MEANING, CAUSES AND TREATMENT OF UTERUS CANCER

Definition:

·         Cancer of the uterus is an abnormal over growth resulting from excessive proliferation of abnormal extra and useless cells in tissues forming the uterus.

·         It may affect the muscles(myometrial cancer) or, the innerlaye (endometrium).

·         Cancer of the endometrium is the most common gynaecologic cancer which is highly curableand primarily affects women over 50 years of age.

·         It is the fourth most common cancer in women

Risk factors

·         Many factors have been identified  and include :

·         Age: commonest after the age of 50 years

·         Obesity

·         Nulliparity

·         Late menopause (after 52 years)

·         Diabetes melliuts

Step 3:  Pathophysiology of Cancer of the Uterus (25 Minutes)

·         Uterine hyperplasia differs to some extent from dysplasia  of the cervix in that some  lesions revert to normal and some persist as hyperplasia and a few progress to endometrial adenocarcinoma

·         This cancer is an excellent example of estrogen dependant cancer

·         The pathophysiology involves  overgrowth of the endometrium or myometrium  in response to an estrogen –dominant hormonal environment

Signs and Symptoms

·         Abnormal uterine bleeding is the most common symptom

·         Purulent, blood stained vaginal discharge

·         Anemia as a result of prolonged bleeding

 Stages of endometrial cancer

·         STAGE  1  Confined to corpus

·         STAGE 2  Involves  the corpus and cervix

·         STAGE 3  Extends outside but not outside the pelvis(vaginal but not bladder or rectum)

·         STAGE 4  Involves bladder,rectum,or tissue outside the pelvis

Step 4   Diagnostic Procedures( 15 minutes)

·         Patients complaints

·         Clinical features presented by the patient

·         Patients history of prolonged uterine bleeding

·         Laboratory tests of endometrial tissue (biopsy)or fluid obtained by endometrial aspiration,endometrial washings and through dilatation and curettage ,Pap test

Step 5 Treatments and Nursing Management of Patients with cancer of the Uterus (45 minutes)

·         Cancer of the uterus is a slow-growing cancer and is very responsive to treatment if detected early

·         It is treated  according to its stage

·         Medical treatment involves the use of hormones in patients with  advanced disease has not proved successful

·         The most common treatment is simple is hysterectomy and bilateral salpingo-oophorectomy after which if the cancer is limited to the uterus only, no further treatment is needed.

·         The only exception is to those patients with a poorly differentiated ,deeply invasive cancer in which radiation can prevent further local and distant recurrence(in all other incidences radiation does not appear to be of benefit)

Pre-operative care

·         Give a clear explanation of the patient about the procedure so that she understands and cooperates

·         Patient signs a consent form

·         Laboratory tests are done to determine the patients fitness for the operation

·         The patient fasts 6-8 hours before the operation

·         Check and record vital signs

Post operative care

·         Receive the patient from theatre

·         Check and record the vital signs

·         Assess the patient to note the condition of the wound

·         Assist the patient with cleanliness

·         Assist the patient with feeding and elimination activities

Step 6:  Complicatons of Cancer of the Uterus (10 minutes)

·         Anaemia associated with prolonged uterine bleeding

·         Infertility

·         Metastasis of cancer to other organs

·         Emotional depression