G-Y in Gynaecology: Gynaecological Malignancies – themedideas Facts & Figures

  • Sunday, January 19th, 2014

Updated on 04.12.2016.

Gynaecological malignancies include a vast and heterogenous group of malignancies that affect the female reproductive tract. These are associated with significant morbidity an mortality in the female primarily due to delayed diagnosis. The aim should be early detection and appropriate management, and taking preventive measures where available and feasible. The outcome of management is usually expressed in 5-year survival, but the quality of survival is equally important.

Life Cycle

Conception <———– Genetic Predisposition

Pregnancy/Intrauterine Life/Life before birth <———– ?Intrauterine factors

Birth

Life after birth <———– Environmental factors

Malignancies

Death

 

FAQs

What are the issues that would affect someone with a diagnosis of cancer?

What would they want to know?

What do you have to take into account in relation to diagnosis of cancer?

Issues in relation to diagnosis of female genital tract cancer

1. Breaking the bad news

2. Prognosis

3. Psychological impact

4. Impact on the Family

5. Impact on the Sexual life

6. Impact on the Fertility

7. Cost implications (in developing countries/countries where treatment is not free)

 

Principles of Management

* Diagnosis and treatment should be undertaken urgently.

* Multidisciplinary Team (MDT – General Gynaecologist/Gynaecological Oncologist, Medical Oncologist, Oncology Nurse, Pain management team member etc) discussion / treatment plan

* Treatment options

i> Surgery

ii> Radiotherapy

iii> Chemotherapy

iv> Palliative therapy (symptomatic treatment, pain management etc) for terminal cancer

* Treated by

i> General Gynaecologist

ii> Gynaecological Oncologist (Gynaecologist specialising in Gynaecological Oncology)

* Follow up at intervals

* Hospice (special hospital for patients with terminal cancer)/Palliative care (at home/hospital)

 

FIGO Staging – General Principles

* Stage 1 – cancer is confined to the organ

* Stage 2 – cancer has involved adjacent organs/areas

* Stage 3 – cancer has spread further/beyond  adjacent organs/areas

* Stage 4 – Distant metastases

Organs involved and the method of staging

*—Vulva – Clinical/Histological

*—Vagina – EUA/Surgical

*—Cervix – Clinical (Examination Under Anaesthesia)/Histological

*Endometrium – Histological

*Fallopian tube – Surgical

*Ovary – Surgical

 

Prognosis – General Principles

* Prognosis depends on Stage (and Grade especially in some cancers at earlier Stage e.g. endometrial cancer)

 

Organs involved
Female reproductive tract

1. Vulva

2. Vagina

3. Uterus

a) Cervix

b) Body

i> Endometrium

ii>Muscle

4. Fallopian tubes

5. Ovaries

Gynaecological Malignancies – Key Points

1. Vulva

*Visible from outside

*Any lump, ulcer etc visible

*Any lump, ulcer, discolouration etc of skin visible

*Early presentation

*Early detection possible

*Good prognosis

2. Vagina

*Not visible from outside

*Any lump, ulcer etc not visible

*May present with abnormal vaginal bleeding or discharge

*Early presentation

*Visible on speculum examination

*Early detection possible

3. Uterus

a) Cervix

*Not visible from outside

*Any lump, ulcer etc not visible

*May present with abnormal vaginal bleeding or discharge, PCB

*Early presentation

*Portio vaginalis visible on speculum examination

*Early detection possible

b) Body

i> Endometrium

*Not visible from outside or on speculum examination

*Any lump, ulcer etc not visible

*May present with abnormal vaginal bleeding (e.g PMB) or discharge

*Early presentation

*Visible on hysteroscopy

*Early detection possible

ii> Muscle

*Not visible from outside, on speculum examination or hysteroscopy

*Any lump not visible early

*May present with abdominal/pelvic mass

*Usually Late presentation

*Early detection unlikely

4. Fallopian tubes

*Not visible from outside, on speculum examination or hysteroscopy

*Any lump not visible early

*May present with abnormal vaginal discharge or abdominal/pelvic mass

*Usually late presentation

*Usually late detection

5. Ovaries

*Not visible from outside, on speculum examination or hysteroscopy

*Any lump not visible early

*May present with abdominal distension, anorexia, abdominal/pelvic mass etc

*Usually late presentation

*Usually late detection

Gynaecological malignancies

Vulval cancer – available at present

Vaginal cancer

—Cervical cancer

Endometrial cancer

Fallopian tube cancer

Ovarian cancer

 

“Gynaecological Malignancies” – themedideas (PDF) is available. If you want to book it please send an e-mail to themedideas@gmail.com. The materials would be sent to you electronically by e-mail once the payment is cleared.

Please do not pay until you receive the confirmation e-mail that the PDF file could be provided. If you do so, it would be your responsibility. No refund or PDF file would be provided if you do so.

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© Dr Sudipta Paul, themedideas.com, 2014

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