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What is the worst Gyno cancer
Ovarian
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what is the most common GYN Cancer
Endometrial
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What staging is Gyno cancers
FIGO
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What are some risk factors for cervical cancer
- multiple partners
- Mothers who took DES while pregnant
- multiple pelvic infections
- early sexual activity
- smoking
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What are some risk factors for endometrial cancers
- use of estrogen
- high fat diets
- family history
- post menopausal
- diabetes
- hypertension
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What are some risk factors for vaginal and vulvar cancer
- diabetes
- STDs
- poor hygiene
- mothers who took DES while in utero
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What are some risk factors for ovarian cancer
- late or few pregnancies
- late menopause
- lack of birth control
- family history
- personal history of breast, colon, or endometrial cancer
- diets high in meat or animal fat
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What are the presenting signs for cervical cancer
- Most common is bleeding
- postcoital bleeding
- increased menstrual bleeding
- painful sex
- smell
- pelvic pain
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Where does cervical cancer spread
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What is the pathology for cervical cancer
squamous cell
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what is the tx for cervical cancer
Usually a TAH which tandem and ovoid brachy therapy to 45-55 point A and then external beam to about 45
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What is the staging for the cervix
- TIS- carcinoma in situ
- T1-confined to cervix
- T1a micro invasive depth of penetration 3mm or less
- T2b invasive depth of penetration greater than 3mm
- T2-extension into the vagina (upper 2/3 parametrium)
- T2a extension into vagina
- T2b extension into parametrium (not pelvic wall)
- T3- extension to lower 1/3 vagina/parametrium/pelvic wall
- T3a extension to lower 1/3 of vagina
- T3b extension into parametrium and pelvic wall
- T4-extension into bladder/rectum/beyond true pelvis
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What are Pt A and B location
- Point A 2 cm superior and 2 cm lateral to external os
- Point B 2 cm superior and 5 cm lateral to external os
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What is a fletcher apparatus
- Tandem and ring/ovoids or copolstats
- Tandem is inserted into the uterus and ovoids lie in the lateral fornices on each side of the cervix
- Point A is assoc with uterus dose
- and Point B is assoc with dose to the nodal areas
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What is a common symptom of ovarian cancer
Ascites
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Which tumor marker is assoc with ovarian cancer
CA 125
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which pathology are the ovaries
epithelial
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What is the best tx for ovarian cancer
- surgery and chemo
- RT is usually just palliative
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Women who have taken what drug are at risk for endometrial cancer
Tamoxifen for breast cancer
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What are the most common symptoms for endometrial cancer
vaginal bleeding and discharge
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What is the pathology for the uterus
adenocarcinoma
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What brachytherapy procedure is usually used on the uterus
cylinder to a .5 depth at 8-7 GY in 3-5 fractions
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What pathology is the vulva
squamous cell
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What part of the vulva is cancer usually found
labia majora
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What position is the pt normally treated in for vulvar cancer
frogleg
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What is the #1 cause of vaginal cancer
Vaginal cancer is rare but the only cause know is previous DES use
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What pathology is the vagina
squamous cell
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What is the tx of choice for the vagina
RT with XRT and brachy therapy up to 80GY
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What are some side effects for treating gyno cancers
- fatigue
- diarrhea
- dysuria
- N&V
- anal irritation
- menopause
- vaginal fibrosis and dryness
- bowel obstruction
- dry and moist desquamation
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What age is cervical cancer usually found
Normally young women
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as far as gyno cancers, which is the most radiotolerant and which is radiosensitive
- the uteral canal is radiotolerant
- the ovaries are radiosensitive
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The opening into the pelvis where the baby's head enters
pelvic inlet
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What is the most common side effect for reating the cervix
anemia
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The connective tissue immediately lateral to the uterine cervix is called
parametrium
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Which gyno cancers even if at an early stage will often involve metastatic spread throughout the abdominal cavity
ovarian
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A pt having abdominal pain and distension and/or non specific gastrointestinal symptoms (nausea, heartburn) could be symptomatic to which gyno cancer
ovarian
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The cervix often protrudes into the vagina producing lateral spaces in the vaginal apex called
fornices
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Diabetes, hypertension, overweight and increased use of estrogen relate to which gyno cancer
endometrium
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Since anemia is a big risk factor when treating cervical or ovarian cancer, what is the normal hemoglobin
12-16 g/dl
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Which isotope is used for treating ovarian cancer
Phosphorus 32
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Why is ovarian the most deadly of all female cancers
few symptoms and widely disseminated at time of dx
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If a pt with cervical cancer has periaortic nodal involvement, there is a 35% increase chance of spread to
scv
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Radioisotope used in the tx of vagina cancer
Cesium 137
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What is the most common risk factor for cervical cancer
HPV
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What are the 3 layers of the uterus
- endometrium
- myometrium
- perimetrium
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What is the most definitive method of dx for endometrium cancer
D&C dilation and curettage
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