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27 Cards in this Set
- Front
- Back
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tamoxifen association w/ endometrial cancer
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tamoxifen use increases possibility of endometrial cancer
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obesity assoc w/ endometrial cancer
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obesity= increased risk
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OC use assoc w/ endometrial cancer
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oral contraceptives= decreased risk
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Endometiral screening in healthy women?
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not recommended
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Endometrial screening for women on tamoxifen?
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not recommended unless symptomatic
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most common clinical symptom in endometrial cancer
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post-menopausal bleeding or other abnormal vaginal bleeding
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most common site of hematogenous spread for endometrial cancer
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lung
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tumor marker for endometrial
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CA-125
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treatment of early stage (I & II) endometrial cancer
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surgery or RT. Chemo is of no benefit.
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treatment of advanced stage (III & IV) endometrial cancer
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surgery or RT. Chemo is cat 3 recommendation by NCCN
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Treatment of endometrial recurrent disease w/ surgery or RT
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limited/no role
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endocrine therapy in recurrent endometrial + dose
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NO DOSE RESPONSE FOR AGENTS:
Provera 150mg IM Qmo or 200mg QD x 14d Q mo Megace 160-320mg QD tamoxifen 20-40mg QD |
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agents useful in single agent chemo w/ endometrial
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cisplatin, carbo, doxorubicin, paclitaxel
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standard first line combo therapy for advanced or recurrent endometrial cancer
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AP-T (doxorubicin +cisplatin d1 + paclitaxel d2)
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2 unfavorable histologic types of endometrial cancer:
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serous or clear cell. Both metastasize easier
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cervical cancer is causally related to infection with
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HPV
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PAP test guidelines
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(1) 3 yr after 1st intercourse, no later than 21
(2) annually w/ reg PAP or every other year w/ liquid based (3) after age 30 if no risk and 3 normal PAP tests in row, decrease to every 2-3 yrs (4) annually for life if risk factors (5) stop if TAH/BSO including removal of cervix unless due to cervical cancer |
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dosing regimen for Guardasil
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women ages 9-26: injections at 0, 2, and 6 mo
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treatment of early stage (I and IIA) cervical
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surgery or RT, surgery preferred
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treatment of advanced stage (IIB, III, IVA) cervical or high risk of recurrence post hysterectomy
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no role for surgery. RT + sensitizing cisplatin is standard
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hold cisplatin for creatinine > ____
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>1.5 mg/dL or rapid rise if still in normal limits
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combination therapy for cervical cancer?
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combine newer agent with cisplatin to enhance response rate
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carboplatin vs cisplatin in cervical cancer
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carbo not as active
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Hormone receptor positivity for adenocarcinoma + clear cell/ papillary serous
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Clear cell/ papillary serous are usually ER/PR negative, so avoid hormanal treatment in these subtypes
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Typical cisplatin dose for chemoradiation?
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40 mg/m2/wk
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Typical side effects of chemoradiation
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diarrhea, electrolyte abnormalaties, anemia
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Treatment of recurrent cervical cancer when not a candidate for RT or surgery
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cisplatin doublets or single agent cisplatin, carboplatin, paclitaxel as alternatives
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