ovarian cancer.ppt

Cancer of ovary

1. OVARIAN CANCER

2. •It is the malignant neoplastic growth of the
ovary.

3. Incidence
•Ovariancancerconstitutesabout15to20
percentofgenitalmalignancy.
•ItismoreprevalentinUSAbutlessinJapan
andIndia

4. ETIOLOGY
•Advancedage
•Nulliparity–womanwhohasnevergiven
birth
•Infertility
•Personalhistoryofbreastorcoloncancer
•Genetic
•Earlymenarche

5. •Latemenopause.
•Highfatdiet.
•Obesity.
•Useofperinealtalcumpowderorhygienicsprays.
•Olderthan30yearsatfirstpregnancy.
•Hormonereplacementtherapyformorethan10years.

6. Classification
•Epithelialcancer-Malignantepithelial
tumorsarebothcysticandsolidtypes.
•Germcelltumors-Commonlyoccurin
youngwomen
•Specializedstromalcellcancers-Usually
involveoneovary

7. •Cancersmetastatictotheovariesarecalled
Krukenbergtumors.

8. Clinical features
-Feelingofabdominaldiscomfortorpain
whichthepatientmayexpressasgas,
indigestion,bloating,swellingorcramps.
-Nausea,diarrhea,constipation
-Lossofappetite
-Feelingfullevenafteralightmeal

9. •Suddenlossofweight
•Urinaryfrequencyorincontinence
•Abnormalvaginalbleeding
•Pelvicpain,backpain
•Fatigueandpallor
•Edemaoflegorvulva
•Respiratorydistressduetoascitesorpleural
effusion

10. Diagnostic measures
•Cytologyexaminationoffluidcollectedfrom
abdominalparacentesis
•ChestXraytoexcludepleuraleffusionandchest
metastasis
•Bariumenematodetectanylowerbowelmalignancy.

11. •Ultrasoundabdomenandpelvis
•CTscan–retroperitoneallymphnodeassessment
•MRI–todetecttheinvolvementoflymphnodes
•PETscan
•Tumormarkers-CEA,CA125,AFP,HCG,placental
alkalinephosphatase.

12. Staging Of Ovarian Cancer
•StageI–limitedtotheovaries
•StageIA–oneovaryisinvolved
•StageIB–bothovariesinvolved
•StageIC–Bothovariesinvolvedwithruptureof
ovariancyst,malignantascites
•StageII–spreadtoadjacentpelvicstructures

13. •StageIIA–spreadtouterusorfallopiantubes
•StageIIB–Spreadtopelvicperitoneum
•StageIII–spreadtoupperabdomen
•StageIV–distantspreadbeyondthe
abdomen,liver,lungetc.

14. Pathophysiology
•Epithelial type : serous or mucinous type’ the
epithelial type originates from cells on the
surface of the germinal epithelium
•Non epithelial type: germ cell type[ ova]
•Direct metastasis
•Lymphatic spread
•Peritoneal spread helps in the wide spread

15. Management
•Surgicalmanagement
•Chemotherapy
•Radiationtherapy
•Immunotherapy
•Adjuvanttherapy

16. Surgical management
•totalabdominalhysterectomywithbilateral
salpingio-oophrectomy.

17. •Chemotherapy:
Alkylatingagents(melphelan,cyclophosphamide,etc.)
Platinumcompounds(cisplatin,carboplatin)
Taxamederivatives(paclitaxel,docetaxel)
Combinationchemotherapy.

18. •Radiotherapy:-
Verylittlescope.Totalabdominoperitoneal
irradiationisemployed.
Radioactiveisotopes.
•Immunotherapy-combinationofBCG,
corynebacteriumparvumoralphainterferon

19. •NURSING
MANAGEMENT

20. •Acutepain
•Fatigue
•Deficientfluidvolume
•Imbalancednutrition
•Situationallowself-esteem
•Riskforinfection