Carcinoma cervix by Dr roman
-
Upload
ayub-medical-college -
Category
Health & Medicine
-
view
57 -
download
2
Transcript of Carcinoma cervix by Dr roman
![Page 1: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/1.jpg)
CARCINOMA OF
CERVIX
![Page 2: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/2.jpg)
INVASIVE CARCINOMA OF
CERVIX
• Definition
• Epidemiology
![Page 3: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/3.jpg)
Atiology
• Early exposure to sexual intercourse before 20 years of age
• Multiple sexual partners
• A male partner with multiple previous sexual partners
• Smoking
• Persistent infection by high risk papillomavirus HPV (Hr Specially HPV 16, 18)
![Page 4: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/4.jpg)
Pathology
![Page 5: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/5.jpg)
• Irregular vaginal bleeding
• Postcoital bleeding
• Pain (less common)
• Edema (in advanced stage)
Clinical Feature
![Page 6: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/6.jpg)
• Cervical biopsy
• Metastatic work up, once the diagnosis of
invasive carcinoma is made, then we can do
pelvic examination, chest-x-ray, intravenous
pyelogram, cystoscopy and sigmoidoscopy
• Imaging Studies: CT, MRI
Diagnostic Tests
![Page 7: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/7.jpg)
Staging of Cervical Carcinoma • Stage O : CIS• Stage I : Spread limited to cervix• Ia1 : Invasion is < 3 mm deep• Ia2 : Invasion is > Ia1 but < 5 mm deep • Ib : Invasion is > 5 mm deep• Stage IIa : Involves upper 2/3 of vagina• IIb : Invasion of parametrium• Stage III : Carcinoma extending the pelvic sidewall and lower
1/3 of vagina• IIIa : Involves lower 1/3 of vagina• IIIb : Extends to the pelvic sidewalls• Stage IV : Ca spread far away from cervix• IVa : Involves bladder or rectum• IVb : Distant metastasis
![Page 8: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/8.jpg)
Management
![Page 9: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/9.jpg)
Specific by Stage
• Ia1 : Total simple hysterectomy
• Ia2 : Radical hysterectomy. It includes removal of
cervix, upper 3rd of vagina, uterus and
parametrical tissue
• Ib or IIa : Radical hysterectomy or radiation therapy and pelvic node disection
• IIb, III or IV: Radiation therapy and chemotherapy.
![Page 10: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/10.jpg)
Follow Up
• All Patients: patients with invasive cervical cancershould follow up with a pap smear every 3months for 2 years after treatment and thenevery 6 months for the subsequent 3 years.
• Local Reoccurrence: Patient having localreoccurrence should be treated with radiationtherapy.
• Distant Metastasis: In these case patient shouldbe treated with chemotherapy e.g. cisplatinum.
![Page 11: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/11.jpg)
Invasive Carcinoma in Pregnancy
![Page 12: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/12.jpg)
Complication of Surgery
• Anesthetic complication and haemorrhage
• Post operative, chest, wound and urinary tract
infection
• Urological complication include atonic bladder
• Obturator nerve damage may occur
• Thromboembolism
![Page 13: Carcinoma cervix by Dr roman](https://reader031.fdocuments.in/reader031/viewer/2022020218/55a71a011a28abcf048b4796/html5/thumbnails/13.jpg)
Complication of Radiotherapy
• Premature menopause due to radiationinduced ovarian.
• Urinary complication: haemorrhagic cystitis,urinary frequency, contracted bladder, chronichaematuria, ureteric stricture and fistula.
• Bowel Complication: Chronic diarrhea,proctocolitis, rectal stricture
• Avascular necrosis of femoral head.