Dysplasia is easily detected in a routine Pap smear and is completely treatable. Cervical cancer is the third most common gynecologic cancer in the US. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. chapter twelve. yuki juan ntust jun 9, 2003. outline. 1. See our User Agreement and Privacy Policy. pre-pregnancy health diagnosing pregnancy, Anticipatory Guidance During Pregnancy - . J. Obstet, Gynecol. Most cases of cervical cancer occur in developing countries, where it is … Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21.Screening tests include: 1. The cervix leads from the uterus to the vagina (birth canal).. Enlarge Anatomy of the female reproductive system. Teen pregnancy and HPV vaccination continue to be a pressing issue for low-income populations. • Zemlickis D., Lishner M. Degendorfer P.et.el. • Hormones • Metabolic Changes • Hemodynamics • Immunology • Increased vascularity • Age • Few cases – anecdotal experience • Inherent bias – breast, ovarian cancer, General Considerations • Pregnancy does not have a proven negative effect on any cancer • Maintaining pregnancy after diagnosis • Delay of treatment (assume delivery at 34th week) • First trimester diagnosis: up to 28 week delay • Second trimester diagnosis: up to 22 week delay • Third trimester diagnosis: up to 10 week delay, General Considerations • Surgery • Wait until 16-18 weeks for abdominal surgery: Spontaneous Abortion: 40%  3% • Don’t remove corpus luteum if possible until 14th week (progesterone supp. No public clipboards found for this slide. miscarriage ectopic hyperemesis, Pancreatic Cancer & the Whipple Procedure - Medical management & nutrition therapy guidelines. CrystalGraphics brings you the world's biggest & best collection of cervical cancer PowerPoint templates. Cervical cancer is a cancer of the female reproductive system that originates in the cervix.. It’s one of the most common cancers in women and it’s usually the result of an infection by the human papillomavirus, or HPV.. First trimester easiest. Treatment of Breast Cancer • Treatment same as non-pregnant • Lumpectomy • Sentinal node biopsy • 2.5mCi technetium 99 – 4.3 mGy at worst. • P.Struyk, P.S. 4 CIN . 9: 1956, 1991. caryn gee morse, md march 20, 2001. lung cancer: the problem . Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Am.J. Create stunning presentation online in just 3 steps. dose 54 cGy): • No failure • Ovaries at edge of radiation field (avg. 43 cases with f/u for 3-19 yrs. • Control bleeding with: • Pressure • Monsel’s solution (Ferric subsulfate) • Silver nitrate, Management of Cervical SIL On Biopsy • Satisfactory Colposcopy • LSIL / HPV+/- : Re-evaluate 6-8 weeks postpartum • HSIL / HPV+/- : F/U depends on trimester • Low grade SIL (50%) regress postpartum (Delivery route seems to matter) • High grade SIL(30%) regress postpartum • Vaginal delivery, Management of Cervical SIL • Cone biopsy in pregnancy • Indications • Unsatisfactory colposcopy/ Pap: SCC, HSIL • Adenocarcinoma in situ • Microinvasive SCC • Perform at 16-18 weeks • Risks • Abortion: 5% • Hermorrhage: immediate: 9%, delayed: 4% • Technique • Local wedge resection • Shallow cone • LEEP • Circumferential figure 8 sutures at cervical-vaginal junction • Vasopressin/ local anesthetic with epinephrine, Management of Cervical SIL HSIL/ HPV positive: No Lesion Visible on Colposcopy • Reinspect: Vulva, Vagina, Anus and Cervix • Lugol’s: Vagina and Cervix • Review Cytology • Consider Random Biopsies: 6 and 12:00 • Careful Follow-up: Pap and Colpo, Vulvar/ Vaginal Condylomata or SIL in Pregnancy • Warts and SIL often enlarge rapidly in pregnancy • No treatment unless symptomatic • Often regresses dramatically postpartum • Treat if symptomatic or interferes with vaginal delivery - disease on perineal body or posterior fourchette • Treatment options: • Trichloroacetic Acid • Podophyllin • Aldara • 5-FU cream • Laser • Excision: scalpel; LEEP • Cryotherapy, Cervical Cancer in Pregnancy • Work-up • MRI of pelvis/abdomen • Chest X-ray • Carcinoembryonic Antigen (CEA) • CBC, BUN, Creatine, LFT’s • Advanced disease • Urine cytology/ cystoscopy • Stool for occult blood/ sigmoidoscopy, Cervical Cancer in Pregnancy: Treatment by Stage • Stage IA1 - <3mm invasion; < 7mm wide • 1.2% positive nodes • Cone biopsy • No further treatment necessary; simple hysterectomy • Vaginal delivery at term, Cervical Cancer in Pregnancy: Treatment by Stage • Stage IA2 (3-5mm invasion, no vascular inv. Clipping is a handy way to collect important slides you want to go back to later. epidemiology. • Cervical cancer is the third most common cancer in women worldwide. In a small percentage of people, however, the virus survives for years, contributing to th… During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities. 2005;19(4):611-30. • Prognosis: Leukemia in Pregnancy • Most abort spontaneously • Average age is 28 • Usually recommend termination of pregnancy because of aggressive chemotherapy • Prognosis – dependant on cell type, Hodgkins Disease/Lymphoma in Pregnancy • Gestational Age/ Stage • <20 weeks: TAB • >20 weeks: XRT • Chest mantle first • Chemotherapy depending on stage • Abdominal XRT after delivery • 80% curable – depending on cell type, Melanoma in Pregnancy • Incidence rising • 50% occur in women of child bearing age • 9% of cases occur in pregnancy • Extremities most common site • Pregnancy does not affect prognosis, Ovarian Function and Chemotherapy • Dose and age related • Younger than 25: permanent amenorrhea uncommon • Older than 40: 50% permanent ovarian failure • Birth control pills may prevent ovarian failure • Risk of birth defects in offspring not increased (4%) • Wait 2-3 years after therapy to become pregnant • Allow for possible recurrent disease, Ovarian Function and Fertility and Radiation Therapy • Age and dose related (<20 years old – better) • Ovaries outside radiation field (avg. and pelvic LND when mature, Cervical Cancer in Pregnancy: Treatment by Stage • Stage IA2, IB, IIA • Second trimester: delay of up to 22 weeks • Depends on desire for pregnancy • Can probably safely wait until maturity • Third trimester: delay of up to 10 weeks • C-section, Radical hysterectomy and pelvic Lymph node dissection at maturity, Cervical Cancer in Pregnancy: Treatment by Stage • Stage IB (bulky) or Stages IIb-IV • First trimester – delay of up to 28 weeks • Depends on desire for pregnancy • Unwanted • Whole pelvic radiation therapy/ chemotherapy • If SAB occurs before XRT is finished – proceed with cesium insertions (about 35 days) • Occasionally will need hysterotomy and pelvic LND if no SAB and then cesium insertions; or a “small” radical hyst. All patients diagnosed with cervical cancer during pregnancy should be counselled by a multidisciplinary team to produce an individualised treatment plan based on the patient's wishes, stage of disease, and pregnancy gestation. fuat demirkıran, md istanbul university, cerrahpaşa school of medicine, ob&gyn department, Molecular Biology of Cancer - . dr suzy matts frcog consultant obstetrics and gynaecology george eliot hospital. If cervical cancer is caught early enough (Stage 0 or 1A1), the tumor can be removed entirely through a cold knife cone biopsy. At the early phase of the pregnancy, such as . Herod J, Decruze S, Patel R. A report of two cases of the management of cervical cancer in pregnancy by cone biopsy and laparoscopic pelvic node dissection. & pelvic … Cervical cancer is a malignant tumour deriving from cells of the cervix. peggy andrews emt-paramedic chemeketa community college. overview of the lecture. Dysplasia is easily detected in a routine Pap smear and is completely treatable. Cancer in Pregnancy. Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. General Considerations • Radiation Exposure • Diagnostic Radiation • Avoid “unnecessary” diagnostic pelvic x-rays • Use MRI when possible • CXR/Mammogram – little risk with shielding • Therapeutic Radiation • High incidence of abortion and anomalies -Dose and trimester dependent, General Considerations • Obstetrical Considerations • First trimester SONO: if dates? Ovarian Masses in Pregnancy Acta.Scand. Cervical cancer occurs in several subtypes: squamous cell carcinoma (60% of cases), adenocarcinoma (25%), and other histologies (6%). professor lorraine sherr. pregnancy is a period of adaptation for:. -20cm – multiple nodules • Bilateral: 1/3 of cases • 25% have increased. alcohol use in pregnancy. CDC’s National Breast and Cervical Cancer Early Detection Program provides low-cost breast and cervical cancer screenings. castration is not beneficial • No adverse effects on prognosis from subsequent pregnancies. Cervical cancer There has been a significant decrease in the incidence of invasive cervical cancer in young women in the UK as a result of the advent of the cervical screening programme. Cervical cancer is one of the most common malignancies in pregnancy and one percent of women diagnosed with cervical cancer are pregnant or postpartum at … Cervical Cancer Screening Market & Patients-North America: Ken Research - Cervical cancer is one of the most common causes of cancer death for North American women. Human papillomavirus (HPV) is a common sexually transmitted infection which is the cause of several cancers, including cervical cancer, and genital warts. The new iOS & Android mobile apps and the Web application, to streamline navigation of the guidelines, have launched. Occurrence of cancer in pregnancy Cancer is the 2nd most common cause of death during the reproductive years The occurrence of cancer in a pregnant woman is relatively rare (0.07 - 0.1% of all malignant tumours) In Europe, yearly 3,000 to 5,000 patients are diagnosed with cancer during pregnancy Background: To assess the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for cervical cancer propagation before surgery, especially in … Ob/Gyn: Oh No! • Get a Gyn/Onc involved! OB/GYN 53:330, 1979. • Baltzer J., Regenfrecht M., Kopche W., Carcinoma of the Cervix and Pregnancy Int. Physician Reaction. | PowerPoint PPT presentation | free to view 63: 421, 1984. 1. Standing Ovation Award: "Best PowerPoint Templates" - Download your favorites today! Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.When exposed to HPV, the body's immune system typically prevents the virus from doing harm. Cervical cancer is a disease in which malignant (cancer) cells form in the tissues of the cervix. There is about 1 case of vaginal or cervical clear-cell adenocarcinoma in every 1,000 women whose mothers took DES during pregnancy. If the mitoses and immature cells are present simply in the lower third of the epithelium, the lesion usually is designated as CIN1. dose 290 cGy): • 25% failure • Start to lose function at 150 cGy • Ovaries in radiation field: • At 500 cGy most women are amenorrheic • Oophoropexy to the iliac fossa • Use clips to identify ovaries, Metastases to Fetus/Placenta • Only 50 cases in literature • Melanoma (50% of reported cases) • Leukemia: 1/100 affected pregnancies • Lymphoma • Breast. Cervical Cancer in Pregnancy: Treatment by Stage • Stage IB (bulky) or Stages IIb-IV • First trimester – delay of up to 28 weeks • Depends on desire for pregnancy • Unwanted • Whole pelvic radiation therapy/ chemotherapy • If SAB occurs before XRT is finished – proceed with cesium insertions (about 35 days) • Occasionally will need hysterotomy and pelvic LND if no SAB and then cesium insertions; or a “small” radical hyst. 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