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- Southern African Journal of Gynaecological Oncology
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- Volume 2, Issue 1, 2010
Southern African Journal of Gynaecological Oncology - Volume 2, Issue 1, 2010
Volume 2, Issue 1, 2010
Author Greta DreyerSource: Southern African Journal of Gynaecological Oncology 2 (2010)More Less
The FIGO committee revised the staging of some gynaecologic cancers. Most notable is the strong and continued move to more accurate staging based on surgical and histopathological evidence. In this and future issues we bring you the new staging with comments from local and international experts on the implications of these changes.
Author Gerhard LindequeSource: Southern African Journal of Gynaecological Oncology 2 (2010)More Less
Cancers are staged to allow for standardised terminology, appropriate prognosis, and worldwide communication. Therapeutic guidelines often flow from staging data. FIGO (International Federation of Gynecology and Obstetrics) has provided a staging system since 1958. More recently, International Union Against Cancer and the American Joint Commission on Cancer have also generated staging systems. As staging is based on research data and progressive science, the staging systems need to be revised frequently.
Author S.J. NaylerSource: Southern African Journal of Gynaecological Oncology 2, pp 7 –12 (2010)More Less
HER2 status in breast cancer has major significance in terms of prognostication and prediction of response to chemotherapeutic agents, as well as being an absolute indicator for the use of trastuzumab. Recent guidelines for the testing and interpretation for HER2 overexpression have resulted in more accurate and concordant results. Excellent concordance between immunohistochemistry and in situ hybridisation techniques can be achieved if these recommendations and guidelines are followed. The recently developed diagnostic techniques of chromagenic in situ hybridisation (CISH) and brightfield dual in situ hybridisation (BDISH) combine the techniques of immunohistochemistry (IHC) and in situ hybridisation (ISH) and will revolutionise HER2 testing.
Reflections on the USPSTF breast screening recommendations from a South African perspective : opinionAuthor J. ApffelstaedtSource: Southern African Journal of Gynaecological Oncology 2, pp 13 –14 (2010)More Less
Recent recommendations from the USA on the benefit of mammography for certain age groups have the potential to be indiscriminately applied in other countries, especially with regard to entry age for screening examinations and medical insurance cover. There exists a grave danger that specific local factors may be overlooked if these recommendations are simply taken as gospel and are not considered carefully.
Author M.H. BothaSource: Southern African Journal of Gynaecological Oncology 2, pp 16 –20 (2010)More Less
Ovarian cancer often presents late and the mortality associated with the diagnosis is high. Even with careful clinical examination, many subtle signs may be missed. Observational studies confirm that tubal ligation and hysterectomy confer a protective effect. Screening of low-risk individuals is not yet a useful health intervention. This review evaluates various screening options including clinical examination, biochemical markers, morphological and vascular markers and a combination of tests.
Cervical cancer and human papillomavirus : South African guidelines for screening and testing : clinical guidelinesSource: Southern African Journal of Gynaecological Oncology 2, pp 23 –26 (2010)More Less
Cervical carcinoma is still the most common cancer of women on the African continent. Mortality remains high - worldwide at 50% - mainly because of late presentation, advanced stage of disease and absence of a functioning screening process. The aetiological link between human papillomavirus (HPV) infection and cervical cancer has been well established and a number of high-risk HPV genotypes have been identified. HPV infection is the most common sexually transmitted infection (STI) in the world today - up to 80% of sexually active females will harbour HPV at some point in their lives. The majority of women will experience natural elimination of HPV infection because of an intact immune system. Persistent infection with a high risk type HPV puts women at high risk to develop precursors of cervical cancer or carcinoma itself. As part of a public health response to this serious problem, several HPV vaccines are under development. Use of vaccines still poses unanswered questions in many respects.
Source: Southern African Journal of Gynaecological Oncology 2, pp 30 –32 (2010)More Less
Vulval epithelioid sarcoma is a rare, locally-aggressive malignant soft tissue tumour, which may present diagnostic difficulties, both clinically and pathologically. This can result in a delay in appropriate treatment, which consists primarily of radical wide local excision of the tumour. We report a case of a recurrent epithelioid sarcoma of the vulva, with a discussion of the pathological features and management.
Current knowledge of the effect of tibolone on the breast and uterus : an extract from the guidelines for the use of tibolone in South Africa : clinical guidelinesSource: Southern African Journal of Gynaecological Oncology 2, pp 34 –36 (2010)More Less
Tibolone is an analogue of the progestin, norethynodrel. After ingestion, it is converted to three metabolites, namely 3 alpha and 3 beta hydroxytibolone which have oestrogenic effects, and delta 4 isomerase, which has progestogenic and androgenic properties. Both the oestrogenic metabolites bind to the alpha oestrogen receptor, but not the beta oestrogen receptor, whilst the delta 4 isomer binds to the alpha and beta oestrogen, the progestogen and the androgen receptors. Tibolone also is a sulphatase inhibiter, blocking conversion of oestrone sulphate to oestrone, as well as stimulating local sulphotransferase activity. In contrast to other forms of postmenopausal hormonal therapy, it decreases sex hormone binding globulin and hence increases circulating free testosterone, and thereby further adding to its androgenicity. Tibolone significantly decreases vasomotor symptoms, mood disorders, insomnia, bone loss, vaginal atrophy. It has a favourable impact on the cardiovascular system and minimal impact on the endometrium and on mammary tissue. It has been classified as a selective tissue oestrogenic activity regulator, a STEAR. Tibolone is an important treatment option in the management of the menopause and its specific properties not only relieve the general symptoms of the menopause, but have specific value amongst postmenopausal women with specific conditions. This would include, most notably, postmenopausal women with symptoms such as significant malaise and fatigue, marked insomnia, impaired sexual well being, labile moods, excessive breast tenderness or mastalgia. Women with premature ovarian failure, and possibly even the young woman who has been rendered menopausal by surgical bilateral salpingo-oophorectomy, would benefit specifically from its use.