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Edited by
Laurie J. Mckenzie, University of Texas MD Anderson Cancer Center, Houston,Denise R. Nebgen, University of Texas MD Anderson Cancer Center, Houston
Lung cancer has emerged as a distinct disease in women, and women have unique risk factors as compared to men. Women are more likely to be diagnosed at a young age with adenocarcinoma, lack a significant smoking history and carry driver mutations. Current screening guidelines center around tobacco use, so health care disparities related to gender may impact those women who never smoked and/or prone to lung cancer from distinct etiologies. Molecular and immune markers are important in the workup for cancer, and new treatments with targeted and immune-mediated therapies are available. Women diagnosed with lung cancer have improved survival rates compared to men even while accounting for stage of diagnosis, age, smoking history and treatment modality. Lung cancer survivorship issues can contribute to significant symptom burden, and these can include cancer-related fatigue, reproductive issues, sexual health and sleep disruption. The impact of lung cancer and its’ therapies can affect quality of life especially when treatment-related complications are persistent.
Emergencies in gynaecological oncology are influenced by the site of cancer, stage of disease, presence of associated comorbidities and the treatment received. Women with advanced cervical cancer may develop distressing symptoms and may present with acute admissions. Vaginal bleeding caused by endometrial cancer can be usually managed conservatively. If there is an associated pyometra, operative treatment for endometrial cancer should be preceded by intravenous antibiotic treatment to avoid septicaemia and other septic postoperative complications. In severe cases, respiratory compromise may require omission of laparoscopy or conversion to laparotomy and postoperative ventilatory support. Catastrophic haemorrhage after gynaecological cancer surgery is uncommon, owing to the extensive use of electronic haemostatic devices; however, persistent oozing from large dissected surfaces may lead to haematomas. The most common complications, which require admission during chemotherapy, are febrile neutropenia and vomiting. Complications of radiotherapy depend on radiation-related factors and patient-related characteristics.
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