeding (postcoital) • Pain • =Parametrial tissue involvement • Bowel or Bladder symptoms • = a late sign • Fistula • Urine or feculent material • Peak incidence 45 – 55 years of age

  3. Ca Cx - Staging • Microinvasive • =through basement membrane but <5mm • Stage 1 • = confined to cervix • Stage 2 • = parametrial involvement • Stage 3 • = to the side wall of the pelvis • Stage 4 • = Bladder, bowel or distant metastases

  4. Ca Cx – Preparation for Rx • Team approach • Gynae oncologist • Radiotherapist • Oncology Nurse • Social worker/Counsellor • Assess fitness for surgery • Evaluate extent of disease • Will require EUA • Surgery or Radiotherapy?

  5. Radiotherapy Older patient Unfit for surgery Advanced disease Affects Bladder & Bowel Causes vaginal stenosis And premature menopause through damage to ovaries Surgery Age <45 years Can leave ovaries Ureters are vulnerable Bleeding & Abscess common Adjuvant XRT possible Pelvic exenteration for recurrence sometimes Ca Cx – Treatment Options

  6. Ca Cx - Prognosis • Microinvasive 95- 100% “cured” • Stage 1B 85 -90% • Stage 2 70 -75% • Stage 3 30 – 40% • Stage 4 10 – 20% • Adenocarcinoma worse • And now >10% of Ca Cx are AdenoCa • Results from surgery slightly better

  7. Ca Cx – Follow Up • Pap smears • Examine • Watch for distant metastases • The main dilemma is what to do when recurrence is detected • Chemotherapy with Cysplatin is adjuvant ?role in palliation

  8. Ca Cx – In Pregnancy • The dilemma is the fetus • Ignore in the 1st trimester • Proceed with surgery or XRT • Wait for fetal viability after 24 w • Realistically >30w • Caesarean delivery better

  9. Ca Cx – Burden of Illness in PNG • Required 203 admissions at PMGH in 2010 • This was 82% of all admissions for gynaecological malignancy • Only 12 patients were deemed suitable for attempted therapy by Wertheim Hysterectomy

More Related