Uterine Cancer

By: 4E
 Uterine Cancer: Description
• Abnormal growth of tumor
in the uterine lining
(endometrium)
• Usually called
ENDOMETRIAL CANCER.
 Uterine Cancer: Description
• Tumor: growth of extra cells that form a mass

Classified as:
1. Benign: do not spread to other parts of body
• Fibroid
• Endometriosis
• Endomettrial hyperplasia

2. Malignant: life threatening; can metastasize

ANATOMY & PHYSIOLOGY: UTERUS
• Uterus:
– hollow, pear-shaped organ where fertilized egg retain and nourish
– Located in the pelvis between the bladder and the rectum
Parts:
•Corpus/Body: middle part

•Fundus: dome shaped top of

the uterus

•Cervix: narrow, lower portion

of the uterus
ANATOMY & PHYSIOLOGY: UTERUS
• Wall of the uterus:

– ENDOMETRIUM (inner)
– MYOMETRIUM (middle)
– PERIMETRIUM
(outermost)
Uterine Cancer: Pathophysiology
Predisposing Factors:
Precipitating Factors: -Age: over 50 yrs old
-Hormone Replacement Therapy (HRT): -Race: black Americans
ESTROGEN -Genetic
-Obesity: increase ESTROGEN -Disease: Endometrial hyperplasia,
-Lifestyle: exposure to carcinogens colorectal menstruation
-Sexual Activity: nulliparity -Physiologic changes:Early menstruation,
Late menopausal stage, amenorrhea

Excessive Increase estrogen

Suppress LH & FSH

Slows ovarian cycle

increase reformation of endometrial lining and slow regeneration

 Normal cells continuously growing and old cells do not die

Extra cell form together

TUMOR

ENDOMETRIAL CANCER

Watery, malodorous Bladder

UNUSUAL vaginal bleeding Pain
vaginal discharge dysfunction
Uterine Cancer: Management
A. Surgical
1. Hysterectomy: surgical
removal of the uterus
2. Bilateral Salphingo-
oophorectomy: surgical
removal of both fallopian
tube and ovaries.
 Uterine Cancer: Management
3. Dilation and curettage-
the dilation
(widening/opening) of the
cervix and surgical removal of
part of the lining of the uterus
and/or contents of the uterus
by scraping and scooping
(curettage)
 Uterine Cancer: Management
B. Medical
1. Staging of Cancer
– Stage I: tumor limited to the endometrium
– Stage II: endocervical glandular involvement only
– Stage III: tumor invades serosa or adnexa, or malignant peritoneal
cytology ;metastasis to pelvic or para-aortic lymph nodes
– Stage IV: invasion of the bladder or bowel ;distant metastasis,
including intraabdominal or inguinal lymph nodes
 Uterine Cancer: Management
2. Radiation Therapy: high-energy radiation to shrink tumors and kill cancer
cells
– External:
– Internal: radiation delivered from radiation sources (radioactive
materials) placed inside or on the body
 Uterine Cancer: Management
3. Hormonal Therapy: progesterone agents
4. Chemotherapy : for metastasis and recurrent disease.
 Uterine Cancer: Nursing Care Plan
A. ASSESSMENT:
1. Physical Assessment
i. Identify risk factors?
a. Exposure to carcinogens
b. Hereditary history of any CA
c. Marital status
d. Sexual activity
e. Start of menstruation
f. Menopausal
g. Past health history
Uterine Cancer: Nursing Care Plan
ii. Check for any discharges/ bleeding?
a. Color (watery, blood-streaked)
b. Odor (foul)
iii. Pain?
a. Pelvic area
b. During intercourse
c. urination
 Uterine Cancer: Nursing Care Plan
2. Diagnostic and Laboratory Studies
2.1 Pelvic Exam: An examination of the organs of the female reproductive
system; a speculum (an instrument for opening and widening certain
passages of the body) is used to open the vagina and aid in visualizing the
uterine cervix
2.2 Pap Smear: medical procedure in which a sample of cells from a
woman's cervix (the end of the uterus that extends into the vagina) is
collected and spread (smeared) on a microscope slid
2.3 Transvaginal UTZ: A technique in which sound waves are sent out by
an ultrasound probe that has been inserted in the vagina. The waves go
through the vaginal wall and bounce off the ovaries, and a computer uses
the ultrasound echoes to create a picture (a sonogram)
2.4: Biopsy:
 Uterine Cancer: Nursing Care Plan
Nursing Diagnosis:
1. Acute/Chronic Pain R/T tumor growth
2. Fear R/T Cancer treatment option
3. Knowledge Deficient R/T disease process and intervention
4. Disturbed body image R/T surgical treatment.

Planning:
1. Help client in understanding the disease, diagnosis, and treatment.
2. Provide means to decrease pain felt.
 Uterine Cancer: Nursing Care Plan
Nursing Intervention:
1. Relieving Pain
1.1 Administer pain medications as prescribed and monitor patient’s
response.
1.2 Encourage use of relaxation techniques to help promote comfort.

2. Relieving Fear
1.1 Support patient through the disease process and reinforce
information given by health care provider about treatment options.
1.2 Prepare for radiation therapy and surgery.
 Uterine Cancer: Nursing Care Plan
3. Nutrition
1.1 Encourage intake of calories and protein to promote healing,
maintain strength, and keep a healthy weight.

4. Support client on side effects of chemo therapeutic drugs.

5. Follow up care
Uterine Cancer: Nursing Care Plan
Prognosis:
Cancer of the uterus grows slowly and women are altered to a
problem by abnormal bleeding from the vagina. Most cancers are
detected and treated at an early stage.
Cure rates following surgery are very high.