Cancer of the Female

Reproductive Tract
 Terminal Learning
Objectives
 At the completion of this lesson, you
(the student) will be expected to provide
safe and effective care IAW
Christensen and Timby, when given a
scenario of a patient with cancer of the
female reproductive system or a
hysterectomy
 Enabling Learning
Objectives
 A: Compare the
etiology/pathophysiology, assessment,
diagnosis and medical/nursing
management of cancer of the cervix,
edometrium, and/or ovary
Cervical Cancer
 Cervical Cancer
 Higher incidence among
– Hispanic American
– African American
– Native American
 Diethylstilbestrol (DES)
 Cervical Cancer
 Causes
– Herpes
– Human papillomavirus
– Sexual activity at early age with multiple
partners
– Frequent sexual activity
– Presence of genital warts (condyloma)
 Cervical Cancer

 Types of cervical cancer

– Dysplasia
– Carcinoma in situ (CIS)
– Invasive carcinoma
 Cervical Cancer

 Symptoms.
– Postcoital bleeding
– Leukorrhea
– Feeling of pressure on the bladder or
bowel
– Spotting between periods
– Pain radiating to lower extremities
 Cervical Cancer

 Diagnosis
– Pap smear
– Cervical inspection
– Cervical biopsy
 Cervical Cancer
 Treatment
– Radiation therapy (external and internal)
– Electrocautery
– Laser therapy
– Cryosurgery
– Chemotherapy
– Surgery
 Cervical Cancer

 Nursing Management
– Emotional support
– Comfort measures
– Strict intake and output.
– Assess vaginal drainage/bleeding
– Treatment concerns
 Cervical Cancer
 Prognosis
– Good if treated in the early stages
Endometrial Cancer
 Endometrial Cancer
 Most common malignancy
 More common in postmenopausal
women
 Risk increases when high-level
estrogen
 Endometrial Cancer

 Symptoms
– Bleeding most common and earliest
symptom
– Pain - usually a late symptom
– Watery malodorous vaginal discharge.
– Fever, bowel and bladder dysfunctions are
a late sign
 Endometrial Cancer

 Diagnosis.
– Pelvic exam (enlarged uterus may be
palpated)
– Endometrial biopsy
– Fractional D&C (Dilation and Curettage)
– Hysteroscopy
– Cystoscopy
 Endometrial Cancer
 Treatment
– Hysterectomy (primary therapy)
– Radiation (pre/postoperative)
– Radium implants
– Chemotherapy
– Hormonal therapy (progestational agents)
 Endometrial Cancer
 Nursing management.
– Emotional support
– Explain treatment and procedures
– Comfort measures
– Patient/family education
 Endometrial Cancer.

 Prognosis.
– Good if treated early
– Stage I tumors have the highest 5-year
survival rate (77%)
Ovarian Cancer
 Ovarian Cancer
 Second most common GYN cancer
 Most common cause of gynecological
death in the United States
 Fourth-most cause of cancer death in
women
 Women between ages 55 to 59
 Direct spread intra-abdominally and
lymphatics
 Ovarian Cancer
 Symptoms
– No pain (early)
– Pain
– Gastrointestinal symptoms
– Menstrual irregularities
– Pressure on the bladder/frequency
/urgency
– Ascites (late)
– Weight loss/gain
 Ovarian Cancer
 Diagnosis
– Pelvic exam
– Ultrasound and CT scan
– Laparotomy
– CA 125 increase is suggestive of
enlargement of the tumor
 Ovarian Cancer
 Treatment
– Oophorectomy - removal of ovary
– External or internal radiation
– Chemotherapy
– Total abdominal hysterectomy (TAH)
 Ovarian Cancer
 Nursing management
– Emotional support
– Explain treatment/procedures
– Patient and family education
– Provide pre/post-operative care
 Ovarian Cancer
 Prognosis.
– Good if treated early
– More than 60% of women with ovarian
cancer are diagnosed with advanced
disease.
– The 5-year survival rate for stage I tumors
is 60% to 70%; for stage II tumors, the
survival rate is 0% to 40%.
– For stages III and IV it is extremely poor
 Internal Radiation Therapy
 Minimize exposure
 Lead aprons
 Pregnant avoid exposure
 Drainage and dressings
 Check for dislodged implants
 Educate family
 Diversional activities
General Nursing
Considerations
 General Nursing
Considerations
 Teach early detection
 Listen carefully to the fears and
concerns
 General Nursing
Considerations
 Teach early detection
 Listen carefully to the fears and
concerns
 Nursing diagnoses
 Pain R/T
 Altered urinary elimination R/T
 Risk for infection R/T chemotherapy
 Risk for fluid volume deficit R/T
 Self-esteem disturbance R/T
 Anxiety R/T
 Potential for sexual dysfunction R/T
 CHECK ON LEARNING:
 Why do you think ovarian cancer is the
leading cause of death among GYN
cancers?
 ANSWER
 Due to it usually not being diagnosed
until it's late stage of development
QUESTION
S