Exam 8: Reproductive System; Cancer of the Reproductive System
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| Cervical Canver | Cancer of the Cervix
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| Cervical Cancer: Incidence | Higher in Hispanic, African and Native Americans
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| Cervical Cancer: Risk | Sexually transmitted diseases
Human papillomavirus
Sexual activity at early age
Multiple sexual partners
Smoking
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| Cervical Cancer: Stages | Dysplasia
Carcinoma in situ (CIS)
Invasive Carcinoma
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| Cervical Cancer: Symptoms | Leukorrhea
Spotting between periods
Postcoital bleeding
Feeling pf pressure on the bladder or bowel
Pain radiating to lower extremities
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| Cervcial Cancer: Diagosis | Pap Smear, Cervical Inspection, Cervical Biopsy
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| Cervical Cancer: Treatment | Prevention
Removal of affected area
Surgery/Radiation/Chemotherapy
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| Cervical Cancer: Nursing Management | Emotional support
Comfort measures
Strict intake and output.
Assess vaginal drainage/bleeding
Treatment concerns
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| Cervical Cancer: Prognosis | Good if treated early
5 year survival rate for localized stage is 92%
4070 Cervical Cancer deaths
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| Endometrial Cancer | Cancer of the Endometrial wall.
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| Endometrial Cancer: Incidence | Most common female reproductive malignancy
More common in post menopausal women
Risk increases when high-level estrogen
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| Endometrial Cancer: Symptoms | Bleeding: 50% of women with postmenopausal bleeding have uterine cancer
Pelvic Pain (usually a late symptom)
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| Endometrial Cancer: Diagnosis | Pevlic and rectal exam (enlarged uterus may be palpated)
Endometrial biopsy
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| Endometrial Cancer: Treatment | Hysterectomy (primary therapy)
-Total abdominal (TAH)
-Bilateral Salpingo-oophorectomy (BSO)
Radiation (pre/postoperative)
Chemotherapy
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| Endometrial Cancer: Nursing Management | Emotional support
Explain treatment and procedures
Comfort measures
Patient/family education
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| Endometrial Cancer: Prognosis | Slow growing
Late metastasis
Bleeding is early sign
Good if treated early
5-year survival rate 83%
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| What are 5 causes for increased risk of cervical cancer? | Herpes; Human papillomavirus; Sexual activity at early age; multiple partners; smoking
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| What percent of women with postmenopausal bleeding have endometrial cancer? | 50%
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| Ovarian Cancer | Cancer of the Ovaries
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| Ovarian Cancer: Incidence | Fourth most-common cause of cancer death in women.
Risk increases with age.
Early stage asymptomatic.
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| Ovarian Cancer: Symtopms | Vague abdominal discomfort (early)
Pelvic or abdominal pain
Gastrointestinal symptoms
Menstrual irregularities
Pressure on the bladder/frequency /urgency
Ascites (late)
Weight loss/gain
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| Ovarian Cancer: Diagnosis | Early detection difficult
Pelvic Exam
US & CT Scan
Laparotomy
CA 125 (Cancer antigen)
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| Ovarian Cancer: Treatment | Oophorectomy-Removal of ovary
External or internal radiation
Chemotherapy
Total Abdominal Hysterectomy (TAH)
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| Ovarian Cancer: Nursing Management | Emotional support
Explain treat/procedures
Patient and family education
Provide pre/post-operative care
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| Ovarian Cancer: Prognosis | > 75% diagnosed with advanced disease.
5-year survival rate 46%
If diagnosed earyl and localized-survival rate 93%
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| Radiation Therapy | Body marked for external radiation
Patient Education
-Protects skin
-diet
-Side Effects
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| Internal Radiation Therapy | Minimize exposure.
Pregnant avoid exposure.
Drainage and dressings.
Check for dislodges implants.
Educate family.
Diversional Activities.
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| Why do you think ovarian cancer is the leading cause of death among GYN cancers? | Due to it usually not being diagnosed until it's late stage of development
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| Breast Cancer | Most common malignancy of women in the U.S.
Ranks second among cancer death in women.
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| Breast Cancer: Etiology | Cause is not known.
Primary risk factors:
-Female
-Older than 50
-N. American or Northern European decent
-Family Hx
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| Breast Cancer: Occurence | Males = 1%
Females: 1 out of every 8
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| Breast Cancer: Pathophysiology | Cancer occurs most often in the upper/outer quadrants of the breast
Metastasis via the lymphatic system & blood stream
Rapid-growing cancer have a much shorter preclinical course and a greater tendency to metastasize
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| Breast Cancer: Prognosis | Positive/negative axillary lymph node involvement is the single most important prognosticator
After the disease spreads beyond the breast, the survival rate drops dramatically
Prognosis is related to stage of disease and age
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| Breast Assessments: Frequency | Monthly BSE’s beginning at age 20
CBE’s every 3 years between ages 20-40
CBE’s every year after age 40
Annual screening with mammograms beginning at age 40
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| Breast Cancer: S/S | Skin reddened or dark, puckering or dimpling (skin appearance of orange-peel) of tissue, nipple discharge, axillary tenderness, nipple or skin retraction, peeling or flaking of the nipple, a lump or thickening that feels different from surrounding tissue
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| Breast Cancer: Procedures and Diagnostic tools | Mammography
Ultrasound
MRI
Positron Emission Tomography (PET)
Sentinel lymph node mapping
Biopsy
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| Which diagnostic test is used to confirm a diagnosis of breast cancer? | Biopsies
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| Breast Cancer: Stages | Staging is based on tumor size, node involvement & metastases.
Stages 0, I, IIA -IIB, IIIA-IIIB-IIIC,IV
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| Breast Cancer: Stage 0 | Cacinoma in situ. Confined to milk duct or lobule. No lymph nodes affected. No meatastasis
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| Breast Cancer: Stage I | Tumor less than 2cm. Lymph nodes neg. No metastasis
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| Breast Cancer: Stage IIA | Tumor less than 5cm. May have spread to up to 3 axillary nodes, but no distant cancer spread
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| Breast Cancer: Stage IIB | Tumor can be >5cm. Can involve up to 3 lymph nodes. No organ metastasis.
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| Breast Cancer: Stage IIIA | Tumor >5cm. Can involve 3-10 lymph nodes. No distant organ metastasis.
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| Breast Cancer: Stage IIIB | Spread to chest wall or skin, regardless of size. Lymph node involvement with no distant metastasis
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| Breast Cancer: Stage IIIC | Same as IIIB except more than 10 lymph node involvement
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| Breast Cancer: Stage IV | Tumor of any size, with nodal involvement and metastasis to distant organs
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| Breast Cancer: Treatment Variables | Tumor stage
Pt age & health
Hormonal Status
Presence of Estrogen Receptors in tumor
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| Lumpectomy | Removal of tumor
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| Simple Masectomy | Removal of entire breast. Skin flap to cover area. Both pectoralis major and pectoralis minor muscles left intact.
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| Modified Radical Masectomy | Overlying skin, nipple and pectoralis minor muscles are removed. Pectoralis major remains intact.
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| Breast Cancer: Radiation Therapy | Maybe used as primary therapy or with surgery
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| Breast Cancer: Chemotherapy | Typically used with lymph node involvement or metastasis to distant organs
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| Cancer of the Testis: Assesment/ Diagnosis | Enlarged scrotum
Firm, painless, Smooth mass
Patient may speak of a feeling of heaviness.
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| Cancer of the Testies: Medical Management | Radical inguinal orchiectomy
Radiation or chemotherapy generally follow surgery
A retroperitoneal lymph node dissection
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| Cancer of the Penis: Risk Factors | Rare.
Generally occurs in men over 50 years of age:
-Uncircumcised
-Poor hygiene
-Hx of STD
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| Cancer of the Penis: Assessment/Diagnosis | Painless tumor
Wart like growth or ulceration on the glans under the prepuce
Metastasis commonly occurs to the inguinal nodes and adjacent organs
Biopsy confirms the diagnosis
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| Cancer of the Penis: Medical Managment | Surgical Intervention
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| Cancer of the Penis: Nursing Interventions | Emotional support
Monitor Urine Output
Elevate Scrotum
Comfort Measures
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| What age group is most at risk for testicular cancer? | Men age 15-35 y/o
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| Cancer of the Penis: Risk Factors | Rare.
Generally occurs in men over 50 years of age:
-Uncircumcised
-Poor hygiene
-Hx of STD
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| Cancer of the Penis: Assessment/Diagnosis | Painless tumor
Wart like growth or ulceration on the glans under the prepuce
Metastasis commonly occurs to the inguinal nodes and adjacent organs
Biopsy confirms the diagnosis
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| Cancer of the Penis: Medical Managment | Surgical Intervention
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| Cancer of the Penis: Nursing Interventions | Emotional support
Monitor Urine Output
Elevate Scrotum
Comfort Measures
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| What age group is most at risk for testicular cancer? | Men age 15-35 y/o
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| Testicular Self Exam (TSE) | Method for early detection of tumors of the testis
Priority for care of patients who have or are at risk for a tumor of the testis
Monthly basis beginning at age 15
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