Ovarian cancer

Ovarian cancer is when abnormal cells in the ovary begin to multiply out of control and form a tumor. If left untreated, the tumor can spread to other parts of the body. This is called metastatic ovarian cancer.
The ovaries are two female reproductive glands that produce ova, or eggs. They also produce the female hormones estrogen and progesterone.

Ovarian cancer often goes undetected until it has spread within the pelvis and stomach. At this late stage, ovarian cancer is more difficult to treat and can be fatal.
Ovarian cancer often has no symptoms in the early stages. Later stages are associated with symptoms, but they can be non-specific, such as loss of appetite and weight loss.

Blood test to measure cancer antigen 125 (CA-125) levels. This is a biomarker that is used to assess treatment response for ovarian cancer and other reproductive organ cancers. However, menstruation, uterine fibroids, and uterine cancer can also affect levels of CA-125 in the blood.
Biopsy. This involves removing a small sample of tissue from the ovary and analyzing the sample under a microscope. A biopsy is the only way your doctor can confirm whether you have ovarian cancer.

Surgery and chemotherapy are generally used to treat ovarian cancer.

1. OVARIAN CANCER
Presented by
Mr. B kalyankumarMsc(N)
Dept OfMSN

2. INTRODUCTION
Ovariesarereproductiveglandsfoundonlyinfemales
(women).Theovariesproduceeggs(ova)for
reproduction.Theeggstravelfromtheovariesthrough
thefallopiantubesintotheuteruswherethefertilized
eggsettlesinanddevelopsintoafetus.Theovaries
arealsothemainsourceofthefemalehormones
oestrogenandprogesterone.Oneovaryisoneachside
oftheuterus.

3. DEFINITION
Cancerthatformsintissuesoftheovary(oneofa
pairoffemalereproductivegland)mostovarian
cancersareeitherovarianepithelialcancersor
malignantgermcelltumors.

4. CAUSES
Genetics:Ifyouhaveafamilyhistoryofovarian,breast,
fallopiantube,orcolorectalcancer,yourrisksfordeveloping
ovariancancerarehigher.
Reproductivehistory:Womenwhousebirthcontrolactually
havealowerriskofovariancancer,butwomenwhousefertility
drugsmayhaveahigherrisk.Likewise,womenwho’vebeen
pregnantandbreastfedtheirinfantsmayhavealowerrisk,but
womenwho’veneverbeenpregnantareatanincreasedrisk.
Age:Ovariancancerismostcommoninolderwomen,ovarian
cancercanfindaftermenopause.

5. TYPESOFOVARIANCANCER
The ovaries are mainly made up of 3 kinds of cells. Each type
of cell can develop into a different type of tumor:
1. Epithelial tumorsstart from the cells that cover the outer
surface of the ovary. Most ovarian tumorsare epithelial cell
tumors.
2. Germ cell tumorsstart from the cells that produce the eggs
(ova).
3. Stromaltumorsstart from structural tissue cells that hold the
ovary together and produce the female hormones oestrogen and
progesterone.

6. Someofthesetumorsarebenign(non-cancerous)andnever
spreadbeyondtheovary.
Malignant(cancerous)ovariantumorscanSpread
(metastasize)tootherpartsofthebody.

7. CLINICAL MANIFESTATIONS
Pain in the pelvis, the lower abdomen
Back pain
Indigestionorheartburn
More frequent and urgent urination
Pain during sexual intercourse
Changes in bowel habits, such asconstipation
Nausea
Weight loss
Breathlessness
Tiredness
Loss of appetite.

8. DIAGNOSTIC PROCEDURES
History collection
Physical examination
Blood investigations (CBC, Lipid profile)
CA-125
Ultrasound
X-ray
CT Scan
MRI
Biopsy.

9. MANAGEMENT
The extent of the surgerydepends onthe stage of the cancer.
Salpingo-oophorectomy:Surgeryisdonetoremovetheovaries
andfallopiantubes.
Hysterectomy:Thesurgeonremovestheuterusandany
surroundingtissuethatisaffected.
Lymphnodedissection:Thesurgeonremoveslymphnodesin
thepelvis.
Cytoreductivesurgery:Ifthecancerhasspreadbeyondthe
pelvicarea,thesurgeonwillreduceasmuchcanceroustissueas
possible.Thismayincludetissuefromthegallbladderandother
organs.Thisprocedurecanhelprelievesymptomsandmake
chemotherapymoreeffective.

10. Chemotherapy
HormoneTherapy
Radiationtherapy.

11. NURSING MANAGEMENT
Pre operative nursing interventions
Assistpatienttoseekinformationonstageofcancer
andtreatmentoptions.Explainaboutsideeffectsof
radiationandchemotherapy.
Giveexplanationtopatientaboutphysicalpreparation
andproceduresthatareperformedpreandpost
operatively.
Administeranalgesicsandtellthepatientthatheavy
lifting,strenuousexerciseandsexualintercoursemay
increasepain.
Encouragesmall,frequent,blandmeals/liquid
nutritionalsupplementsasable.

12. Observethepatientforsignofshock,checkwounddressing
regularly.Ifthereisawounddrainchecksamountandtypeof
drainageregularly.
Haemorrhagemayoccurwithin24hours,thenurseshould
observeforsignsofinternalandexternalbleeding.
Haemorrhageismorecommonaftervaginalhysterectomy
Giveappropriateanalgesicdrugsasprescribed
Encouragefrequentchangesofpositioninbed,activity
decreasespainbyincreasingcirculation.
Monitorstoolcharacteristicsandfrequency.Restrictoralfluid
andfooduntilperistalsisresumes.
POSTOPERATIVEINTERVENTIONS