Ovarian cancer

ovarian cancer

1. Prepared by : Jwan Kareem Salh Msc.Student Ovarian cancer

2. Content Definition of ovarian cancer Types of ovarian cancer Stage of ovarian cancer Grade of ovarian cancer Signs and symptoms of ovarian cancer Risk factor of ovarian cancer Diagnosis of ovarian cancer Treatment of ovarian cancer Prevention of ovarian cancer Nursing intervention of ovarian cancer

3. Definition Ovarian cancer is a disease in which, depending on the type and stage of the disease, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone.

4. Types of ovarian cancer Epithelial tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors. Germ cell tumors start from the cells that produce the eggs (ova) occur in young woman. Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones estrogen and progesterone.

5. Staging ovarian cancer Stage I. Cancer is found in one or both ovaries. Stage II. Cancer has spread to other parts of the pelvis. Stage III. Cancer has spread to the abdomen. Stage IV. Cancer is found outside the abdomen.

6. Signs and symptoms Abdominal bloating, pressure, and pain Abnormal fullness after eating Difficulty eating An increased urge to urinate Other symptoms, such as: Fatigue Indigestion heartburn constipation back pain Menstrual irregularities Painful intercourse

7. Grades of ovarian cancer GX : The grade cannot be evaluated. GB : The tissue is considered borderline cancerous. This is commonly called low malignant potential (LMP). G1 : The tissue is well-differentiated (contains many healthy looking cells). G2 : The tissue is moderately differentiated (more cells appear abnormal than healthy). G3 to G4 : The tissue is poorly differentiated or undifferentiated (more cells appear abnormal, and lack normal tissue structures).

8. Risk factors Age (<12 Years and ≥50 years). Inherited gene mutation(BRCA1 and BRCA2). Estrogen hormone replacement therapy. Age when menstruation started and ended. Never being pregnant(nulliparity).

9. Cont … Fertility treatment( clomiphene citrate, gonadotropins,IUI,IVF ). Smoking. Family history. Poly cystic ovarian syndrome. Pelvic inflammatory disease. Endometriosis.

10. Diagnosis Medical history. Pelvic examination. Imaging tests, such as ultrasound or CT scans, MRI. Blood test, which can detect a protein (CA 125). Chest x-ray. Biopsy. Positron emission tomography scan(PET).

11. Treatment Surgery Oophorectomy the surgical removal of one or both ovaries. Women who have only one ovary removed may still become pregnant. If both the ovaries and fallopian tubes are removed, it is called bilateral  salpingo -oophorectomy. Hysterectomy (the surgical removal of the uterus and  cervix ) and removal of other tumor that may have spread outside the ovary, is done in more advanced ovarian cancer. Once the uterus is removed, a woman is no longer able to become pregnant.

12. Cont …. Chemotherapy Itis recommended for women with ovarian cancer after surgery. It is a drug treatment that uses chemicals to kill fast-growing cells in the body,These drugs can be injected into a vein or taken by mouth. The drugs can be injected directly into the abdomen (intraperitoneal chemotherapy). It can also be used before surgery for advanced cancer to enable the removal of as much of the ovarian cancer cells as possible.

13. Prevention Avoiding certain risk factors. Using Oral contraceptive. Gynecologic surgery (tubal ligation and hysterectomy,bilateral salpingo -oophorectomy). Breast feeding. Pregnancy.

14. Nursing Interventions Teach women about; The importance of having routine screenings for cancer of the reproductive system. (pap smear, and pelvic exam). The risk factors of the reproductive system. Menopause signs and symptoms after bilateral oophorectomy. Hormone replacement therapy and the side effects. Manage client's pain related to chemotherapy . Monitor for infection .

15. CONT… Teach client how to prevent DVTs after surgery, i.e. frequent changes in positions, leg exercises to promote circulation. Explain the need for increased intake of fruits, vegetables, and whole grains. Also, a decreased fat intake of <30% of calories. Administer anti nausea (antiemetic) medications as needed. Assess patient for body image changes as a result of disfiguring treatment. Psychotherapy.