Tuesday, March 9, 2010

Uterine cancer

Uterine cancer - Acute

Definition  

A group of uterine malignancies including, most commonly, endometrial cancer, which primarily affects postmenopausal women, and 3 rarer, distinct uterine sarcomas: carcinosarcomas arising in the endometrium, leiomyosarcomas arising from myometrial muscle, and sarcomas arising in the endometrial stroma


 

Medical History  

* At risk - finding

* Estrogen excess

* Tamoxifen use

* Obesity

* Finding related to menstrual cycle

* Hereditary nonpolyposis colon cancer

* Polycystic ovary syndrome

* Parity finding

* Contraception status

* Dietary finding

* Exercise history finding

* Smoking

* Alcohol Abuse


 

Findings  

* Vaginal bleeding

* Dyspareunia

* Dysuria

* Pain in pelvis

* Vaginal discharge


 

Tests  


 

Suspected endometrial cancer  

* Endometrial biopsy: Histological information obtained from the endometrial biopsy is generally sufficient for proceeding with definitive treatment .


 

Suspected uterine cancer  

* Transvaginal ultrasound: Transvaginal ultrasound as a first step, followed by biopsy, is the most cost-effective approach in populations with a low prevalence of endometrial carcinoma .


 

Suspected uterine cancer  

* Echogynography: Sonohysterography may permit improved imaging of the fallopian tubes and the uterine cavity, but there may be a risk of peritoneal contamination by malignant cells .


 

Suspected uterine cancer  

* CA 125 measurement


 

Differential Diagnosis  

* Uterine leiomyoma - Chronic

* Polyp of corpus uteri

* Pregnancy problem

* Victim of child molestation

* Anovulation

* Female genital tract infection

* Disease of liver

* Pituitary adenoma

* Prolactinoma - Chronic

* Polycystic ovary syndrome - Chronic

* Disorder of thyroid gland

* Hormonal Contraceptive

* Anticoagulant

* Antipsychotic

* Estrogen/Progestin Combination

* Endometriosis - Chronic

* Dysplasia of cervix

* Endometrial hyperplasia

* Cervical cancer - Chronic


 

Treatment  


 

Drug Therapy  


 

Uterine cancer  


 

CISPLATIN


 

CARBOPLATIN


 

DOXORUBICIN HYDROCHLORIDE  


 

IFOSFAMIDE


 

MEGESTROL ACETATE


 

MEDROXYPROGESTERONE ACETATE  


 

TAMOXIFEN CITRATE  


 

Procedural Therapy  


 

Uterine cancer  

* Operation on uterus: Surgery remains the primary and most important therapeutic intervention for uterine cancer.


 

Uterine cancer  

* Radiation therapy: Radiation therapy is used as adjuvant therapy as well as primary therapy in patients with uterine cancer who are poor surgical candidates .
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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence