Ovarian Cancer

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Ovarian Tumor & Cancer

1
Cancer of The Ovary
 Ovarian cancer is the leading cause of gynecological
cancer death in the united state ovarian tumors are often
difficult to detect because they are usually deep in the
pelvis .
 N0 definitive factors have been determined , but
pregnancy and oral contraceptive appear to provide a
protective effect.
 Most 90% ovarian cancer are
epithelial in origin.
Risk Factors

 Risk factors include:


 History of breast cancer
 Family history of ovarian cancer
 Older age
 Low parity
 Obesity.
Stages of Ovarian Cancer
1. Cancer is contained within the ovary.

2. Cancer is in one or both ovaries and has involved other


organ . Example: uterus fallopian tubes , bladder, the
sigmoid colon or rectum.

3. Cancer involves one or both ovaries and one or both of


following are present.

4. Cancer has spread beyond the pelvis to the lining of


abdomen.
Cont….
5. Cancer has spread to lymph nodes.

6. The most advanced stage of ovarian cancer. Cancer is


in one or both ovaries.
 There is distant metastasis to liver , lungs or other
organs outside the peritoneal cavity, ovarian cancer
cells in the pleural cavity are evidence of stages of IV
diseases.
SIGN / SYMTOMS

 Increase abdominal girth.  Urinary urgency.


 Pelvic pressure .  Indigestion.
 Bloating.  Flatulence.
 Back pain.  Increases waist size.
 Constipation.  Leg pain.
 Abdominal pain.  Pelvic pain.
Cont….
 Vagus GI symptoms or a palpable ovary in a
postmenopausal woman.
 A palpable ovary in a woman who has gone through
menopause is investigated immediately because ovaries
normally become smaller and less palpable after
menopause.
Assessment & Diagnosis
 Any enlarged ovary must be investigated pelvic
examination often does not detect early ovarian cancer
and pelvic imaging techniques are not always definitive.
 Ovarian tumors are classified as benign if there is no
proliferation or invasion, borderline if there is
proliferation but no invasion and malignant if there s
invasion.
 Trans vaginal ultrasound and CA 125
antigen testing are helpful for high
risk women.
Medical Management
 Surgical removal is the treatment of choice.
 Pre-operative workup can include a
 Barium enema.
 Colonoscopy.
 Upper GI series.
 MRI.
 ultrasound.
 CT scan
Cont….
 Staging of the tumor is performed to direct treatment .
 Likely treatment involves a total abdominal
hysterectomy with removal of the fallopian tubes and
ovaries and possibly, the omentum(bilateral salpingo-
oophorectomy and omentectomy).
 Chemotherapy including liposomal and intraperitoneal
delivery is the most common from of treatment for
advanced diseases.
 Gene therapy is a future possibility.
Nursing Intervention
 Nursing intervention includes those relative to the
patients treatment plan which may include surgery.
 Chemotherapy
 Palliative care
 Emotional support
 Comfort measures
 Information plus attentiveness and caring are important
of nursing care.
Cont….
 Administering IV fluid prescribed to alleviate fluid and
electrolytes imbalance.
 Administering parentral nutrition to provide adequate
nutrition –providing postoperative care.
 Controlling pain and managing drainage tubes.
 Patient with pleural effusion may experience shortness of
breath,hypoxia,pluritic chest pain and cough.
Reference
 Smeltzer .S. C. Bare. B.G .Hinkle.J.L & Cheever.
K. H.(2010). Text Book Of Medical-surgical
Nursing. vol-1.(12th Ed).Lippincott Williams &
Williams Tokyo.

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