logging in or signing up Carcinoma of Cervix drshabnamnaz Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 2997 Category: Education License: All Rights Reserved Like it (3) Dislike it (0) Added: January 05, 2011 This Presentation is Public Favorites: 4 Presentation Description No description available. Comments Posting comment... By: yangyijun1990 (4 month(s) ago) how can I download Saving..... Post Reply Close Saving..... Edit Comment Close By: yoginidevi (15 month(s) ago) requestin permission for Dnload Anemia ppt. for councelling purpose. Saving..... Post Reply Close Saving..... 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Death rate is 3.1 in 100, 000 annum have decline recently because of aggressive screening program.TYPES OF CA CERVIX: TYPES OF CA CERVIX According to invasion Non invansive (CIN) Invasive (Ca cervix) Histological type Squmous cell ca (95 %) columnar (5%) Rare (Adenosqumous, small cell, transitional, lymphoma, sarcoma) Clinical Ulcerative or Endophytic Polypoidal or Exophytic Or cauliflowerETIOLOGY : ETIOLOGY Age 35-50 years Parity 2-4 times more in married women Race Jews less common S.E.S poor S.E statusSlide 9: Coitus Common in prostitutes (frequency of coitus,change of partner) Unknown in nuns Cervical irritation & infection Cervical trauma Chronic cervicitis Erosion Severe dysplasia HPV 16, 18, 33CLINICAL FEATURES : CLINICAL FEATURES Asymptomatic (+ ve pap smear) Irregular vaginal bleeding Post coital bleeding Foul smelling, blood staind vaginal discharge. symptoms of metastasis Pain :(Advance stage)CLINICAL EXAMINATION: CLINICAL EXAMINATION Early Stage Patient looking healthy No + ve findings Evaluate Anemia Jaundice Supraclavicular, inguinal lymph nodes P/A Liver enlargement Abdominal mass Continue…..: Continue….. P/S Visual evidence of CA cervix Look for change in cervix Cervix looks edematous, irregular & enlarged, P/V Cervix hard, friable, ulcearated, fixed, bleed to touch Fungating mass/ cauliflower In Advance Stage Spread to parametrium, vagina, uterus, bladder Rectal Examination exclude posterior extensionSPREAD: SPREAD Local extension Down Vagina Up Uterus Laterally Para metrium & pelvic side wall Lymphatic Obturator, External iliac, Internal iliac Para- aortic Lymph nodes Rarely Inguinal & Supra clavicular lymph nodesSlide 19: LOCAL SPREADSlide 20: LYMPHATIC SPREAD continue……: continue…… Blood borns Liver Lungs BonesDIFFERENTIAL DIAGNOSIS : DIFFERENTIAL DIAGNOSIS Cervical erosin Cervical ulcer Benign cervical growthDIAGNOSIS: DIAGNOSIS Mandatory investigations Full blood count Blood urea, creatinin, Electrolytes LFT I/V/U X Ray chest Optional investigations Abdomino pelvic U/S C.T MRI LymphangiographySTAGING (FIGO staging) : STAGING (FIGO staging) Staging (FIGO staging) Based on EUA & results of routine investigations EUA Proctoscopy Sigmoidoscopy Cystoscopy Cervical biopsy Curatings from uterine cavity & endocervix.Slide 30: STAGING OF CA CERVIXPROPHYLAXIS OF CA CERVIX: PROPHYLAXIS OF CA CERVIX Vaccination against HPV 16 & 18TREATMENT: TREATMENT Surgery Radiotherapy Surgery + Radiotherapy Radiotherapy + Surgery Stage I, II a ---- Surgery Stage II b to IV -----Radiotherapy /chemotherapy Supportive treatment Continue…..: Continue….. SURGERY Simple hysterectomy Wertheims Operations Schauta Amreich vaginal operation Supportive & palliative treatment 5 years survival is 30-40 of exentractionSlide 34: WERTHEIMS HYSTRECTOMY continue……: continue…… RADIOTHERAPY Radical pelvic radiotherapy with external beam x.ray treatment (Teletherapy) to the pelvis 20 fractions over 4 weeks Followed by brachytherapy Intra cavity treatment. continue……: continue…… in this vaginal delivery system is inserted under anesthesia & radiation delivered by a selectrom machine taking 12-18 hours The patient is awake during treatment & discomfort may be delivered by caudal block or sedation Some patient require second insertion 2-3 weeks after the 1 st.Slide 37: Acute diarrhea treated by low residual diet & imodium or codein. Long term S/E occurs in 5-10% include diarrhea, radiational cystitis, radrative proctitis (rectal bleeding) & vaginal stenousuSlide 38: RADIOTHERAPYCAUSES OF DEATH IN CERVICAL CANCER: CAUSES OF DEATH IN CERVICAL CANCER Uremia Haemorrhage Cachexia5 years survival rate : 5 years survival rateRECURRENT CA CERVIX: RECURRENT CA CERVIX 30-70 of recurrence 60 % in 1st year 25 % in 2nd year Lymph node involved…increased risk of recurrence Faster recurrence worst prognosis 80 % die within 2 yearsCA OF CERVICAL STUMP: CA OF CERVICAL STUMP After subtotal hysterectomy Radiotherapy Brachytherapy is not possible then dose of teletherapy is increased You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.