Cervical and uterine tumors presentation

MSN -II

1. CERVICAL & UTERINE TUMOURS

2. Uterine Cancer
The term uterine cancer may refer to any of several different types of cancer
that occur in the uterus, namely:
Endometrial cancer: originates from cells in the glands of the endometrium
(uterine lining).
Cervical cancer: arises from the transformation zone of the cervix, the lower
portion of the uterus.

3. Risk Factors
▪Increased estrogen
▪Hormone therapy
▪Obesity
▪Infertility
▪Genetics
▪Smoking
▪Overuse of contraceptive
▪Unsafe sexual practices

4. SYMPTOMS
• Bleeding or watery discharge from the vagina
• Difficult or painful urination
• Back Pain
• Swelling in Legs
• In the later stages of the disease, women may feel pelvic pain and experience
unexplained weight loss.

5. PATHOPHYSIOLOGY
HPV Infection
Viral Persistence
Integration of HPV DNA
Expression of Oncogenes (E6 & E7)
Cellular Transformation
Precancerous Lesions (CIN 1, CIN 2, CIN 3)
Immune System Evasion
Invasion and Metastasis

6. DIAGNOSTIC MEASURES
❑Transvaginal ultrasound
❑Hysteroscopy
❑Biopsy
❑CT Scan
❑MRI
❑CA 125 Blood test

7. TREATMENT
Once cancer has been diagnosed, treatment strategy depends on the extent
(stage) of your cancer.
Stages of endometrial cancer include:
❑Stage I cancer is found only in the uterus.
❑Stage cancer is present in both the uterus and cervix.
❑Stage Ill cancer has spread beyond the uterus, but hasn’t reached the rectum
and bladder. The pelvic area lymph nodes may be involved.
❑Stage IV cancer has spread past the pelvic region and can affect the bladder,
rectum, and more distant parts of your body.

8. ➢Surgery
▪Hysterectomy: Removal of uterus
▪Lymph node dissection: Removal of lymph nodes near the tumor if the
cancer has spread beyond the uterus.
➢Radiation Therapy
Radiation therapy is most often given after surgery to destroy any cancer cells
remaining in the area but rarely given before surgery to shrink the tumor.
Radiation therapy options for endometrial cancer may include radiation
directed towards the whole pelvis externally or tiny radioactive seeds placed in
the body close to a tumor which is termed Brachytherapy.

9. ➢Hormone Therapy
▪Hormone therapy for uterine cancer often involves the hormone
progesterone, given in pill form.
▪Other hormone therapies include the Aromatase inhibitors (Als) often used
for the treatment of women with breast cancer, such as Anastrozole and
Letrozole. An Al is a drug that reduces the amount of the hormone estrogen
in a woman's body by stopping tissues and organs other than the ovaries from
producing it with other types of treatment.
▪Hormone therapy may also be used for women who cannot have surgery or
radiation therapy or in combination.

10. ➢Chemotherapy
▪The chemo often includes the combination of Doxorubicin+ Cisplatin+
Paclitaxel.
▪Bevacizumab (Avastin) blocks angiogenesis (the formation of new blood
vessels) and is under evaluation in clinical trials.
▪Pazopanib blocks angiogenesis and stops the growth of cancer cells.

11. ➢Vaccination
▪The World Health Organization (WHO), as well as public health officials in
Australia, Canada, Europe, and the United States, recommend this
vaccination against HPV.
▪Gardasil and Cervix
▪Both vaccines protect against the two HPV types (HPV-16 and HPV-18) that
cause 70% of cervical cancers.
▪Both Gardasil and Cervix have been shown to prevent cervical hyperplasia
due to viral infection.
▪Both vaccines are given as a series of three injections over six months.
▪The second dose is given one to two months after the first dose, and the third
dose is given six months after the first dose

12. ➢Nursing Management
▪Monitor for adverse effects of radiation therapy such as fatigue, sore throat,
dry cough, nausea, and anorexia.
▪Monitor for adverse effects of chemotherapy; bone marrow suppression,
nausea and vomiting, alopecia, weight gain or loss, fatigue, stomatitis,
anxiety, and depression.
▪Realize that a diagnosis of breast cancer is a devastating emotional shock to
the woman. Provide psychological support to the patient throughout the
diagnostic and treatment process.
▪Involve the patient in planning and treatment.
▪Describe surgical procedures to alleviate fear.

13. ▪Prepare the patient for the effects of chemotherapy, and plan ahead for
alopecia, and fatigue.
▪Administer antiemetics prophylactically, as directed, for patients receiving
chemotherapy.
▪Administer I.V. fluids and hyperalimentation as indicated.
▪Help the patient identify and use support persons or family or community.
▪Suggest to the patient that psychological interventions may be necessary for
anxiety, depression, or sexual problems.
▪Teach all women the recommended cancer screening procedures