14. Malignant tumors of the urinary system (kidney, bladder) - clinical picture, classification, staging and complex treatment.
Covers treatment approaches for gynaecological cancers: ovarian, endometrial, cervical and vaginal. It runs through each cancer by stage, setting out surgery, adjuvant chemotherapy with agents such as paclitaxel and cisplatin, radiotherapy and hormonal therapy with tamoxifen. Nothing on urinary tract tumours appears in the note.
Inside: 1 section · 13 flashcards · 2 min
Topic 47 of 50 in the MU Sofia syllabus for Nuclear Medicine (Medicine, Year 4). The free AceMed note covers it in 1 section, about 220 words (2 min of reading), with 13 flashcards.
In this note
Approaches for treatment of common female reproductive system
Approaches for treatment of common female reproductive system
Ovarian cancer
Stage I
Confirm starting with lymphadenectomy
If low risk stage 1, do not offer adjuvant therapy, high risk stage I, offer six cycles of carboplatin prior to surgery
Stage II
Primary surgery followed by adjuvant first line chemotherapy
Cytotoxic chemotherapy recommended (Paclitaxel)
Endometrial cancer
Surgery is the initial treatment (90%), typically a hysterectomy.
Stage III and IV, cytoreductive surgery is the norm.
Adjuvant radiotherapy and/or chemotherapy is recommended in high-risk cancers
Chemotherapy generally combination of Paclitaxel and platins (cisplatin), chemotherapy has been found to be more effective adjuvant therapy that radiotherapy
Radiotherapy can be used in early stage endometrial cancer as vaginal brachytherapy, sometimes as first line where surgery is contraindicated, sometimes as neoadjuvant therapy.
Hormonal therapy can be used in certain types of tumors, specifically, tamoxifen which blocks progesterone and estrogen receptors is valuable, especially if the tumour has metastasized.
Cervical cancer
Surgery is first line in early stage cancers, often hysterectomy. This is often followed by adjuvant radiotherapy via brachytherapy.
Late stage tumors can be treated with radiation therapy and cisplatin based chemotherapy, often as adjuvant therapy to hysterectomy.
Highly advanced tumors do not attempt surgery, and instead use a radiotherapy-chemotherapy combination
Vaginal cancer
Historical EBRT radiotherapy has been used in early stage vaginal cancer, however surgery is becoming more common.
These cancers are very rare
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