Gynecological Cancers - Clinical Medicine

Explore the pathophysiology, diagnosis, and treatment of major gynecological malignancies in this comprehensive clinical medicine lecture. Learn about ovarian cancer's three main tumor types (epithelial, germ cell, and sex-cord stromal) and their associated tumor markers, understanding how patients typically present with late-stage symptoms including bloating, early satiety, and pelvic pain, along with complications such as ascites, pleural effusion, bowel obstruction, and ovarian torsion. Examine endometrial cancer by distinguishing between estrogen-dependent Type I and estrogen-independent Type II disease, reviewing risk factors like obesity, nulliparity, and tamoxifen use, while focusing on abnormal uterine bleeding as the hallmark symptom and complications including anemia and pyometra. Study cervical cancer development through HPV infection's disruption of tumor suppressor pathways, following the diagnostic sequence from Pap smears and HPV testing to colposcopy and cone biopsy, plus staging and management approaches, with emphasis on complications like hydronephrosis and metastatic spread to bladder, rectum, bone, and lungs. Investigate vaginal cancer, differentiating between secondary spread from cervical cancer and primary HPV-driven cases, and vulvar cancer's dual pathways involving HPV-related disease in younger women versus chronic inflammatory dermatoses like lichen sclerosus in older women, with persistent pruritus as a key early feature. Master the unified approach to risk factors, clinical presentations, diagnostic strategies, treatment protocols, and preventive measures across all five gynecological cancers, including the critical role of HPV vaccination, barrier protection, and routine screening in reducing disease burden.