Site-Specific Cancer Series: Gynecologic Cancers

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Preface ix.
Chapter 1. Overview 1
Introduction 1
References 2
Chapter 2. Anatomy, Physiology, and Pathophysiology 3
Introduction 3
Internal Female Reproductive Organs 3
External Genitalia (Vulva) 9
Lymphatic Drainage of the Female Genital Tract 10
Breasts 11
Sexual Function 11
Sexually Transmitted Diseases 12
Pelvic Inflammatory Disease 13
Pelvic Pain 13
Menstrual Issues/Differential Diagnosis 13
Summary 14
References 14
Chapter 3. Prevention and Early Detection of Cancers of the Cervix, Ovaries, and Endometrium 17
Introduction 17
Cervical Cancer 17
Ovarian Cancer 23
Endometrial Cancer 28
Summary 31
References 31
Chapter 4. Preinvasive Disease of the Cervix, Vulva, and Vagina 37
Introduction 37
Preinvasive Disease 37
Evaluation of the Cervix 37
Diagnostic Tests 38
Vulvar Intraepithelial Neoplasia 39
Vaginal Intraepithelial Neoplasia 40
Risk Factors for Premalignant Vaginal and Vulvar Lesions 40
Management of Preinvasive Disease 40
Special Considerations 42
Summary 43
References 43
Chapter 5. Invasive Cervical Cancer 47
Introduction 47
Types of Cervical Cancer and Histology 47
Signs, Symptoms, and Diagnosis of Cervical Cancer 47
Cervical Cancer Staging 51
Treatment 51
Special Situations 57
Palliative Care 57
Future Directions 58
Summary 58
References 58
Chapter 6. Endometrial Cancer 63
Introduction 63
Etiology and Epidemiology 63
Risk Factors 64
Risk Reduction and Protective Effects 65
Treatment 67
Recurrent Disease 71
Future Trends 71
Summary 71
References 71
Chapter 7. Epithelial Ovarian Cancer, Fallopian Tube Carcinoma, and Primary Peritoneal Carcinoma 75
Introduction 75
Epidemiology and Risk Factors 75
Hereditary Epithelial Ovarian Cancer 76
Screening, Presentation of Symptoms, and Diagnostic Testing 77
Staging Surgery 79
Pathology 80
Immunomarkers 80
Adjuvant Chemotherapy 80
Consolidation and Maintenance Therapy 83
Radiotherapy 83
Surveillance 83
Recurrent Disease 84
Future Outlook 85
Summary 86
References 86
Chapter 8. Nonepithelial Ovarian Cancer 91
Introduction 91
Ovarian Germ Cell Tumors 91
Sex Cord Stromal Tumors 96
Rare Nonepithelial Ovarian Tumors 98
Summary 99
References 99
Chapter 9. Gynecologic Sarcomas 103
Introduction 103
Etiology and Epidemiology 103
Clinical Presentation and Diagnostic Evaluation 107
Staging 107
Treatment 107
Recurrent Disease 108
Summary 108
References 108
Chapter 10. Trophoblastic Disease 113
Introduction 113
Epidemiology of Trophoblastic Variants 113
Gestational Trophoblastic Disease 114
Gestational Trophoblastic Neoplasia 117
Placental Site Trophoblastic Tumor 121
Evidence-Based Practice 122
Psychosocial Impact of Trophoblastic Disease 112
Chapter 11. Vulvar and Vaginal Cancers 127
Vulvar Cancer 127
Vaginal Cancer 131
Summary 137
References 137
Chapter 12. Pelvic Exenteration and Reconstruction 139
Introduction 139
Exenterative Surgery 140
Nursing Care 144
Summary 147
References 148
Chapter 13. Acute Symptom Management 149
Introduction 149
Surgery 149
Chemotherapy 149
Radiation Therapy 158
Summary 158
References 158
Chapter 14. Long-Term Symptom Management 165
Introduction 165
Peripheral Neuropathy 165
Lower Extremity Lymphedema 168
Menopausal Management 172
Summary 178
References 178
Appendix: International Federation of Gynecology and Obstetrics Staging Classification for Gynecologic Cancer 183
Index 187
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