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Carcinoma of The Cervix 2
Carcinoma of The Cervix 2
INTRODUCTION
INCIDENCE
• Unknown
Risk Factors
1
NATURAL HISTORY/ SPREAD
PATHOLOGY
• Up to 95% are squamous cell carcinoma
• About 5% are adenocarcinoma
PRESENTATION
• Asymptomatic – detection is from abnormal cell cytology
• Symptomatic – abnormal vaginal bleeding (postcoital bleeding,
intermenstrual bleeding)
Postmenopausal bleeding
Offensive blood stained vaginal discharge
Others-backache, leg pain/edema, haematuria, bowel
changes, malaise and weight loss.
DIAGNOSIS
Good history
Appropriate / detailed examination
. Cytological smears
. Colposcopy
. Punch biopsies
. Conization
2
.D&C
. EUA including cystoscopy, rectosigmoidoscopy
INVESTIGATIONS
. FBC
. Group and Cross match 2 units of blood
. Serum E/U/Cr + Uric acid
. LFT
. Urinalysis
. IVU
. CXR – PA
. Barium Enema
. USS
. Lymphangiography
. CAT Scan
. MRI
STAGING
. Enables appropriate planning of treatment
. Gives an idea of prognosis i.e survival is stage dependent
. Facilitates exchange of information between treatment centres
3
FIGO STAGING OF CERVICAL CANCER (1995)
STAGE DESCRIPTION
0 Preinvasive carcinoma (carcinoma-in-situ,
CIN)
MANAGEMENT
5
IB & IIA Radical hysterectomy +
bilateral pelvic . for young women
lymphadenectomy +
oophorectomy . Ovaries preserved
. Reduced risk of
sexual dysfunction
6
IVa with Fistular
already present.
RECURRENT CANCER
FOLLOW UP
7
• For life
• Every 3 months for the 1st 2 yrs
• Thereafter every 6 months for the next 3yrs
• Then yearly
At each visit ask of general health, coping with work. Look for anaemia.
Do careful abdominal, vaginal, rectal examination for evidence of
metastasis / recurrence.