Invasive Cervical Cancer. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Invasive Cervical Cancer. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology"

Transcription

1 Invasive Cervical Cancer Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology

2 Cervical Cancer Etiology Human Papilloma Virus (HPV): Detected in 99.7% of cervical cancers Cancer develops years following HPV infection HPV is necessary but not sufficient to develop cancer Requires persistent disease Cofactors: HIV, immunosupression, smoking Walboomers et al., J. Pathol, 1999

3 Cervical Cancer Risk Factors Persistent HPV infection is the cause of preinvasive cervical neoplasia and invasive cancer Other risk factors (indirect measures of HPV infection): Lower socioeconomic status More sexual partners Lower age at first intercourse

4 Cervical Cancer Prevention Primary Prevention: HPV Vaccination Secondary Prevention (Screening): Cytology (Pap test) HPV DNA testing Visual inspection with acetic acid (VIA)

5 Invasive Cervical Cancer

6 Presenting Symptoms Early Stage Disease: Frequently asymptomatic Vaginal discharge Abnormal bleeding Post-coital Irregular menses Postmenopausal bleeding Late Stage Disease: Pelvic/back pain Sciatica/leg swelling Weight loss Uremia Fistula: Rectovaginal Vesicovaginal

7 Histology Squamous (70-80%) Adenocarcinoma (20-25%) Other (~5%): Adenosquamous Glassy Cell Carcinoid Neuroendocrine Small-cell

8 Cervical Cancer Diagnosis Cytology (Pap) suspicion of cancer Colposcopy with biopsy is required to confirm If a visible lesion -> directly to biopsy If abnormal Pap/biopsies with no visible lesion -> cervical conization/leep is required Cone Biopsy LEEP (Loop Electro Excisional Procedure)

9 Local: Patterns of Spread cervical stroma, vagina, parametrium Lymphatic: pelvic -> common -> para-aortic Hematogenous: Liver, lung

10 Cancer Cervical Staging Internacional Federation of Ginecology and Obstetrics (FIGO) Clinical staging (not surgical): Physical exam, cone/leep, cystoscopy, proctoscopy Chest x-ray, Intravenous pyelogram (IVP) Allows use of the same staging system for low and high-resource areas

11

12 Cervical Cancer Survival FIGO Stage 5y Overall Survival IA1 98% IA2 95% IB1 89% IB2 76% IIA 73% IIB 66% IIIA 40% IIIB 42% IVA 22% IVB 9%

13 Cervical Cancer Treatment

14 Treatment Microinvasive (Stage IA1): Simple (extrafascial) hysterectomy/cone Early Stage (IA2 or IB1): Radical hysterectomy/trachelectomy vs. chemoradiation Locally Advanced (IB2-IVA) Primary chemoradiation (cisplatinum) Distant Metastases (IVB) Palliative care/systemic chemotherapy

15 Treatment of Early Stage Disease Stage IA1-IB1

16 Surgical Options Early Stage Cancer Cervical Stage IA1 Simple hysterectomy Cervical conization (preserve fertility) Stage IA2-IB1 Radical hysterectomy with lymphadenectomy Radical trachelectomy with lymphadenectomy (preserve fertility)

17 Simple vs. Radical Hysterectomy

18 Radical Trachelectomy Fertility Preservation

19 Early Stage Disease Summary Stage IA1: Simple hysterectomy or conization Stage IA2-IB1: Radical hysterectomy of trachelectomy Primary RT if poor surgical candidate Post-operative chemort if high-risk disease Post-operative RT if intermediate-risk disease (Sedlis criteria)

20 Locally Advanced Disease Stage IB2-IVA Treatment is radiation therapy with weekly chemotherapy (chemoradiation) * Neoadjuvant chemotherapy followed by surgery and/or chemoradiation is an option if radiation is not available

21 Primary Chemoradiation Radiotherapy: External beam Whole pelvis Extended field if positive paraaortic nodes Intracavitary (Brachytherapy) Tandem and ovoids

22 Primary Chemoradiation Adding weekly chemotherapy with cisplatin to primary radiation therapy decreases rate of death by 30-50% Has been confirmed in several randomized trials and a meta-analysis NCI clinical announcement in concurrent cisplatinum-based chemotherapy and RT are standard of care in the treatment of locally advanced cervix cancer

23 Locally Advanced Disease Summary: Stage IB2-IVA Primary chemoradiation is the treatment of choice Neoadjuvant chemotherapy followed by surgery and/or chemoradiation is an option if RT not available

24 Treatment of Recurrent and Metastatic Disease

25 Recurrent Disease Localized Recurrent Disease: Surgery for those with previous radiation Radiation for those with previous surgery When curative surgery or XRT not possible- PALLIATION is the goal Supportive care Chemotherapy Clinical trials

26 Pelvic Exenteration Indication: central recurrence in patient with previous radiation Cure rate of 30-50% Removal: Pelvic reproductive organs Rectum and anus Bladder and distal ureters Entire pelvic floor Ileal conduit, colostomy and VRAM flap

27 Cervical cancer is preventable: Effective vaccines Treatable pre-invasive disease Early stage disease: Surgery (radical hysterectomy, trachelectomy) Locally advanced disease: Chemoradiation Recurrent disease: Pelvic exenteration only curative option Metastatic disease: Palliative chemotherapy Summary

28 Thank You

Carcinoma of the Cervix. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology

Carcinoma of the Cervix. Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Carcinoma of the Cervix Kathleen M. Schmeler, MD Associate Professor Department of Gynecologic Oncology Cervical Cancer Treatment Treatment Microinvasive (Stage IA1): Simple (extrafascial) hysterectomy/cone

More information

SCAN Gynaecological Group. Clinical Management Protocols: Cancer of the Cervix. www.scan.scot.nhs.uk

SCAN Gynaecological Group. Clinical Management Protocols: Cancer of the Cervix. www.scan.scot.nhs.uk SE Scotland Cancer Network SCAN Gynaecological Group Clinical Management Protocols: Cancer of the Cervix www.scan.scot.nhs.uk Table of contents 3 Introduction 4 Diagnosis 5-6 Staging and spread of disease

More information

Uterine sarcomas are very rare. They are responsible for only 1 to 5 percent of all malignancies

Uterine sarcomas are very rare. They are responsible for only 1 to 5 percent of all malignancies EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition 2001 Uterus: Uterine Sarcomas Jeffrey L. Stern, MD Uterine sarcomas

More information

UICC HPV and CERVICAL CANCER CURRICULUM

UICC HPV and CERVICAL CANCER CURRICULUM UICC HPV and CERVICAL CANCER CURRICULUM 01 Chapter 6.c.1 Methods of treatment Algorithm Charité Universitätsmedizin Berlin, Germany 02 Cervical cancer Diagnostics Staging Therapy - Surgery - Radiation

More information

Carcinoma of the vagina is a relatively uncommon disease, affecting only about 2,000 women in

Carcinoma of the vagina is a relatively uncommon disease, affecting only about 2,000 women in EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition, 2001 Vagina Jeffrey L. Stern, MD Carcinoma of the vagina is

More information

Cervical Cancer The Importance of Cervical Screening and Vaccination

Cervical Cancer The Importance of Cervical Screening and Vaccination Cervical Cancer The Importance of Cervical Screening and Vaccination Cancer Cells Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Sometimes, this

More information

2015 RN.ORG, S.A., RN.ORG, LLC

2015 RN.ORG, S.A., RN.ORG, LLC Cervical Cancer WWW.RN.ORG Reviewed September, 2015, Expires September, 2017 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2015 RN.ORG, S.A., RN.ORG,

More information

Cancer of the Cervix

Cancer of the Cervix Cancer of the Cervix WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 A woman's cervix (the opening of the uterus) is lined with cells. Cancer of the cervix occurs when those cells change,

More information

A Gynecologic Cancer Intergroup (GCIG) Trial led by the NCIC CTG. GCIG Trial Designation: The SHAPE Trial NCIC CTG Protocol Number: CX.

A Gynecologic Cancer Intergroup (GCIG) Trial led by the NCIC CTG. GCIG Trial Designation: The SHAPE Trial NCIC CTG Protocol Number: CX. A RANDOMIZED TRIAL COMPARING RADICAL HYSTERECTOMY AND PELVIC NODE DISSECTION VS SIMPLE HYSTERECTOMY AND PELVIC NODE DISSECTION IN PATIENTS WITH LOW RISK EARLY STAGE CERVICAL CANCER A Gynecologic Cancer

More information

Building Awareness of Cervical Cancer

Building Awareness of Cervical Cancer Building Awareness of Cervical Cancer Guest Expert: Peter, MD John Slade Ely Professor of Obstetrics, Gynecology & Reproductive Sciences www.wnpr.org www.yalecancercenter.org Welcome to Yale Cancer Center

More information

Cervical Cancer. What is cancer?

Cervical Cancer. What is cancer? What is cancer? Cervical Cancer The body is made up of trillions of living cells. Normal body cells grow, divide to make new cells, and die in an orderly way. During the early years of a person's life,

More information

Endometrial cancer-carcinoma of the lining of the uterus-is the most common gynecologic

Endometrial cancer-carcinoma of the lining of the uterus-is the most common gynecologic EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4th Edition 2001 Uterus: Endometrial Carcinoma Jeffrey L. Stern, MD Endometrial

More information

Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy

Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy Sarah Hutto,, MSIV Marc Underhill, M.D. January 27, 2009 Past History 45 yo female

More information

Cervical Cancer. Cervical smear test. The cervix. Dysplasia. Cervical cancer. The female reproductive system

Cervical Cancer. Cervical smear test. The cervix. Dysplasia. Cervical cancer. The female reproductive system INFORMATION SHEET Cervical Cancer This information sheet has been written to provide you with information about cervical cancer (cancer of the cervix). The sheet has information about the different types

More information

Myths & Facts. about cervical cancer. What you need to know

Myths & Facts. about cervical cancer. What you need to know Myths & Facts about cervical cancer What you need to know Clinical opinions expressed in this book are those of the authors and do not necessarily reflect the opinions of the supporter, editors, or the

More information

Overview of Gynaecologic Cancer

Overview of Gynaecologic Cancer Overview of Gynaecologic Cancer Stuart Salfinger Gynaecologic Oncologist St John of God Hospital King Edward Memorial Hospital Cervical Cancer Cervical Cancer Risk HPV Smoking?OCP Cervical Cancer Symptoms

More information

What is cervical cancer?

What is cervical cancer? Cervical Cancer What is cervical cancer? Let us explain it to you. www.anticancerfund.org www.esmo.org ESMO/ACF Patient Guide Series based on the ESMO Clinical Practice Guidelines CERVICAL CANCER: A GUIDE

More information

What is neuroendocrine cervical cancer?

What is neuroendocrine cervical cancer? Key Points: 1. Neuroendocrine cancer of the uterine cervix is a rare and aggressive disease. 2. Treatment for neuroendocrine cervical cancer is usually more intensive than that for most other types of

More information

SCBT 11: Revised FIGO: What Every Radiologists Needs to Know. Susan M. Ascher, M.D. Georgetown University School of Medicine Washington, DC

SCBT 11: Revised FIGO: What Every Radiologists Needs to Know. Susan M. Ascher, M.D. Georgetown University School of Medicine Washington, DC SCBT 11: Revised FIGO: What Every Radiologists Needs to Know Susan M. Ascher, M.D. Georgetown University School of Medicine Washington, DC GYNECOLOGIC MALIGNANCY: LECTURE OUTLINE ENDOMETRIAL & CERVICAL

More information

Cervical Cancer: Definitive Chemoradiation

Cervical Cancer: Definitive Chemoradiation Cervical Cancer: Definitive Chemoradiation Huma Chaudhry Jordan Kharofa Faculty: Dr. Beth Erickson, MD Medical College of Wisconsin Department of Radiation Oncology July 14, 2013 Clinical Presentation

More information

An introduction to invasive cancer of the uterine cervix

An introduction to invasive cancer of the uterine cervix An introduction to invasive cancer of the uterine cervix Preclinical invasive cancer refers to early cervical cancer, with minimal stromal invasion, often without any symptoms or clinical features. As

More information

CERVICAL CANCER What every woman should know What is a cervix?

CERVICAL CANCER What every woman should know What is a cervix? CERVICAL CANCER What every woman should know What is a cervix? The cervix is the entrance to the womb from the vagina. It is the narrow, lower part of the uterus that is the passageway connecting the uterus

More information

Cervical Cancer. Shannon Bartley Liliya

Cervical Cancer. Shannon Bartley Liliya Cervical Cancer Shannon Bartley Liliya The quality of life turned to be better than before. Nowadays people live in better conditions. They eat high quality food and receive all vitamins needed for health.

More information

SIGN. Management of cervical cancer. Scottish Intercollegiate Guidelines Network. A national clinical guideline

SIGN. Management of cervical cancer. Scottish Intercollegiate Guidelines Network. A national clinical guideline SIGN Scottish Intercollegiate Guidelines Network Help us to improve SIGN guidelines - click here to complete our survey 99 Management of cervical cancer A national clinical guideline 1 Introduction 1 2

More information

A WOMAN S GUIDE foundationforwomenscancer.org

A WOMAN S GUIDE foundationforwomenscancer.org Understanding Cervical Cancer A WOMAN S GUIDE foundationforwomenscancer.org Contents Introduction...1 Cervical Cancer: An Overview...2 Medical Evaluation...3 WORKING WITH YOUR TREATMENT TEAM...3 TREATMENT...4

More information

Cervical Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2015 NCCN.org. Continue

Cervical Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2015 NCCN.org. Continue NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2015 NCCN.org Continue Version 1.2015, 08/07/14 National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN

More information

GYNECOLOGIC CANCERS Facts to Help Patients Make an Informed Decision

GYNECOLOGIC CANCERS Facts to Help Patients Make an Informed Decision RADIATION THERAPY FOR GYNECOLOGIC CANCERS Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY FACTS ABOUT GYNECOLOGIC CANCERS Gynecologic cancers

More information

What is cervical cancer?

What is cervical cancer? What is cervical cancer? Cervical cancer is a term used for a tumour that starts in the cervix where the uterus (womb) meets the vagina (birth canal). The cells of the cervix don t suddenly turn into cancer;

More information

Radiotherapy in Cervix & Uterine Cancer. A/Prof Raphael Chee Radiation Oncologist

Radiotherapy in Cervix & Uterine Cancer. A/Prof Raphael Chee Radiation Oncologist Radiotherapy in Cervix & Uterine Cancer A/Prof Raphael Chee Radiation Oncologist Multi-Disciplinary Management WA Gynaecological Oncology Team Gynae-Oncological Surgeons Medical Oncologist Radiation Oncologist

More information

Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE

Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Introduction This guide is designed to help you clarify and understand the decisions that need to be made about your care for the

More information

the most likely cause for this will be Chlamydia trachomatis; see Differential diagnosis).

the most likely cause for this will be Chlamydia trachomatis; see Differential diagnosis). Cervical cancer and HPV - Management View full scenario What are the clinical features that are suspicious of cervical cancer? Many women with cervical cancer will be asymptomatic and are diagnosed through

More information

Frequently Asked Questions About Ovarian Cancer

Frequently Asked Questions About Ovarian Cancer Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues

More information

Cervical Cancer. Understanding your diagnosis

Cervical Cancer. Understanding your diagnosis Cervical Cancer Understanding your diagnosis Cervical Cancer Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the large amount

More information

Further investigations, treatments and new technologies

Further investigations, treatments and new technologies Promoting Cervical Screening Information for Health Professionals Further investigations, treatments and new technologies Population Health Queensland Cancer Screening Services Branch Queensland Cervical

More information

PRIMARY TREATMENT CLINICAL PRESENTATION INITIAL EVALUATION. Conclude procedure with/without lymph node dissection

PRIMARY TREATMENT CLINICAL PRESENTATION INITIAL EVALUATION. Conclude procedure with/without lymph node dissection INITIAL EVALUATION History and Physical CXR Pathology review 1 Labs Consider CA125, and pre-operative imaging of abdomen and pelvis Screen for Lynch Syndrome by family history or molecular testing CLINICAL

More information

Guidelines for reporting histopathology of cervical carcinoma

Guidelines for reporting histopathology of cervical carcinoma Guidelines for reporting histopathology of cervical carcinoma Naveena Singh, Consultant Pathologist Introduction Cancer management is multidisciplinary Histopathology report has a MAJOR impact on management

More information

The main surgical options for treating early stage cervical cancer are:

The main surgical options for treating early stage cervical cancer are: INFORMATION LEAFLET ON TOTAL LAPAROSCOPIC RADICAL HYSTERECTOMY (TLRH) FOR EARLY STAGE CERVICAL CANCER (TREATING EARLY STAGE CERVICAL CANCER BY RADICAL HYSTERECTOMY THROUGH KEYHOLE SURGERY) Aim of the leaflet

More information

An abnormal Pap smear - what does it mean?

An abnormal Pap smear - what does it mean? An abnormal Pap smear - what does it mean? It is natural to feel worried if you have just found out that your Pap smear result is not normal (abnormal). Around 1 in 10 Pap smears will show changes in the

More information

Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening.

Examples of good screening tests include: mammography for breast cancer screening and Pap smears for cervical cancer screening. CANCER SCREENING Dr. Tracy Sexton (updated July 2010) What is screening? Screening is the identification of asymptomatic disease or risk factors by history taking, physical examination, laboratory tests

More information

A practical guide to understanding cancer. Understanding. cervical. CAnCER

A practical guide to understanding cancer. Understanding. cervical. CAnCER A practical guide to understanding cancer Understanding cervical CAnCER Contents Contents About Understanding cervical cancer 4 What is cancer? 5 The lymphatic system 7 The cervix 9 How cervical cancer

More information

Uterine Sarcoma. Chapter 5. Fred Ueland, MD. Division of Gynecologic Oncology University of Kentucky

Uterine Sarcoma. Chapter 5. Fred Ueland, MD. Division of Gynecologic Oncology University of Kentucky Uterine Sarcoma Chapter 5 Fred Ueland, MD Division of Gynecologic Oncology University of Kentucky University of Kentucky Annual New Cancers 140 128 120 100 80 60 40 84 82 42 Uterus Ovary Cervix Vulva Other

More information

Treatment Guide Gynecologic Cancer

Treatment Guide Gynecologic Cancer Treatment Guide Gynecologic Cancer Cleveland Clinic experts tailor treatment to their patients needs, taking into account the type of cancer, the degree to which the cancer has spread, the age of the individual

More information

PrevalenceofCervicalCancerinDevelopingCountryPakistan

PrevalenceofCervicalCancerinDevelopingCountryPakistan : F Diseases Volume 15 Issue 3 Version 1.0 Year 2015 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online ISSN: 2249-4618 & Print ISSN: 0975-5888

More information

Cervical Cancer. Understanding your diagnosis

Cervical Cancer. Understanding your diagnosis Cervical Cancer Understanding your diagnosis Cervical Cancer Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the large amount

More information

Guideline for the Management of Endometrial Cancer Formerly the Guideline for Post Menopausal Bleeding and Endometrial Cancer

Guideline for the Management of Endometrial Cancer Formerly the Guideline for Post Menopausal Bleeding and Endometrial Cancer Guideline for the Management of Endometrial Cancer Formerly the Guideline for Post Menopausal Bleeding and Endometrial Cancer Date Approved by Network Governance May 2012 Date for Review May 2015 Changes

More information

Cervical Cancer Overview

Cervical Cancer Overview Cervical Cancer Overview The information that follows is based on the more detailed information in our document, Cervical Cancer.. What is cancer of the cervix? Cancer starts when cells in the body begin

More information

Cervical Carcinoma. Chris DeSimone, M.D. Assistant Professor Division of Gynecologic Oncology

Cervical Carcinoma. Chris DeSimone, M.D. Assistant Professor Division of Gynecologic Oncology Cervical Carcinoma Chris DeSimone, M.D. Assistant Professor Division of Gynecologic Oncology Outline Cervical Carcinoma Epidemiology Clinical symptoms Risk factors Staging Cell types Prognostic factors

More information

Outcome of Early Cervical Carcinoma Treated by Wertheim Hysterectomy with Selective Postoperative Radiotherapy

Outcome of Early Cervical Carcinoma Treated by Wertheim Hysterectomy with Selective Postoperative Radiotherapy ORIGINAL ARTICLES 613 Outcome of Early Cervical Carcinoma Treated by Wertheim Hysterectomy with Selective Postoperative Radiotherapy S K Tay,*FAMS, MD, FRCOG, L K Tan,**MBBS, M Med (O & G), MRCOG Abstract

More information

Gestational Trophoblastic Tumors

Gestational Trophoblastic Tumors 32 Gestational Trophoblastic Tumors C58.9 Placenta SUMMARY OF CHANGES Gestational trophoblastic tumors are effectively treated with chemotherapy even when widely metastatic so that traditional anatomic

More information

PROPERTY OF ELSEVIER SAMPLE CONTENT - NOT FINAL ABNORMAL PAP SMEAR (ABNORMAL CERVICAL CYTOLOGIC FINDINGS) Kathleen Dor

PROPERTY OF ELSEVIER SAMPLE CONTENT - NOT FINAL ABNORMAL PAP SMEAR (ABNORMAL CERVICAL CYTOLOGIC FINDINGS) Kathleen Dor 1 ABNORMAL PAP SMEAR (ABNORMAL CERVICAL CYTOLOGIC FINDINGS) Kathleen Dor Cervical cytology screening has significantly decreased rates of mortality from cervical cancer; however, 400 women die each year

More information

Surgical Staging of Endometrial Cancer

Surgical Staging of Endometrial Cancer Surgical Staging of Endometrial Cancer I. Endometrial Cancer Surgical Staging Overview Uterine cancer types: carcinomas type I and type II, sarcomas, carcinosarcomas Hysterectomy with BSO Surgical Staging

More information

Small Cell Lung Cancer

Small Cell Lung Cancer Small Cell Lung Cancer Types of Lung Cancer Non-small cell carcinoma (NSCC) (87%) Adenocarcinoma (38%) Squamous cell (20%) Large cell (5%) Small cell carcinoma (13%) Small cell lung cancer is virtually

More information

Chapter 14 Cancer of the Cervix Uteri

Chapter 14 Cancer of the Cervix Uteri Carol L. Kosary Introduction Despite the existence of effective screening through the use of Pap smears since the 195 s, there were 9,71 estimated cases of invasive cervical cancer and 3,7 deaths in 26

More information

Ovarian cancer. A guide for journalists on ovarian cancer and its treatment

Ovarian cancer. A guide for journalists on ovarian cancer and its treatment Ovarian cancer A guide for journalists on ovarian cancer and its treatment Contents Contents 2 3 Section 1: Ovarian Cancer 4 i. Types of ovarian cancer 4 ii. Causes and risk factors 5 iii. Symptoms and

More information

CMScript. Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014

CMScript. Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014 Background CMScript Member of a medical scheme? Know your guaranteed benefits! Issue 7 of 2014 Prostate cancer is second only to lung cancer as the leading cause of cancer-related deaths in men. It is

More information

Emily Hill, MD Clinical Assistant Professor Gynecologic Oncology Division University of Iowa Hospitals and Clinics

Emily Hill, MD Clinical Assistant Professor Gynecologic Oncology Division University of Iowa Hospitals and Clinics Emily Hill, MD Clinical Assistant Professor Gynecologic Oncology Division University of Iowa Hospitals and Clinics Learning Objectives What you need to know: Risk factors Symptoms Diagnosis/treatment Prevention

More information

Pap Smears Where are we headed. Ian H. Thorneycrroft PhD,MD,FACOG

Pap Smears Where are we headed. Ian H. Thorneycrroft PhD,MD,FACOG Pap Smears Where are we headed Ian H. Thorneycrroft PhD,MD,FACOG Where are we headed/ Less frequent sampling. More use of DNA technology.?increase in cervical cancer. History The test was invented by and

More information

General Information About Non-Small Cell Lung Cancer

General Information About Non-Small Cell Lung Cancer General Information About Non-Small Cell Lung Cancer Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung. The lungs are a pair of cone-shaped breathing

More information

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer.

Smoking and misuse of certain pain medicines can affect the risk of developing renal cell cancer. Renal cell cancer Renal cell cancer is a disease in which malignant (cancer) cells form in tubules of the kidney. Renal cell cancer (also called kidney cancer or renal adenocarcinoma) is a disease in which

More information

Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent. Disclosure

Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent. Disclosure Re irradiation Using HDR Interstitial Brachytherapy for Locally Recurrent Cervical lcancer Yasuo Yoshioka, MD Department of Radiation Oncology Osaka University Graduate School of Medicine Osaka, Japan

More information

The Emperor s New Clothing

The Emperor s New Clothing Chemotherapy for Early Stage High-Risk Endometrial Cancer: Opposed Hal Hirte Medical Oncologist Juravinski Cancer Centre Hamilton, Ontario The Emperor s New Clothing The Emperor s New Chemotherapy Outline

More information

Radiation Oncology Treatment for Gynecological Cancers

Radiation Oncology Treatment for Gynecological Cancers Radiation Oncology Treatment for Gynecological Cancers Guest Expert: Susan, MD Associate Professor of Therapeutic Radiology Yale School of Medicine www.wnpr.org www.yalecancercenter.org Welcome to Yale

More information

Sentinel Lymph Node Mapping for Endometrial Cancer. Locke Uppendahl, MD Grand Rounds

Sentinel Lymph Node Mapping for Endometrial Cancer. Locke Uppendahl, MD Grand Rounds Sentinel Lymph Node Mapping for Endometrial Cancer Locke Uppendahl, MD Grand Rounds Endometrial Cancer Most common gynecologic malignancy in US estimated 52,630 new cases in 2014 estimated 8,590 deaths

More information

INTERVENTIONAL PROCEDURES PROGRAMME

INTERVENTIONAL PROCEDURES PROGRAMME NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of radical laparoscopic hysterectomy for early stage cervical cancer Introduction This overview

More information

PROGNOSTIC FACTORS IN ADVANSED OVARIAN CANCER

PROGNOSTIC FACTORS IN ADVANSED OVARIAN CANCER PROGNOSTIC FACTORS IN ADVANSED OVARIAN CANCER Dr. Hisham Rahahle Gynecologist, MD, Ph.D Subspecialty in Gynecological Oncology E-mail: hisham_re@yahoo.com Abstract: This study includes (68) patient diagnosed

More information

American Academy of Family Physicians

American Academy of Family Physicians American Academy of Family Physicians Barbara E. Stanford MD Grand Rapids Family Medicine Residency Wege Family Medicine HPV is transient in most women HPV-75% Normal ASCUS LSIL HSIL Cancer 80-90% 75%???

More information

HPV and Head Neck Cancer

HPV and Head Neck Cancer HPV and Head Neck Cancer Becky Massey, MD Assistant Professor Division of Head and Neck Surgical Oncology and Reconstruction Department of Otolaryngology & Communication Sciences Medical College of Wisconsin

More information

S2k Guideline on the Diagnosis and Treatment of Cervical Carcinoma

S2k Guideline on the Diagnosis and Treatment of Cervical Carcinoma S2k on the Diagnosis and Treatment of Cervical Published in February 2008 by the Working Group on Gynecological Oncology (Arbeitsgemeinschaft für Gynäkologische Onkologie e.v, AGO), affiliated to the German

More information

Follow-Up Care for Breast Cancer

Follow-Up Care for Breast Cancer A Patient s Guide Follow-Up Care for Breast Cancer Recommendations of the American Society of Clinical Oncology The American Society of Clinical Oncology (ASCO) is a nonprofit organization which represents

More information

Cervical Cancer Screening and Management Guidelines: Changing Again, Huh?

Cervical Cancer Screening and Management Guidelines: Changing Again, Huh? Cervical Cancer Screening and Management Guidelines: Changing Again, Huh? Summary of 2013 recommendations from ASC (American Cancer Society), ASCCP (American Society for Colposcopy and Cervical Pathology),

More information

Thema: p53 codon 72 polymorphism in HPV-related cervical cancer

Thema: p53 codon 72 polymorphism in HPV-related cervical cancer Aus der Klinik für Frauenheilkunde der Medizinischen Fakultät Charité Universitätsmedizin Berlin DISSERTATION Thema: p53 codon 72 polymorphism in HPV-related cervical cancer zur Erlangung des akademischen

More information

Cervical Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version NCCN.org. Continue

Cervical Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version NCCN.org. Continue NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2016 NCCN.org Continue Version 1.2016, 11/25/15 National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN

More information

Nursing Care of the Patient Receiving Brachytherapy for Gynecologic Cancer

Nursing Care of the Patient Receiving Brachytherapy for Gynecologic Cancer Nursing Care of the Patient Receiving Brachytherapy for Gynecologic Cancer Una Randall, RN, BSN, OCN Dana Farber / Brigham and Women s Cancer Center Department of Radiation Oncology Una Randall is not

More information

Colposcopy Mentorship Program FAQs

Colposcopy Mentorship Program FAQs Colposcopy Mentorship Program FAQs What is the Colposcopy Mentorship Program? The ASCCP Colposcopy Mentorship Program (CMP) is a three-tiered educational program designed to improve the beginning colposcopist

More information

The society for lower genital tract disorders since 1964.

The society for lower genital tract disorders since 1964. The society for lower genital tract disorders since 1964. Updated Consensus Guidelines for Managing Abnormal Cervical Cancer Screening Tests and Cancer Precursors American Society for and Cervical Pathology

More information

Gynecologic Malignancies. J. Brian Szender 31 March 2016

Gynecologic Malignancies. J. Brian Szender 31 March 2016 Gynecologic Malignancies J. Brian Szender 31 March 2016 Outline Female Cancer Statistics Uterine Cancer Adnexal Cancer Cervical Cancer Vulvar Cancer Uterine Cancer Endometrial Cancer Uterine Sarcoma

More information

Cervical Cancer Prevention and Early Detection What is cervical cancer?

Cervical Cancer Prevention and Early Detection What is cervical cancer? Cervical Cancer Prevention and Early Detection What is cervical cancer? Cervical cancer starts in cells lining the cervix. The cervix is the lower part of the uterus (womb). It is sometimes called the

More information

Treatment Guidelines. Gynaecology SELCN. June 2012

Treatment Guidelines. Gynaecology SELCN. June 2012 Treatment Guidelines Gynaecology SELCN June 2012 SELCN Treatment Guidelines - Agreement Sheet The Gynaecology SELCN Treatment Guidelines have been agreed by: Position MDT Lead Clinician (on behalf of MDT

More information

Endometrial Cancer Treatment

Endometrial Cancer Treatment Endometrial Cancer Treatment January 2006 By Shelly Smits, RHIT, CCS, CTR mary by Ian Thompson, MD Data Source: Cancer registry information on uterine cancer diagnosed 1/1/2000 to 12/31/2004. Reason for

More information

INITIAL EXPERIENCE OF RADICAL HYSTERECTOMY FOR EARLY CERVICAL CANCER AT A CANCER HOSPITAL IN NEPAL

INITIAL EXPERIENCE OF RADICAL HYSTERECTOMY FOR EARLY CERVICAL CANCER AT A CANCER HOSPITAL IN NEPAL ORIGINAL ARTICLE J Nep Med Assoc 2004; 43: 297-302 INITIAL EXPERIENCE OF RADICAL HYSTERECTOMY FOR EARLY CERVICAL CANCER AT A CANCER HOSPITAL IN NEPAL ABSTRACT The purpose of this study was to find out

More information

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER

GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER GUIDELINES FOR THE MANAGEMENT OF LUNG CANCER BY Ali Shamseddine, MD (Coordinator); as04@aub.edu.lb Fady Geara, MD Bassem Shabb, MD Ghassan Jamaleddine, MD CLINICAL PRACTICE GUIDELINES FOR THE TREATMENT

More information

worry When to Cervical Abnormalities CME Workshop What s the situation? What are the trends? By Dianne Miller, MD, FRCSC In this article:

worry When to Cervical Abnormalities CME Workshop What s the situation? What are the trends? By Dianne Miller, MD, FRCSC In this article: CME Workshop When to worry Cervical Abnormalities By Dianne Miller, MD, FRCSC What s the situation? Over 600,000 Papanicolaou s (Pap) smears were performed in British Columbia in 2000. Approximately 13,400

More information

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD

Epidemiology, Staging and Treatment of Lung Cancer. Mark A. Socinski, MD Epidemiology, Staging and Treatment of Lung Cancer Mark A. Socinski, MD Associate Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive Cancer Center University of

More information

BLADDER CANCER GLOSSARY OF TERMS

BLADDER CANCER GLOSSARY OF TERMS BLADDER CANCER GLOSSARY OF TERMS Abdomen: The part of the body that contains the pancreas, stomach, intestines, kidneys, urinary bladder, liver, gallbladder, and other organs. Anesthesia: Loss of feeling

More information

Understanding Cervical Cancer. A guide for women with cancer, their families and friends.

Understanding Cervical Cancer. A guide for women with cancer, their families and friends. Understanding Cervical Cancer A guide for women with cancer, their families and friends. Understanding Cervical Cancer A guide for women with cancer, their families and friends. First published January

More information

Your Colposcopy Clinic Visit

Your Colposcopy Clinic Visit The Colposcopy Clinic Juravinski Hospital Your Colposcopy Clinic Visit Welcome to the Colposcopy Clinic. We recognize that coming to the Clinic may be very stressful. We will give you clear information

More information

Biomedical Engineering for Global Health. Lecture Thirteen

Biomedical Engineering for Global Health. Lecture Thirteen Biomedical Engineering for Global Health Lecture Thirteen Outline The burden of cancer How does cancer develop? Why is early detection so important? Strategies for early detection Example cancers/technologies

More information

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda

Stomach (Gastric) Cancer. Prof. M K Mahajan ACDT & RC Bathinda Stomach (Gastric) Cancer Prof. M K Mahajan ACDT & RC Bathinda Gastric Cancer Role of Radiation Layers of the Stomach Mucosa Submucosa Muscularis Serosa Stomach and Regional Lymph Nodes Stomach and Regional

More information

Recurrence of cancer cervix in patients treated by radical hysterectomy followed by adjuvant external beam radiotherapy

Recurrence of cancer cervix in patients treated by radical hysterectomy followed by adjuvant external beam radiotherapy Bangladesh Med Res Counc Bull 2010; 36: 52-56 Recurrence of cancer cervix in patients treated by radical hysterectomy followed by adjuvant external beam radiotherapy Fauzia Sobhan 1, Farzana Sobhan 2,

More information

Metastatic Cancer: Questions and Answers. Key Points

Metastatic Cancer: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Metastatic Cancer: Questions

More information

An Overview Cervical Cancer Screening and Cervical Intraepithelial Neoplasia (CIN)

An Overview Cervical Cancer Screening and Cervical Intraepithelial Neoplasia (CIN) An Overview Cervical Cancer Screening and Cervical Intraepithelial Neoplasia (CIN) Linda Kelly, DNP, ANP-BC Obstetrics and Gynecology Massachusetts General Hospital Sonja and Deborah Kelly Scholar February

More information

International Journal of Gynecology and Obstetrics

International Journal of Gynecology and Obstetrics International Journal of Gynecology & Obstetrics 119S2 (2012) S100 S109 Contents lists available at SciVerse ScienceDirect International Journal of Gynecology and Obstetrics journal homepage: www.elsevier.com/locate/ijgo

More information

Treatment Algorithms for the Management of Lung Cancer in NSW Guide for Clinicians

Treatment Algorithms for the Management of Lung Cancer in NSW Guide for Clinicians Treatment Algorithms for the Management of Lung Cancer in NSW Guide for Clinicians Background The Cancer Institute New South Wales Oncology Group Lung (NSWOG Lung) identified the need for the development

More information

Table 7a Corpus Uterus Cancer Average Annual Number of Cancer Cases and Age-Adjusted Incidence Rates* for

Table 7a Corpus Uterus Cancer Average Annual Number of Cancer Cases and Age-Adjusted Incidence Rates* for Corpus Uterus Cancer Figure 7 Definition: The uterus is a hollow organ in the pelvis of females. 1 There are three parts: the top is called the fundus, the middle is called the corpus, and the bottom part

More information

Breast Cancer Treatment Guidelines

Breast Cancer Treatment Guidelines Breast Cancer Treatment Guidelines DCIS Stage 0 TisN0M0 Tamoxifen for 5 years for patients with ER positive tumors treated with: -Breast conservative therapy (lumpectomy) and radiation therapy -Excision

More information

Cervical cancer screening with the HPV test and the Pap test in women ages 30 and older

Cervical cancer screening with the HPV test and the Pap test in women ages 30 and older Cervical cancer screening with the HPV test and the Pap test in women ages 30 and older When to get tested and how to make sense of your test results If you are 30 years or older and your Pap test is normal

More information

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What?

RESEARCH EDUCATE ADVOCATE. Just Diagnosed with Melanoma Now What? RESEARCH EDUCATE ADVOCATE Just Diagnosed with Melanoma Now What? INTRODUCTION If you are reading this, you have undergone a biopsy (either of a skin lesion or a lymph node) or have had other tests in which

More information

SMALL CELL LUNG CANCER

SMALL CELL LUNG CANCER Protocol for Planning and Treatment The process to be followed in the management of: SMALL CELL LUNG CANCER Patient information given at each stage following agreed information pathway 1. DIAGNOSIS New

More information

7. Prostate cancer in PSA relapse

7. Prostate cancer in PSA relapse 7. Prostate cancer in PSA relapse A patient with prostate cancer in PSA relapse is one who, having received a primary treatment with intent to cure, has a raised PSA (prostate-specific antigen) level defined

More information

Lung Cancer: Diagnosis, Staging and Treatment

Lung Cancer: Diagnosis, Staging and Treatment PATIENT EDUCATION patienteducation.osumc.edu Lung Cancer: Diagnosis, Staging and Treatment Cancer begins in our cells. Cells are the building blocks of our tissues. Tissues make up the organs of the body.

More information