120 Questions
What is the goal of accelerated radiation in treating breast cancer?
To deliver the therapy needed to prevent recurrence of the disease in a shorter time frame.
What is brachytherapy, and how does it differ from external beam radiation?
Brachytherapy is a form of radiation that enables the client to complete her radiation in an even shorter time, and is not delivered via external beam. Instead, a deflated balloon is inserted into the space left by the lumpectomy and is filled with saline.
What is the purpose of adjuvant chemotherapy in treating breast cancer?
To eradicate or impede the growth of micrometastatic (microscopic cell metastasis) disease.
What is intraoperative radiation, and when is it used?
Intraoperative radiation is done at the time of surgery in the operating room, and is used for small, less aggressive tumors.
What is the difference between accelerated radiation and brachytherapy?
Accelerated radiation delivers a slightly larger dose of radiation over a 3-week period, while brachytherapy involves inserting a deflated balloon into the space left by the lumpectomy and filling it with saline.
What is the role of radiation rods or seeds in brachytherapy?
Radiation rods or seeds are inserted into the balloon each day for 5 days, and the radiation is completed.
What are the indications for intraoperative radiation?
Small, less aggressive tumors.
What is the goal of adjuvant systemic therapy in treating breast cancer?
To eradicate or impede the growth of micrometastatic (microscopic cell metastasis) disease.
What is often used to treat cervical cancer with parametrial tissue laterally and uterosacral ligaments posteriorly?
Wide excision
When is radiation used to treat cervical cancer?
When there has been cancerous extension to the cervix
What is considered as an adjuvant therapy for cervical cancer?
Chemotherapy
What is the purpose of progestational therapy in treating cervical cancer?
To slow the growth of endometrial cancer
What is a common side effect of progestational therapy?
None (usually does not cause acute side effects)
Who is the author of the study mentioned in the passage?
Cohn
What is the risk associated with using radiation to treat cervical cancer?
Development of lymphedema
What is the goal of surgical treatment options for cervical cancer?
To remove cancerous tissue and surrounding areas
What is the criteria for performing abdominal hysterectomy for leiomyomas?
Leiomyomas larger than a uterus at 12 to 14 weeks of gestation or multiple leiomyomas
What is the purpose of attaching the supporting ligaments to the vaginal cuff during hysterectomy?
To maintain normal depth of the vagina
What is the difference between LAVH and LASH?
LAVH allows the cervix to remain, while LASH does not
What is an important preoperative assessment for a woman considering hysterectomy?
Psychologic assessment
What is one of the benefits of preoperative education for women considering hysterectomy?
She can make an informed decision about treatment
What is the purpose of preoperative and postoperative procedures?
To educate the woman about the recovery process and what to expect
What is an alternative to traditional abdominal hysterectomy?
Laparoscopic-assisted vaginal hysterectomy (LAVH)
What resource is available to help women make decisions about treatment for leiomyomas?
The Fibroid Treatment Collective website (www.fibroids.org)
What is a common symptom of a cystocele?
A feeling of fullness or pressure in the pelvis and vagina
What is the goal of surgery in treating a cystocele?
To place the bladder back into its normal position
What is often combined with an anterior repair to treat a cystocele?
A vaginal hysterectomy
What type of exercises can help strengthen pelvic floor muscles in patients with a cystocele?
Kegel exercises
What may be recommended to patients with a cystocele to relieve symptoms of pressure?
Physical therapy
What is a visible symptom of a cystocele in some cases?
A bulge of tissue in the vagina
What is the name of the surgical procedure used to treat a cystocele?
Anterior repair
According to the National Institute of Diabetes and Digestive and Kidney Diseases, what is the year of the publication cited in the text?
2020
Why is the early introduction of systemic adjuvant therapy considered a prudent course of treatment?
To help destroy undetected cancers that were not surgically removed.
What is the purpose of the Oncotype DX test?
To determine the likelihood of a woman's specific cancer recurring.
What is the goal of neoadjuvant therapy?
To reduce tumor burden, making breast-conserving treatment an option.
What is the role of receptor assays in determining a woman's candidacy for hormonal therapy?
To examine cancer cells for ERs and PRs, indicating the presence of hormone receptors.
Why may chemotherapy be strongly considered for women with a high Oncotype DX score?
Because the score indicates a high likelihood of the cancer recurring.
What can happen to tumor cells as a result of mutations?
They become resistant to the effects of chemotherapeutic agents.
What is the significance of hormone receptor positive and HER2/neu negative status in breast cancer?
These are favorable prognostic factors.
Why can't it be confidently predicted that all tumors of 1 cm or less can be cured with initial local and regional treatment?
Because tumor cells can develop mutations that make them resistant to chemotherapy.
What are the risk factors for ovarian cancer?
Women at risk include those with obesity, later-in-life pregnancies or nulliparity, use of hormone therapy following menopause, family history of ovarian, colorectal, or breast cancer, and genetic mutations.
How does ovarian cancer typically spread?
By direct extension to adjacent organs.
What is the usual treatment for ovarian cancer?
Surgery, specifically laparotomy or laparoscopy.
What is the significance of timing in ovarian cancer treatment?
Timing depends on evaluation of risks to the woman and the fetus, ideally between 16 and 20 weeks of gestation.
Who are the women with the highest incidence of ovarian cancer?
Non-Hispanic White women of North American or northern European descent, and older women.
What are the possible signs and symptoms of ovarian cancer?
Abdominal pain/discomfort, asymptomatic detection on ultrasound imaging.
What is the importance of evaluating risks to the woman and the fetus in ovarian cancer treatment?
To determine the best course of treatment and minimize risks to both the woman and the fetus.
Why is it essential to consider the woman's age and health status in ovarian cancer treatment?
To determine the most appropriate treatment approach, taking into account the woman's overall health and age.
What are some risk factors for persistent HPV infections?
Early age (younger than 20 years) at first coitus, multiple sexual partners, a sexual partner with a history of multiple sexual partners, high parity, and belonging to a lower socioeconomic status group.
Which racial/ethnic groups have the highest incidence of cervical cancer in the United States?
Hispanic and Black women.
What are the symptoms of cervical cancer?
Heavy or irregular vaginal bleeding, postcoital bleeding, and watery, mucoid, purulent, or malodorous discharge.
What is the primary treatment for microinvasive cancer?
Conization, but hysterectomy may be performed if childbearing is not desired.
What is the role of chemoradiation therapy in treating early-stage invasive cancer?
Hysterectomy or chemoradiation therapy may be used to treat early-stage invasive cancer.
What is a potential limitation of cervical cancer screening in the United States?
Decreased access to screening opportunities or follow-up treatment.
What is the significance of socioeconomic status in cervical cancer incidence?
Belonging to a lower socioeconomic status group is a risk factor for cervical cancer.
What are the late symptoms of cervical cancer?
Rectal bleeding, and watery, mucoid, purulent, or malodorous discharge.
What are some of the risk factors associated with human immunodeficiency virus (HIV) or other immunocompromising conditions in the development of cervical cancer?
Cigarette smoking, having given birth to three or more children, intrauterine exposure to diethylstilbestrol (DES), and being infected with human immunodeficiency virus (HIV) or other immunocompromising conditions.
What is the most widely used method to detect preinvasive cervical cancer?
The Pap test.
What are some potential chemotherapeutic agents used in the treatment of cervical cancer?
External and internal radiation therapy and chemotherapy.
What surgical treatment options are available for cervical cancer?
Hysterectomy.
What are some of the disparities in cervical cancer incidence?
Racial and ethnic disparities, socioeconomic disparities.
What is the importance of taking a thorough history in diagnosing cervical cancer?
To identify risk factors, symptoms, and sexual and menstrual history.
What are some potential symptoms of cervical cancer?
Hematuria, pelvic or lower back pain, and vaginal passage of stool.
What are some potential nutrients being investigated as risk factors for cervical cancer?
Low levels of beta-carotene, vitamin C, and folate.
What type of growths are carcinomas, which infiltrate surrounding tissue?
Malignant growths
What is the importance of trying several approaches for a number of months before noting improvement in treating cervical cancer?
To find an effective treatment for the individual
What is the benefit of using evening primrose oil in treating cervical cancer?
It can be effective for some women
Why is it essential to consider the woman's age and health status in ovarian cancer treatment?
To determine the best course of treatment
What is the significance of timing in ovarian cancer treatment?
It affects treatment outcomes
What is the usual treatment for ovarian cancer?
Surgery and chemotherapy
What are the possible signs and symptoms of ovarian cancer?
Various symptoms, including abdominal pain and bloating
Why are disparities in cervical cancer incidence a concern?
They lead to health inequities
What are some possible causes of breast cancer that are currently being researched, but have not been substantiated as definitive causes?
Androgens, talcum powder, and diet
What is the prognosis for breast cancer diagnosed in the early stages?
Good
When can chemotherapy be considered for pregnant women with breast cancer?
In the second or third trimester if absolutely needed
What is the significance of genetic mutations in BRCA1 and BRCA2 genes in breast cancer?
They can increase the risk of breast cancer
What is the role of radiation in treating breast cancer during pregnancy?
It is contraindicated at any time during pregnancy
What is the route of distal spread of breast cancer?
Through the lymph system to the liver and lungs
What is the significance of HNPCC in breast cancer?
It can increase the risk of breast cancer
What is the significance of early diagnosis in breast cancer treatment?
It improves the 5-year survival rate
What is the significance of BRCA1 and BRCA2 genes in relation to cancer?
Mutations in these genes increase the risk of breast and ovarian cancer.
What are the possible signs and symptoms of ovarian cancer?
Abdominal pain/discomfort, asymptomatic and detected on ultrasound imaging.
How does cancer typically spread in the body?
Through the lymph system to the liver and lungs.
What is the significance of early diagnosis in cancer treatment?
Early diagnosis leads to a good prognosis due to effective treatment options.
Who are the women with the highest incidence of ovarian cancer?
Non-Hispanic White women of North American or northern European descent and older women.
What is the role of chemotherapy in cancer treatment?
Chemotherapy can be used in the second or third trimester if absolutely needed.
What are the risk factors for ovarian cancer?
Women at risk include those with obesity, later-in-life pregnancies or nulliparity, use of hormone therapy following menopause, family history of ovarian, colorectal, or breast cancer, and genetic predisposition.
What is the importance of considering risks to the woman and the fetus in cancer treatment?
It is essential to evaluate risks to the woman and fetus in ovarian cancer treatment.
What is the usual treatment for ovarian cancer?
Surgery, typically laparotomy or laparoscopy, depending on the evaluation of risks to the woman and the fetus.
What is the significance of age and health status in cancer treatment?
It is essential to consider the woman's age and health status in ovarian cancer treatment.
What is the significance of evaluating risks to the woman and the fetus in ovarian cancer treatment?
It is essential to consider the risks to the woman and the fetus when deciding on the timing of surgery, ideally between 16 and 20 weeks of gestation.
What are the risk factors for persistent HPV infections?
Early age at first coitus, multiple sexual partners, a sexual partner with a history of multiple sexual partners, high parity, and belonging to a lower socioeconomic status group.
What is the significance of HPV infection in cervical cancer?
HPV infection is a risk factor for cervical cancer, and persistent HPV infections are more likely to lead to cervical cancer.
What are the risk factors for ovarian cancer?
Risk factors include mutations in BRCA1 and BRCA2 genes.
Which racial/ethnic groups have the highest incidence of cervical cancer in the United States?
Hispanic and Black women
How does ovarian cancer typically spread?
Ovarian cancer typically spreads through the lymph system to the liver and lungs.
Which racial/ethnic groups have the highest incidence of cervical cancer in the United States?
Certain racial/ethnic groups, such as African Americans and Hispanics, have a higher incidence of cervical cancer.
What is the importance of cervical cancer screening?
Cervical cancer screening is essential for early detection and prevention of cervical cancer, and it can help reduce the incidence of cervical cancer.
What is the purpose of treatment for invasive cervical cancer?
To remove the cancerous tissue and prevent further growth, and may include surgery, radiation therapy, and chemotherapy.
What are the symptoms of cervical cancer?
Heavy or irregular vaginal bleeding, postcoital bleeding, and watery, mucoid, or purulent discharge.
What is the significance of socioeconomic status in cervical cancer incidence?
Belonging to a lower socioeconomic status group is a risk factor for cervical cancer due to decreased access to screening and treatment opportunities.
What is the role of conization in treating microinvasive cancer?
Conization is often used to treat microinvasive cancer, but a hysterectomy may be performed if childbearing is not desired.
What are the factors that influence the incidence of cervical cancer in the United States?
Decreased access to screening opportunities or follow-up treatment, and factors that may increase the risk of HPV infection, such as early age at first coitus and multiple sexual partners.
What is the association between sexually transmitted infections and cervical cancer?
Sexually transmitted infections, including Human Immunodeficiency Virus (HIV), increase the risk of cervical cancer.
What is the purpose of the Pap test in cervical cancer screening?
The Pap test is used to detect preinvasive cervical cancer changes.
What is the goal of treatment for preinvasive cancer of the cervix?
To remove the abnormal cells and prevent further growth, and may include conization or hysterectomy.
What is the role of chemotherapy in treating cervical cancer?
Chemotherapy is used in combination with radiation therapy to treat locally advanced stages of cervical cancer.
What is the criteria for performing a hysterectomy in cervical cancer treatment?
A hysterectomy is performed if the cancer has extended beyond the cervix but not to the pelvic wall.
What is the disparity in cervical cancer incidence among racial/ethnic groups in the United States?
Some racial/ethnic groups, such as African Americans and Latinas, have a higher incidence of cervical cancer.
What is the relationship between HPV infections and cervical cancer development?
Persistent HPV infections can lead to the development of cervical cancer.
What is the role of radiation therapy in treating cervical cancer?
Radiation therapy is used to treat locally advanced stages of cervical cancer, often in combination with chemotherapy.
What is the significance of vitamin deficiencies in cervical cancer development?
Low levels of beta-carotene, vitamin C, and folate may increase the risk of cervical cancer.
What are the risk factors for persistent HPV infections that may lead to cervical cancer?
Some risk factors for persistent HPV infections
What is the significance of evaluating risks to the woman and the fetus in ovarian cancer treatment?
To determine the best treatment approach
Which racial/ethnic groups have the highest incidence of cervical cancer in the United States?
Some racial/ethnic groups
What is the purpose of receptor assays in determining a woman's candidacy for hormonal therapy?
To determine hormone receptor status
What is the goal of neoadjuvant therapy in treating breast cancer?
To reduce tumor size
What is the significance of hormone receptor positive and HER2/neu negative status in breast cancer?
It determines treatment options
Why may chemotherapy be strongly considered for women with a high Oncotype DX score?
Due to the high risk of recurrence
What is the usual treatment for ovarian cancer?
Surgery and chemotherapy
Study Notes
Treatment for Endometrial Cancer
- Wide excision of parametrial tissue laterally and uterosacral ligaments posteriorly is often used to treat this condition.
- Radiation can be used when there has been cancerous extension to the cervix, but it increases the risk of developing lymphedema.
- Adjuvant therapy with chemotherapy may also be considered.
- Progestational therapy, such as medroxyprogesterone (Provera) and megestrol (Megace), is used to slow the growth of endometrial cancer.
Hysterectomy
- Abdominal hysterectomy is usually performed for leiomyomas larger than a uterus at 12 to 14 weeks of gestation or for multiple leiomyomas.
- The uterus is removed through either a vertical or a transverse incision.
- Vaginal approaches can be used for smaller tumors.
- In both abdominal and vaginal approaches, the uterus is removed from the supporting ligaments (broad, round, and uterosacral).
- Alternatives to these procedures are laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopic-assisted supracervical hysterectomy (LASH).
Preoperative Assessments
- Preoperative assessments needed before surgery include the woman's knowledge of treatment options, her desire for future fertility if she is premenopausal, and the benefits and risks of each procedure.
- Preoperative and postoperative procedures, as well as the recovery process, must be explained to the woman.
- Psychologic assessment is essential, particularly for a woman who is scheduled for a hysterectomy.
Radiation Therapy
- Accelerated radiation delivers a slightly larger dose of radiation over a 3-week period.
- Skin changes (resembling sunburn) can be slightly more prevalent due to the more intense period of time and corresponding dosage.
- Brachytherapy enables the client to complete her radiation in an even shorter time and is not delivered via external beam.
- Partial breast radiation is delivered, recognizing that most local recurrences happen at or near the location of the original cancer.
Adjuvant Systemic Therapy
- Chemotherapy administered soon after surgical removal of the tumor is referred to as adjuvant chemotherapy.
- The role of adjuvant chemotherapy is to eradicate or impede the growth of micrometastatic disease.
- Adjuvant therapy may help to destroy undetected cancers that were not surgically removed.
Surgical Repair for Cystocele
- Surgery involves placement of the bladder back into its normal position and supportive stitch insertion to hold together the muscles and tissue surrounding the bladder.
- An anterior repair is often combined with a vaginal hysterectomy.
- Physical therapy may be recommended to help strengthen pelvic floor muscles and relieve some of the symptoms of pressure caused by the cystocele.
Cervical Cancer
- Risk factors for persistent HPV infections include early age (younger than 20 years) at first coitus, multiple sexual partners, a sexual partner with a history of multiple sexual partners, high parity, and lower socioeconomic status.
- Factors that may influence the increased incidence of cervical cancer include decreased access to screening opportunities or follow-up treatment.
- Preinvasive cancer of the cervix is often asymptomatic, but as the cancer progresses, symptoms may include heavy or irregular vaginal bleeding, postcoital bleeding, and watery, mucoid, or purulent discharge.
- Microinvasive cancer is usually treated with conization, but a hysterectomy is often done if childbearing is not desired.
Ovarian Cancer
- Risk factors for ovarian cancer include women with obesity, later-in-life pregnancies or nulliparity, use of hormone therapy following menopause, family history of ovarian, colorectal, or breast cancer, and genetic mutations.
- Non-Hispanic White women of North American or northern European descent have the highest incidence of ovarian cancer.
- Symptoms may include abdominal pain/discomfort, pelvic or lower back pain, and vaginal passage of stool.
- Diagnosis includes taking a history that includes information about menstrual and sexual activity, and ultrasound imaging.
- Treatment typically involves surgery (laparotomy or laparoscopy), and the timing depends on the evaluation of risks to the woman and the fetus.
General Treatment
- Surgery is the usual treatment for cervical cancer, and the timing depends on the evaluation of risks to the woman and the fetus.
- Radiation therapy is contraindicated during pregnancy, but chemotherapy can be considered in the second or third trimester if absolutely necessary.
- In most cases, the prognosis is good due to early diagnosis, and the 5-year survival rate is high.
Cervical Cancer
- Risk factors for persistent HPV infections include early age (younger than 20 years) at first coitus, multiple sexual partners, a sexual partner with a history of multiple sexual partners, high parity, and lower socioeconomic status.
- Factors that may influence the increased incidence of cervical cancer include decreased access to screening opportunities or follow-up treatment.
- Preinvasive cancer of the cervix is often asymptomatic, but as the cancer progresses, symptoms may include heavy or irregular vaginal bleeding, postcoital bleeding, and watery, mucoid, or purulent discharge.
- Microinvasive cancer is usually treated with conization, but a hysterectomy is often done if childbearing is not desired.
Ovarian Cancer
- Risk factors for ovarian cancer include women with obesity, later-in-life pregnancies or nulliparity, use of hormone therapy following menopause, family history of ovarian, colorectal, or breast cancer, and genetic mutations.
- Non-Hispanic White women of North American or northern European descent have the highest incidence of ovarian cancer.
- Symptoms may include abdominal pain/discomfort, pelvic or lower back pain, and vaginal passage of stool.
- Diagnosis includes taking a history that includes information about menstrual and sexual activity, and ultrasound imaging.
- Treatment typically involves surgery (laparotomy or laparoscopy), and the timing depends on the evaluation of risks to the woman and the fetus.
General Treatment
- Surgery is the usual treatment for cervical cancer, and the timing depends on the evaluation of risks to the woman and the fetus.
- Radiation therapy is contraindicated during pregnancy, but chemotherapy can be considered in the second or third trimester if absolutely necessary.
- In most cases, the prognosis is good due to early diagnosis, and the 5-year survival rate is high.
This quiz is about surgical and radiation treatments for cancer, including wide excision of parametrial tissue and uterosacral ligaments. Learn about the treatment options for cancerous extensions.
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