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- Southern African Journal of Gynaecological Oncology
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- Volume 2, Issue 2, 2010
Southern African Journal of Gynaecological Oncology - Volume 2, Issue 2, 2010
Volume 2, Issue 2, 2010
Author Greta DryerSource: Southern African Journal of Gynaecological Oncology 2 (2010)More Less
Guidelines are written to be followed and to aid the effective, structured and uniform treatment of patients. Staging systems also aim to stratify and group patients and to instruct therapeutic approaches. We should welcome and adopt these new developments, but not without the necessary scrutiny and criticism. In this journal issue, we publish the newly revised FIGO staging for endometrial cancer, and one of the international members of our editorial board reflects and comments on the changes. Endometrial cancer is often detected and managed by generalist gynaecologists. It is mandatory that the correct staging be adopted by everyone who treats these patients. The commentary includes an interesting discussion on the debate about lymph node assessment in endometrial cancer, and probably accurately reflects the position of the academic units in our country.
Author Frederic AmantSource: Southern African Journal of Gynaecological Oncology 2, pp 40 –41 (2010)More Less
Cancer staging is one of the fundamental activities in oncology and is of pivotal importance to the modern management of cancer patients. It is structured to represent a major prognostic factor in predicting patients' outcome and lending order to the complex dynamic behaviour of a cancer.
Source: Southern African Journal of Gynaecological Oncology 2, pp 43 –48 (2010)More Less
The early detection of a gynaecological cancer recurrence is important in order to institute early treatment. Numerous imaging techniques have been used to follow up patients after treatment of gynaecological malignancies. These include plain X-rays, ultrasound, CT scan, MRI scan and PET or PET/CT scans. This review article will attempt to analyse the clinical value of these different modalities taking into account sensitivity, specificity, availability and cost factors.
Author G. DreyerSource: Southern African Journal of Gynaecological Oncology 2, pp 49 –53 (2010)More Less
The diagnosis of inherited cancer-susceptibility syndromes can enable identification of individuals at increased risk for early-onset cancer. The treatment and prognosis of patients diagnosed with malignancy due to a germ-line mutation may differ from the standard therapy. Hereditary breast and ovarian cancer (HBOC) syndrome and hereditary non-polyposis colon cancer (HNPCC) syndrome are the two most important syndromes responsible for inherited cancers in gynaecology. Genetic testing is available for both these syndromes. BRCA testing is affordable and easy in South Africa for patients with Afrikaner or Ashkenazi ancestry, as the mutation patterns are known. Women's health care clinicians must be well informed about these cancer syndromes. Families with a potential genetic mutation should be identified and referred for investigation or counselled for genetic testing. Counselling pre-requisites include complete information about the disease, genetic tests, estimated cancer risk and cancer risk management. Individualised cancer risk can be estimated based on genetic and/or clinical information. Breast, endometrial and ovarian cancers are potentially either preventable or qualify for early detection through advanced screening techniques. Surgical and hormonal prevention is effective, but has important economic, psychosocial and clinical implications. Early detection techniques offer less protection and a smaller improvement in morbidity and mortality. Screening is also a costly option but may be more acceptable to some patients. In colon cancer syndromes, the risk for endometrial and ovarian cancer is much elevated. These risks should be recognised and addressed, as these diseases are easy to prevent.
Author T. SlavikSource: Southern African Journal of Gynaecological Oncology 2, pp 56 –60 (2010)More Less
Gestational trophoblastic neoplasia (GTN) refers to a unique and heterogeneous group of conditions demonstrating differentiation towards various components of gestational trophoblast. Variants of hydatidiform mole (HM) are considered benign, whilst choriocarcinoma (CC), placental site trophoblastic tumour (PSTT) and the more recently described epithelioid trophoblastic tumour (ETT), a variant of PSTT, are malignant gestational trophoblastic tumours (GTT). The early and reproducible pathologic diagnosis of the various forms of GTN has been aided by recent developments in tumour markers, laboratory technology and new insights into our understanding of these different gestational diseases. Whilst CC is usually exquisitely chemosensitive, the much rarer PSTT and ETT require primary surgical management for optimal outcome. This dichotomous approach to the management of malignant GTT, determined by FIGO stage and differing tumour biology based on histology, has ensured an overall cure rate in excess of 90% for this group of tumours.
Author H. SimondsSource: Southern African Journal of Gynaecological Oncology 2, pp 62 –65 (2010)More Less
Complications following pelvic radiation are frequently under-reported and inadequately addressed. This overview examines the nature and the intensity of complications encountered by cancer survivors; it focuses specifically on gastrointestinal and vaginal complications, and the problems surrounding the methods of recording and assessing toxicities.
Author D.G. AllenSource: Southern African Journal of Gynaecological Oncology 2, pp 67 –68 (2010)More Less
Ovarian cancer is the fourth most common cause of death from cancer in women and remains a significant problem. Treatment continues to be difficult as most women have advanced stage cancers at presentation. Some progress in terms of management and survival has been made in the last 20 years, but the mortality rate remains high. Improving outcomes in terms of mortality and quality of life will rely on a better understanding of the aetiology, effective population screening and increased management options.
Author L.C. SnymanSource: Southern African Journal of Gynaecological Oncology 2, pp 69 –70 (2010)More Less
The recently published opinion by Prof J Apffelstaedt reflecting on the US Preventive Services Task Force (USPSTF) breast screening recommendations from a South African perspective refers. The conclusion of this opinion is that currently available data indicate that breast cancer screening in South Africa should start at the age of 40 years. This opinion is based on three arguments. The first argument is that no reliable data are available for the South African population, and the incidence of breast cancer is higher and the disease is diagnosed at an earlier age in African American and Malaysian women. The second argument is that the author is part of a unit that offers high quality mammography screening, and the third is that the most important "harm" attributable to mammography is a negligible risk of radiation.
Source: Southern African Journal of Gynaecological Oncology 2 (2010)More Less
Source: Southern African Journal of Gynaecological Oncology 2, pp 73 –94 (2010)More Less