Endometrial, Cerbvix CA, Radiation Therapy, Treatment, Fields
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| show | cerix (16%), invasive in older group
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| show | endometrial 48%
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| show | increase
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| What does endometrial present with and what is good about it | show 🗑
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| What are risk factors of endometrial ca | show 🗑
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| show | rare, mostly older women, vulvar 3 times as common as vaginal risk
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| show | pap smear, done via curettage
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| Anatomically what is the cervix | show 🗑
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| show | The cervix is the lower third of the uterus that extends into the apex of the vagina
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| show | 4th
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| Of the cancers pertaining to cervix what is the most common | show 🗑
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| What cancer accounts for 10% of cervix cancers | show 🗑
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| show | Small cell and clear cell types, they also have a higher metastatic potential
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| show | external iliac, obturator, and hypogastric (internal iliac) chains.
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| show | FIGO staging system
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| show | Primary tumor cannot be assessed
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| What in regards to the stage of cervix ca is T0 | show 🗑
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| show | Carcinoma in situ, preinvasive carcinoma
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| What is special about stage 0 in regards to FIGO | show 🗑
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| What in regards to the stage of cervix ca is T1 (FIGO I) | show 🗑
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| show | INvasive carcinoma diagnosed by microscopy. Stromal invasion with a max depth of 5 mm and a horizontal measurment of 7 mm or less. If there is vascular space involvement venous or lymphatic does not affect the classification
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| What do you need to know in regards to the stage of cervix ca is T1a1 | show 🗑
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| What do you need to know in regards to the stage of cervix ca T1a2 | show 🗑
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| What do you need to know in regards to the stage of cervix ca T1b | show 🗑
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| show | Clinically visible lesion 4 cm or less in greatest dimension
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| show | Clinically visible lesion more than 4 cm in greatest dimension
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| show | Cervical ca invades beyond uterus but not to pelvic wall or to lower third of vagina
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| What do you need to know in regards to the stage of cervix ca T2a | show 🗑
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| show | Clinically visible lesion 4 cm or less in greatest dimension
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| What do you need to know in regards to the stage of cervix ca T2a2 | show 🗑
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| What do you need to know in regards to the stage of cervix ca T2b | show 🗑
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| show | Tumor extends pelvic wall/ causes hydronephrosis or nonfunctioning kidney
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| What do you need to know in regards to the stage of cervix ca T4 | show 🗑
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| show | IIIB
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| What does T4 represent in figo staging | show 🗑
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| show | M0 no distant mets, M1 Distant mets (including peritoneal spread, involvement of supraclav, mediastinal, or paraaortic lymph nodes, lung liver or bone)
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| show | IVB
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| show | Invasive, keratinizing, nonkeratinizing, verrucous
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| show | initially a pelvic exam, pap smear, and biopsy of any lesions. To further stage, curettage and dilation under anesthesia to examine uterine involvement is needed, this would be paired with a cbc and urine
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| What has replaced IVP's for staging now | show 🗑
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| show | total abdominal hysterectomy and removal of vaginal cuff.
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| show | Tandem and ovoid giving 45 to 55 gy to point a.
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| FOr stage Ia2 what might be used for tx | show 🗑
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| For stage Ib2 cervical disease, what is used | show 🗑
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| show | irradiation and chemo, unless chemo is contraindicated.
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| show | Brachy is important aspect of tx and for control, when brachy is not used survival rates decrease.
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| What is the technique used on a whle pelvis (cervix ca) | show 🗑
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| What is the lower border for RT with cervix cancer | show 🗑
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| show | at top or bottom of L5 or may be extended upward to l4 for a portion of treatment depending on potential involvement of nodes.
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| show | 1.5 to 2 cm lateral to pelvic sidewall in ap/pa plane, ant border of lats may fall beyond pubic symphysis if not at it.
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| show | block that includes external iliac nodes and post border including s3
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| if there is ant or post extension what must happen to the fields (cervix ca) | show 🗑
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| show | To decrease dose given to entire rectum and bladder, the four field technique allows you to block the bladder and rectum
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| in regards to positioning what may help with the tx of cervix ca | show 🗑
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| How is point A prescribed for cervix ca | show 🗑
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| show | 3cm lat to point a
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| What are some of the clinical presentations of endometrial ca | show 🗑
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| show | aspiration curettage is the standard currently, due to the increase of accuracy over pap smears.
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| show | women with uterine bleeding have been getting endometrial sampling or aspiration while in the office setting.
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| show | aspiration, chest xray, blood count, chemistries, urinalysis and nod surgery is the standard for initial defnitive management. An ultrasound and ct/mri is often being performed first if disease may be beyond uterus.
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| What is most common for endometrial ca | show 🗑
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| What is seen about 20% of the time in endometrial cancer (type of ca) | show 🗑
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| What is an extremely malignant form of endometrial ca | show 🗑
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| show | TAH and no other tx
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| show | TAH and brachy alone, low doses of 60 to 70 gy used in one application, or high doses of 5 to 7 gy at a 5mm depth in three applications.
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| What is the treatment guideline for endometrial ca stage Ic or higher, grade 3 | show 🗑
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| show | Nodal dose of 45-50 gy, and 80 gy to the mucosa
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| For medically inoperable and stage III/Iv endometrial patients what tx alone can be used | show 🗑
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| For stage IB, grade 1 &2 and sometimes stage Ia, grade 2 what might be used (tx beyond TAH) | show 🗑
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| show | similar to cervical fields, midline blocking used if brachytherapy is included.
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| show | fatigue, diarrhea, dermatitis, dysuria
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| show | Diarrhea, and is related to large/small bowel treatment. Chemo may significantly worsen problem
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| What can help against diarrhea that patients may experience | show 🗑
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| What is a side effect more common using low energy beams in treating gynecologic cancers | show 🗑
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| show | Domboro soaks, aquaphor and natural gels/lotions.
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| What side effect may occur in the third or fourth week of pelvic irradiation for gynecologic cancers and how can it be lessened | show 🗑
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| What can be used to relieve urinary frequency when patient is having dysuria | show 🗑
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| show | Superficial en face radiation using orthovoltage, high-energy photons, or electrons can be applied directly to the vaginal and cervical tumors with large fraction size and not count against the total prescribed dose.
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| show | hemorrhoidal preparations, steroids, topical anesthetic agents, and sitz baths
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| show | menopause, vaginal dryness/narrowing/shortening, chronic cystitis, proctosigmoiditis, enteritis, and bowel obstruction.
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| What can be done to help late side effects of pelvic irradiation due to gynecologic cancers (vaginal dryness, shrinkage, ulceration) | show 🗑
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| As a therapist what are some things that can help reproducibility with pelvic irradiation | show 🗑
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| show | Watery diarrhea, which needs to be brought to the staff's attention.
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| show | SAD
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