2. INTRODUCTION
⚫The term Uterine cancer may refer to any of several
different types of cancer which occur in the Uterus.
Endometrial cancer: Originate from cells in the glands of
the endometrium. Cervical cancer: Arise from the
transformation zone of the cervix, the lower portion of
the cervix.
3. ⚫ Uterine cancer or endometrial cancer is the most common
gynaecologic cancer.It develops in the body of the Uterus or
womb. Which is hallow organ located in the lower abdomen.
Most endometrial cancers are adenocarcinomas(Cancer that
begin in cells that make and release mucus and other fluids).
4. INCIDENCE
⚫Endometrial cancer originates in the inner lining of the
uterus, accounts for about 90 % of Uterine cancer,
Uterine sarcoma originates in an outer layer of muscle
tissue (Myometrium) and accounts for less than 10 % of
cases.
5. CAUSES AND RISK FACTORS
⚫The cause of uterine cancer is Unknown
⚫Chronic exposure to estrogen
⚫Endometrial hyperplasia
⚫Obesity and related conditions
7. OTHER RISK FACTORS
⚫Age (more common above 50 years )
⚫Family history of uterine cancer.
⚫Personal history of breast, colorectal or ovarian
cancer.
⚫Prior pelvic radiation therapy.
⚫Race (white women are more likely than African-
American women to get uterine cancer).
8. CLINICAL MANIFESTATIONS
⚫Early Uterine cancer usually is asymptomatic. Most
cases of endometrial cancer develop in postmenopausal
women, whose periods have stopped.
⚫Abnormal vaginal bleeding, which is the most common
symptom.
⚫Any bleeding after menopause.
⚫Prolonged periods or bleeding between periods.
⚫An abnormal, non-bloody discharge from vagina.
10. ⚫Advanced uterine cancer may cause loss of appetite,
weight loss, and changes in bladder and bowel
habits.
11. MANAGEMENT
⚫Most doctors recommend either the surgical removal of the
uterus alone (Hysterectomy) or more likely ,the surgical
removal of the uterus, fallopian tubes and ovaries
(Hysterectomy with bilateral salpingo-oophorectomy),
Lymph nodes in the area should also be removed during
surgery along with other tissue samples.
12. ⚫Radiation therapy: Some women with stage 1,II or III
Uterine cancer need both, radiation and surgery. Doctors
use both external and internal radiation therapies.
⚫Hormone therapy: If cancer has spread to other parts of
body. Synthetic progestin, a form of hormone
progesterone, may stop it from growing. Another therapy
option is Gonadotropin-releasing hormone agonists.
These drugs can lower estrogen levels in premenopausal
women.
13. ⚫Chemotherapy : Women with stage III or IV endometrial
cancer will be offered chemotherapy. The following drugs
are used,
⚫Carboplatin
⚫Cisplatin
⚫Doxorubicin
⚫Cyclophosphamide
⚫Taxol
14. NURSING MANAGEMENT
⚫Pre operative nursing 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.
15. ⚫Prepare skin for surgery, skin preparation may include
cleansing the lower abdomen, inguinal areas, upper thighs
before surgical procedure.
16. POST OPERATIVE INTERVENTIONS
⚫Observe the patient for sign of shock, check wound
dressing regularly. If there is a wound drain, check
amount and type of drainage regularly
⚫Hemorrhage may occur within 24 hours, the nurse should
observe for signs of internal and external bleeding.
Hemorrhage 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.
17. ⚫Ensure adequate hydration with intravenous fluids
⚫Encourage the patient to ambulate as soon as possible,
early ambulation promotes peristalsis
⚫AdministerAntiemetics
⚫ Maintain intake and output chart
⚫Patient may require catheterization if unable to pass
urine.
18. PREVENTIVE ASPECTS
⚫Although most cases of endometrial cases aren’t
preventable, certain factors can lower risk of developing
the disease. These include
⚫Taking hormone therapy with Progestin: Taking
synthetic Progestin, a form of the hormone progesterone
with estrogen causes the lining of the uterus to shed. This
kind of combination hormone therapy lowers risk.
⚫A history of using birth control pills: Use of oral
contraceptives can reduce endometrial cancer risk even as
long as 10 years after stop taking them.
19. ⚫Maintaining a healthy weight: Help prevent endometrial
cancer by maintaining a healthy weight. Excess fat tissue
can increase levels of estrogen in body, which increases
risk of endometrial cancer.
⚫Exercise: Women who engage in exercise every day have
half risk of endometrial cancer compared with women
who don’t exercise.
21. Human Papillomavirus: HPV
• Cervix cancer is caused by HPV
• HPV common in men and
women
• HPV causes cervix, other genital
and anal cancers in women
• HPV causes penile, anal, some
head/neck cancers in men
• Sexual transmission: male-
female, same sex; genital-
genital; genital-mouth, anal-
genital; microscopic breaks in
skin
• Vertical transmission-mother to
fetus (rare)
22. Anyone Can Get HPV!
• HPV is less likely to be
cleared in women over
30.
• Incidence of cervical
rises in women 30 and
older
• Cervical cancer takes
10-20 years to
develop. Women who
are no longer sexually
active should still have
periodic Pap tests.
24. Risk factors for Cervical Cancer
• Infection with HPV
• Not getting regular Pap tests –
begin testing at age 21
• Illnesses that weaken your
immune system (HIV)
• Smoking
• Diet
• Multiple sexual partners
throughout one’s lifetime
• Chlamydia (STIs)
• Poverty
• Family history
• DES
25. HPV Infection
• CDC: 6 million new infections/year in
US; 75% in young people 15-24
• Most HPV goes away
• Not all HPVs cause cancer
• Most HPV causes no harm to most
men and women
• Some HPV infections linger and
become cancer in men and women –
we don’t know why
26. How Can People Check for HPV?
• Women can be screened by
a Pap test, HPV test, or
pelvic exam (visual)
• There are no FDA-approved
ways to test men, diagnosis
made by visual inspection
27. HPV-related Diseases
• HPV infections cause
external genital warts,
abnormal Pap tests, vocal
cord obstruction in young
children and cancer in
adults
• Most get HPV when they
start having sex but don’t
know it!
29. How to Prevent Cervical Cancer
(Stop HPV Infection!)
• Vaccination of girls and boys
ages 11-12 (9-26)
• Abstinence
• Waiting until older to have sex
• Condoms
• Limit # of lifetime sex partners
• Regular check-ups
• Don’t smoke
30. Time for Action!
• Educate, educate! ACT!!
• Knowledge is power –
see the big picture
• Health care providers
• Churches, youth groups,
parents/schools
• Organizations: NCCC,
Tamika’s Friends
• Contact your legislators
