Ovarian cancer

Ovarian cancer

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  OVARIAN CANCER Presented by Mr.B kalyankumar Msc (N) Dept Of MSN
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  INTRODUCTION Ovaries are reproductiveglands found only in females (women). The ovaries produce eggs (ova) for reproduction. The eggs travel from the ovaries through the fallopian tubes into the uterus where the fertilized egg settles in and develops into a fetus. The ovaries are also the main source of the female hormones oestrogen and progesterone. One ovary is on each side of the uterus.
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  DEFINITION Cancer that formsin tissues of the ovary(one of a pair of female reproductive gland) most ovarian cancers are either ovarian epithelial cancers or malignant germ cell tumors.
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  CAUSES  Genetics: Ifyou have a family history of ovarian, breast, fallopian tube, or colorectal cancer, your risks for developing ovarian cancer are higher.  Reproductive history: Women who use birth control actually have a lower risk of ovarian cancer, but women who use fertility drugs may have a higher risk. Likewise, women who’ve been pregnant and breastfed their infants may have a lower risk, but women who’ve never been pregnant are at an increased risk.  Age: Ovarian cancer is most common in older women , ovarian cancer can find after menopause.
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  TYPES OF OVARIANCANCER  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 tumors start from the cells that cover the outer surface of the ovary. Most ovarian tumors are epithelial cell tumors. 2. Germ cell tumors start from the cells that produce the eggs (ova). 3. Stromal tumors start from structural tissue cells that hold the ovary together and produce the female hormones oestrogen and progesterone.
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   Some ofthese tumors are benign (non-cancerous) and never spread beyond the ovary.  Malignant (cancerous) ovarian tumors can Spread (metastasize) to other parts of the body.
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  CLINICAL MANIFESTATIONS  Painin the pelvis, the lower abdomen  Back pain  Indigestion or heartburn  More frequent and urgent urination  Pain during sexual intercourse  Changes in bowel habits, such as constipation  Nausea  Weight loss  Breathlessness  Tiredness  Loss of appetite.
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  DIAGNOSTIC PROCEDURES  Historycollection  Physical examination  Blood investigations (CBC, Lipid profile)  CA-125  Ultrasound  X-ray  CT Scan  MRI  Biopsy.
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  MANAGEMENT The extent ofthe surgery depends on the stage of the cancer.  Salpingo-oophorectomy: Surgery is done to remove the ovaries and fallopian tubes.  Hysterectomy: The surgeon removes the uterus and any surrounding tissue that is affected.  Lymph node dissection: The surgeon removes lymph nodes in the pelvis .  Cytoreductive surgery: If the cancer has spread beyond the pelvic area, the surgeon will reduce as much cancerous tissue as possible. This may include tissue from the gallbladder and other organs. This procedure can help relieve symptoms and make chemotherapy more effective.
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   Chemotherapy  HormoneTherapy  Radiation therapy.
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  NURSING MANAGEMENT Pre operativenursing interventions  Assist patient to seek information on stage of cancer and treatment options. Explain about side effects of radiation and chemotherapy.  Give explanation to patient about physical preparation and procedures that are performed pre and post operatively.  Administer analgesics and tell the patient that heavy lifting, strenuous exercise and sexual intercourse may increase pain.  Encourage small, frequent, bland meals/liquid nutritional supplements as able.
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   Observe thepatient for sign of shock, check wound dressing regularly. If there is a wound drain checks amount and type of drainage regularly.  Haemorrhage may occur within 24 hours, the nurse should observe for signs of internal and external bleeding. Haemorrhage is more common after vaginal hysterectomy  Give appropriate analgesic drugs as prescribed  Encourage frequent changes of position in bed, activity decreases pain by increasing circulation.  Monitor stool characteristics and frequency. Restrict oral fluid and food until peristalsis resumes. POST OPERATIVE INTERVENTIONS