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Cervical Cancer 083637

This document outlines the key aspects of cervical cancer, including its definition, incidence, causes, risk factors, pathophysiology, clinical manifestations, diagnostic studies, staging, treatment options, nursing diagnoses, dietary management, and prevention strategies. It emphasizes the importance of early detection through Pap tests and HPV vaccination, as well as various treatment modalities such as surgery, chemotherapy, and radiation therapy. The document serves as an educational resource for nursing students in understanding cervical cancer and its management.

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19 views31 pages

Cervical Cancer 083637

This document outlines the key aspects of cervical cancer, including its definition, incidence, causes, risk factors, pathophysiology, clinical manifestations, diagnostic studies, staging, treatment options, nursing diagnoses, dietary management, and prevention strategies. It emphasizes the importance of early detection through Pap tests and HPV vaccination, as well as various treatment modalities such as surgery, chemotherapy, and radiation therapy. The document serves as an educational resource for nursing students in understanding cervical cancer and its management.

Uploaded by

drakedraken19
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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COURSE : B.

Sc Nursing

SUBJECT : Medical Surgical Nursing II

UNIT : IV ( Female Reproductive system)

PREPARED BY : Mrs. V. MuthuSelvi


:Assistant professor
OBJECTIVES

• At the end of the class the students will be able to


• Define cervical cancer
• State the incidence of cervical cancer
• Identify the causes and risk factors of cervical cancer
• Discuss the pathophysiology of cervical cancer
• Mention the clinical manifestations of cervical cancer
• Outline the staging of cervical cancer
• Describe the treatment modalities of cervical cancer
• Explain the nursing diagnosis of cervical cancer
• Enlist the prevention aspects of cervical cancer
INTRODUCTION
Cervical cancer is the third most common cancer in
women world wide.
Cervical cancer is a disease that develops quite slowly
and begins with a precancerous condition known as
dysplasia.
Dysplasia is easily detected in a routine pap smear and
is completely treatable.
Cervical cancer is a malignant tumor arising from the
cells of the cervix.
DEFINITION
Cervical cancer is a malignant tumor deriving from cells of the
‘’cervix uteri’ , which is the lower part, the neck of the womb, the
female reproductive organ.

INCIDENCE
 Cervical cancer is the 4th most frequent cancer in women
 It is estimated 570,000 new cases in 2018 representing 6.6% of
all female cancers.
 90% of deaths from cervical cancer occurred in low and middle
income countries.
• CAUSES
• HUMAN PAPILLOMA VIRUS- 90% cause of all cervical cancer
• Women with multiple sexual partners
• Early sexual contact before the age of 18yrs
• Has partner who has sexual contact with cervical cancer
women
RISK FACTORS

• Smoking

• Weakened immune system

• Several pregnancies

• Giving birth at a very young age

• Long term use of the contraceptive pills

• Family history
PATHOPHYSIOLOGY
Sexual Activity

Entry of HPV

Virus enter in the basal layer of cervix

HPV infects the basal cells

Damages the genetic material of the cells

Cells become pre cancerous

Damaged cells continue to multiply


CLINICAL MANIFESTATIONS
• Precancerous changes are asymptomatic
• Early cervical cancer is asymptomatic
• Leukorrhea and intermenstrual bleeding occur
• Discharge is usually thin and watery ,becomes dark and
smelling as the disease advances.
• Vaginal bleeding is initially only spotting
• Vaginal bleeding becomes heavier and more frequent
• Pain is a late symptom and is followed by weight loss, anemia,
and cachexia
DIAGNOSTIC STUDIES
• PAP TEST

• American cancer society recommends that a pap test to be


done at least once in every 3 years after first sexual
intercourse, but no later than 21.

• Findings of an abnormal Pap test indicates need for follow up

• Women with minor changes may be followed with a repeated


Pap test in 4-6 months for 2 years
PAP TEST
• Women with more prominent changes will receive additional
procedures like Colposcopy and Biopsy
• HPV DNA TEST
• Like the Pap test, the HPV DNA test involves collecting cells
from cervix for lab testing
• COLPOSCOPY
• It involves examination of the cervix with a binocular
microscope with low levels of magnification
• It helps in identification of possible epithelial abnormalities and
suggests areas for biopsy
• The LUMA cervical imaging system is used with colposcopy
COLPOSCOPY
CONE BIOPSY

• Punch biopsy may be done on an out patient basis with special punch
biopsy forceps
• It involves excision of a cone- shaped section of the cervix
• Conization is accomplished by either cryotherapy(freezing) or by laser
cone vaporization destroy the tissue
CONE BIOPSY
LOOP ELECTRO SURGERY EXCISION PROCEDURE

• It is a thin low voltage electrified wire loop, which is used to cut


away abnormal cervical tissue that can be seen during
colposcopy.

• It is performed as out patient procedure with mild analgesics


and sedation.

• Complications include bleeding , cervical stenosis after healing.


• Other investigations

• Chest x-ray

• CT

• MRI

• Pelvic ultrasound
STAGING OF CERVICAL CANCER
STAGE EXTENT
Stage 0 In situ
Stage 1 Confinement to cervix
Stage II Extension beyond cervix but not to
pelvic wall, or the lower portion of the
vagina
Stage III Extension to pelvic wall, involvement of
lower portion of vagina, hydronephrosis
or non functioning kidney
Stage IV Extension beyond true pelvis or clinical
involvement of the mucosa of bladder or
rectum
MANAGEMENT

• The treatment of cervical cancer depends on


• The stage of tumor
• patient’s age and general state of health
• Invasive cancer of the cervix is treated with
 Surgery
 Radiation
 Chemotherapy as single treatment or combination of both.
CHEMOTHERAPY

• Cisplatin is a platinum group of drug

• It binds to DNA and RNA, miscoding information, and or


inhibiting DNA replication and cells die.

• It is frequently used in combination with radiation therapy


RADIATION THERAPY
• Radiation therapy damages the DNA inside the tumor cells, destroying
their ability to reproduce.

• Radiation may be External (e.g., Cobalt) or Internal (e.g., cesium,


radium)

• Standard radiation treatment is 4-6 weeks of external radiation


followed by 1 or 2 treatments with internal implants.

• For patients with advanced cervical cancer radiation combined with


cisplatin based chemotherapy is the most effective treatment.
SURGICAL MANAGEMENT
• HYSTERECTOMY- It is a surgical removal of the uterus

• RADICAL HYSTERECTOMY- It is a surgical removal of the

• Uterus, cervix, and a part of the vagina.

• The ovaries , fallopian tubes, and nearby lymph nodes may


also be removed.

• PELVIC EXENTERATION – It involves radical hysterectomy,


total vaginectomy, removal of bladder with diversion of urinary
system and resection of bowel with colostomy
SURGICAL MANAGEMENT
PELVIC EXENTERATION
NURSING DIAGNOSIS
• Anxiety related to threat of a malignancy and lack of knowledge
about the disease process and prognosis
• Acute pain related to pressure secondary to an enlarging tumor
• Disturbed body image related to loss of body part and loss of
good health
• Ineffective sexuality pattern related to physiologic limitations
and fatigue
• Grieving related to poor prognosis of advanced disease
DIETARY MANAGEMENT

• Educate the patient to take Flavonoids rich foods which protects


against cancer.

• Flavonoids are rich in fruits, and vegetables

• Flavonoids rich foods are Apples, Black beans, Broccoli ,


Brussels, Sprouts, Cabbage, Garlic, onions, Soy, Spinach
• Folate (water soluble vitamin) reduce the risk of cervical cancer in
people with HPV.
• Foods rich in folate includes Avocados, breads, Lentils, orange juice,
and straw berries
• Carotenoids a source of vitamin A are also helpful in preventing
cervical cancer risk.
• Foods such as carrots, sweet potatoes and pumpkin are rich in
vitamin A
PREVENTION

• HPV ( Human papilloma virus) Vaccine


• It is approved for females aged 9 to 26yrs
• It requires 3 shots 0ver six months.

• Safe sex
• Cervical screening
• Have few sexual partners
• Delay first sexual intercourse
• Don’t smoke
REFERENCES

• Lewis., Text Book of Medical Surgical Nursing, Elsevier publications


Seventh edition.
• Brunner and Suddath's., Text book of Medical Surgical Nursing,
Lippincott publications, Tenth edition.
• Net reference
• www.web med.com
• www. Pub med.com

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