During SHARE's roundtable discussion for women with ovarian cancer, oncology nurse Heather Augustyniak provided tips that can help patients manage the side effects of treatment.
New post-chemotherapy maintenance treatment options for ovarian cancer have emerged in recent years. Dr. Maurie Markman explains and takes questions on maintenance therapies for ovarian cancer in our 4th annual Joan Sommer Educational Program.
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A discussion about low grade serous ovarian cancer with Dr. Amanda Nickles Fader, Director of Kelly Gynecologic Oncology Service, Johns Hopkins Hospital. This type of ovarian cancer behaves differently and is treated differently than other ovarian cancers. Join the conversation to learn more and ask an expert your questions.
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In recent years, researchers have been looking into using a class of drugs called PARP inhibitors to prevent the progression and recurrence of ovarian cancer. Dr. Kathleen Moore of Stephenson Cancer Center, Principal Investigator of the SOLO-1 trial, explains how the results of this trial may affect ovarian cancer patients and where research on ovarian cancer treatment is headed next.
Each year ovarian cancer experts from across the nation gather at the Society of Gynecologic Oncology Conference. Stephanie Blank, MD, Director of Gynecologic Oncology, Mt. Sinai Health System, will report back from the conference on what the research presented there means for patients.
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Dr. Joyce F. Liu, Director of Clinical Research for Gynecologic Oncology at Dana-Farber Cancer Institute, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.
This document summarizes a presentation on recurrent ovarian cancer given by Dr. Sarah Adams. It discusses the likelihood of recurrence based on initial cancer stage, common symptoms of recurrence, methods for diagnosing recurrence including physical exam, CA125 levels, and imaging, and treatment options based on platinum sensitivity including surgery, chemotherapy regimens, targeted therapies, and clinical trials. It also describes a 2010 European study that found initiating treatment earlier based on a CA125 doubling led to longer treatment-free intervals and improved overall survival compared to delayed treatment until symptom recurrence.
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Women with ovarian cancer joined Julie Larson, LCSW, guest speaker Dr. Kathryn Pennington of UW Medicine, and peers via video or phone to discuss genetics and ovarian cancer.
New post-chemotherapy maintenance treatment options for ovarian cancer have emerged in recent years. Dr. Maurie Markman explains and takes questions on maintenance therapies for ovarian cancer in our 4th annual Joan Sommer Educational Program.
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A discussion about low grade serous ovarian cancer with Dr. Amanda Nickles Fader, Director of Kelly Gynecologic Oncology Service, Johns Hopkins Hospital. This type of ovarian cancer behaves differently and is treated differently than other ovarian cancers. Join the conversation to learn more and ask an expert your questions.
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In recent years, researchers have been looking into using a class of drugs called PARP inhibitors to prevent the progression and recurrence of ovarian cancer. Dr. Kathleen Moore of Stephenson Cancer Center, Principal Investigator of the SOLO-1 trial, explains how the results of this trial may affect ovarian cancer patients and where research on ovarian cancer treatment is headed next.
Each year ovarian cancer experts from across the nation gather at the Society of Gynecologic Oncology Conference. Stephanie Blank, MD, Director of Gynecologic Oncology, Mt. Sinai Health System, will report back from the conference on what the research presented there means for patients.
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Dr. Joyce F. Liu, Director of Clinical Research for Gynecologic Oncology at Dana-Farber Cancer Institute, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer.
This document summarizes a presentation on recurrent ovarian cancer given by Dr. Sarah Adams. It discusses the likelihood of recurrence based on initial cancer stage, common symptoms of recurrence, methods for diagnosing recurrence including physical exam, CA125 levels, and imaging, and treatment options based on platinum sensitivity including surgery, chemotherapy regimens, targeted therapies, and clinical trials. It also describes a 2010 European study that found initiating treatment earlier based on a CA125 doubling led to longer treatment-free intervals and improved overall survival compared to delayed treatment until symptom recurrence.
Topic-Driven Round Table on Ovarian Cancer: Understanding Genetics and Ovaria...bkling
Women with ovarian cancer joined Julie Larson, LCSW, guest speaker Dr. Kathryn Pennington of UW Medicine, and peers via video or phone to discuss genetics and ovarian cancer.
This document discusses ovarian cancer research and clinical trials. It provides an overview of ovarian cancer subtypes and gene mutations associated with serous cancer. It also summarizes various drug targets and clinical trials being studied for ovarian cancer treatment, including PARP inhibitors, Akt inhibitors, angiogenesis inhibitors, monoclonal antibodies, immune therapies, vaccines, and CAR-T cells. Challenges in ovarian cancer research like intra-tumor variability and the complexity of genetics are discussed. The importance of patient participation in clinical trials to advance scientific progress is emphasized.
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When ovarian cancer returns, it's not uncommon to experience a range of emotions and feel overwhelmed. But it's important to remember that recurrent ovarian cancer can often be successfully treated. Dr. Shannon N. Westin, gynecologic oncologist and clinical investigator at MD Anderson Cancer Center, goes over the latest treatment options for recurrent disease.
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Breast cancer recurrence is the greatest fear for those with breast cancer. While many survivors know that being overweight can contribute to recurrence of their cancer, the thought of dieting and how to go about it can be overwhelming. Dr. Nicholas Webster, Professor of Medicine, Chief of the Division of Endocrinology and Metabolism, and Associate Director for Shared Resources, Moores Cancer Center discusses his study that suggests a path that is easy to follow and produces the type of results that can be a matter of life and death for some breast cancer patients.
Dr. Olwen Hahn, medical oncologist at the University of Chicago Department of Medicine, discusses recent developments in MBC research and treatment. Joining her is Dionna Koval, a metastatic breast cancer patient advocate.
This document discusses cancer risks associated with hereditary cancer syndromes like BRCA1/2 mutations and HNPCC. It provides lifetime risk percentages for various cancers in mutation carriers compared to the general population. It describes screening and prevention strategies like surveillance, chemoprevention, and prophylactic surgery that can reduce cancer risk. Genetic testing considerations and the importance of informing at-risk relatives is also covered.
This document outlines the process from diagnosis to follow-up care for ovarian cancer. It begins with an introduction and disclosure section. It then covers the diagnosis process, including symptoms, imaging, biopsy and surgery. Treatment options like surgery, chemotherapy, targeted therapy and clinical trials are discussed. The roles of the treatment team members are defined. Follow-up care including exams, imaging and survivorship are also summarized. Resources and questions from patients are addressed. Key terminology around histology, grade, stage and tumor markers is explained.
Kimberly Halla, MSN, FNP-C, Paula J. Anastasia, RN, MN, AOCN, and Nelli Zafman, MSN, CRNP, AOCNP prepared useful Practice Aids pertaining to PARP inhibitor therapy for this CNE activity titled, "Realizing the Promise of PARP Inhibitors in Solid Tumor Therapy: Guiding Oncology Nurses on the Advances and Challenges." For the full presentation, monograph, complete CNE information, and to apply for credit, please visit us at http://bit.ly/2EkO5Ij. CNE credit will be available until May 22, 2020.
Dr. Stephanie Blank and Dr. Melissa Frey update us on the latest developments in ovarian cancer research and treatment from the annual conference of the Society of Gynecologic Oncology. Dr. Blank is a gynecologic oncologist at Perlmutter Cancer Center at NYU Langone Medical Center and an associate professor at NYU School of Medicine. Dr. Frey is a Gynecological Oncology Fellow at NYU Langone Medical Center.
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Deborah K. Armstrong, M.D., explains the newly-released patient guide for ovarian cancer patients, which was sponsored by the National Ovarian Cancer Coalition (NOCC).
Robert P. Edwards, MD, Chair of OB/GYN/RS, Co-Director of Women's Cancer Program at University of Pittsburgh, offers information about the current state of immunotherapy for recurrent ovarian cancer patients.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
The document discusses improving care for ovarian cancer patients. It outlines the "Triple Aim" of better care, better value, and better outcomes. It describes elements to improve patient care like navigation, survivorship care, and advance care planning. It discusses new payment models that incentivize high quality care while reducing costs, and challenges of implementing value-based care. Finally, it covers recent scientific advances in personalized medicine for ovarian cancer through genetic testing and targeted therapies.
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This document summarizes the story of Ted Taylor, a glioblastoma patient who was given a terminal diagnosis but found an effective targeted therapy called Vitrakvi after extensive research. Vitrakvi targets NTRK fusions and Ted tested positive for this biomarker. He worked with his oncologists to gain access to Vitrakvi from Canada and the US. While on Vitrakvi, Ted has experienced significant tumor shrinkage with minimal side effects compared to standard chemotherapy. He hopes to help other patients advocate for themselves to find effective targeted therapies.
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Uterine and endometrial cancer are the most common gynecologic cancers. Risk factors include obesity, tamoxifen use, and certain genetic conditions. Diagnosis involves endometrial biopsy. Treatment typically involves hysterectomy with or without radiation or chemotherapy depending on risk factors like tumor grade and stage. New immunotherapies are showing promise for recurrent or advanced disease. Precision medicine approaches are helping to classify subtypes and identify targeted therapies.
1) The AURELIA trial evaluated bevacizumab combined with chemotherapy versus chemotherapy alone for platinum-resistant recurrent ovarian cancer.
2) The trial found that progression-free survival was significantly longer in the bevacizumab combination group compared to the chemotherapy alone group (median 6.7 months vs 3.4 months).
3) Rates of objective response were also significantly higher in the bevacizumab combination group compared to chemotherapy alone (30.9% vs 12.6%).
Dr. Maurie Markman, President of Science and Medicine at Cancer Treatment Centers of America, shares his expertise on the latest developments in immunotherapy for ovarian cancer.
This document discusses various menstrual disorders including amenorrhea, dysmenorrhea, dysfunctional bleeding, premenstrual syndrome, pelvic inflammatory disease, endometriosis, pelvic relaxation disorders, cystitis, urinary incontinence, and perimenopause. It defines each condition, discusses etiology and pathophysiology, assessment findings, diagnosis, and treatment. Nursing considerations are provided for educating women on prevention and management of these common gynecological issues.
The document discusses palliative surgery for terminally ill patients. It defines terminally ill patients as those with an incurable diagnosis and less than a few months to live. Palliative surgery aims to improve quality of life and relieve symptoms of advanced disease, rather than cure the condition. Common symptoms in these patients like pain, weakness, vomiting, and bowel obstruction are discussed along with potential causes and treatments. Surgical procedures that may provide palliative benefit are also outlined. The document concludes by listing the American College of Surgeons' 10 principles of palliative care, which focus on respecting patient autonomy, communication, symptom relief, and discontinuing futile treatments.
This document discusses ovarian cancer research and clinical trials. It provides an overview of ovarian cancer subtypes and gene mutations associated with serous cancer. It also summarizes various drug targets and clinical trials being studied for ovarian cancer treatment, including PARP inhibitors, Akt inhibitors, angiogenesis inhibitors, monoclonal antibodies, immune therapies, vaccines, and CAR-T cells. Challenges in ovarian cancer research like intra-tumor variability and the complexity of genetics are discussed. The importance of patient participation in clinical trials to advance scientific progress is emphasized.
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When ovarian cancer returns, it's not uncommon to experience a range of emotions and feel overwhelmed. But it's important to remember that recurrent ovarian cancer can often be successfully treated. Dr. Shannon N. Westin, gynecologic oncologist and clinical investigator at MD Anderson Cancer Center, goes over the latest treatment options for recurrent disease.
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Breast cancer recurrence is the greatest fear for those with breast cancer. While many survivors know that being overweight can contribute to recurrence of their cancer, the thought of dieting and how to go about it can be overwhelming. Dr. Nicholas Webster, Professor of Medicine, Chief of the Division of Endocrinology and Metabolism, and Associate Director for Shared Resources, Moores Cancer Center discusses his study that suggests a path that is easy to follow and produces the type of results that can be a matter of life and death for some breast cancer patients.
Dr. Olwen Hahn, medical oncologist at the University of Chicago Department of Medicine, discusses recent developments in MBC research and treatment. Joining her is Dionna Koval, a metastatic breast cancer patient advocate.
This document discusses cancer risks associated with hereditary cancer syndromes like BRCA1/2 mutations and HNPCC. It provides lifetime risk percentages for various cancers in mutation carriers compared to the general population. It describes screening and prevention strategies like surveillance, chemoprevention, and prophylactic surgery that can reduce cancer risk. Genetic testing considerations and the importance of informing at-risk relatives is also covered.
This document outlines the process from diagnosis to follow-up care for ovarian cancer. It begins with an introduction and disclosure section. It then covers the diagnosis process, including symptoms, imaging, biopsy and surgery. Treatment options like surgery, chemotherapy, targeted therapy and clinical trials are discussed. The roles of the treatment team members are defined. Follow-up care including exams, imaging and survivorship are also summarized. Resources and questions from patients are addressed. Key terminology around histology, grade, stage and tumor markers is explained.
Kimberly Halla, MSN, FNP-C, Paula J. Anastasia, RN, MN, AOCN, and Nelli Zafman, MSN, CRNP, AOCNP prepared useful Practice Aids pertaining to PARP inhibitor therapy for this CNE activity titled, "Realizing the Promise of PARP Inhibitors in Solid Tumor Therapy: Guiding Oncology Nurses on the Advances and Challenges." For the full presentation, monograph, complete CNE information, and to apply for credit, please visit us at http://bit.ly/2EkO5Ij. CNE credit will be available until May 22, 2020.
Dr. Stephanie Blank and Dr. Melissa Frey update us on the latest developments in ovarian cancer research and treatment from the annual conference of the Society of Gynecologic Oncology. Dr. Blank is a gynecologic oncologist at Perlmutter Cancer Center at NYU Langone Medical Center and an associate professor at NYU School of Medicine. Dr. Frey is a Gynecological Oncology Fellow at NYU Langone Medical Center.
DCIS Topic-Driven Round Table: Decision-Making and Treatment Choicesbkling
Facilitator Deb Hackenberry is joined by Cecilia Hammond, Senior Medical Science Liaison at Genomic Health, to discuss better decision-making and your treatment choices with DCIS.
Deborah K. Armstrong, M.D., explains the newly-released patient guide for ovarian cancer patients, which was sponsored by the National Ovarian Cancer Coalition (NOCC).
Robert P. Edwards, MD, Chair of OB/GYN/RS, Co-Director of Women's Cancer Program at University of Pittsburgh, offers information about the current state of immunotherapy for recurrent ovarian cancer patients.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
The document discusses improving care for ovarian cancer patients. It outlines the "Triple Aim" of better care, better value, and better outcomes. It describes elements to improve patient care like navigation, survivorship care, and advance care planning. It discusses new payment models that incentivize high quality care while reducing costs, and challenges of implementing value-based care. Finally, it covers recent scientific advances in personalized medicine for ovarian cancer through genetic testing and targeted therapies.
Addressing your COVID-19 Breast Cancer Concerns bkling
Dr. Anne Moore, medical oncologist and Director of the Breast Cancer Survivorship Program at Weill Cornell and Dr. Leticia Varella, Assistant Professor of Medicine at Weill Cornell Medical College will go over changes in treatment and maintenance care for those with an early stage or metastatic breast cancer diagnosis. They will address your risk level as a cancer patient, provide strategies to minimize risk, discuss how to deal with anxiety, and answer your questions to help you through the COVID-19 pandemic.
This document summarizes the story of Ted Taylor, a glioblastoma patient who was given a terminal diagnosis but found an effective targeted therapy called Vitrakvi after extensive research. Vitrakvi targets NTRK fusions and Ted tested positive for this biomarker. He worked with his oncologists to gain access to Vitrakvi from Canada and the US. While on Vitrakvi, Ted has experienced significant tumor shrinkage with minimal side effects compared to standard chemotherapy. He hopes to help other patients advocate for themselves to find effective targeted therapies.
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In this webinar, Dr. Onyinye D. Balogun and Dr. Lisa Newman of Weill Cornell Medicine-New York Presbyterian Hospital Network discuss all aspects of triple negative breast cancer and its impact on women of color in recognition of Black History Month
Uterine and endometrial cancer are the most common gynecologic cancers. Risk factors include obesity, tamoxifen use, and certain genetic conditions. Diagnosis involves endometrial biopsy. Treatment typically involves hysterectomy with or without radiation or chemotherapy depending on risk factors like tumor grade and stage. New immunotherapies are showing promise for recurrent or advanced disease. Precision medicine approaches are helping to classify subtypes and identify targeted therapies.
1) The AURELIA trial evaluated bevacizumab combined with chemotherapy versus chemotherapy alone for platinum-resistant recurrent ovarian cancer.
2) The trial found that progression-free survival was significantly longer in the bevacizumab combination group compared to the chemotherapy alone group (median 6.7 months vs 3.4 months).
3) Rates of objective response were also significantly higher in the bevacizumab combination group compared to chemotherapy alone (30.9% vs 12.6%).
Dr. Maurie Markman, President of Science and Medicine at Cancer Treatment Centers of America, shares his expertise on the latest developments in immunotherapy for ovarian cancer.
This document discusses various menstrual disorders including amenorrhea, dysmenorrhea, dysfunctional bleeding, premenstrual syndrome, pelvic inflammatory disease, endometriosis, pelvic relaxation disorders, cystitis, urinary incontinence, and perimenopause. It defines each condition, discusses etiology and pathophysiology, assessment findings, diagnosis, and treatment. Nursing considerations are provided for educating women on prevention and management of these common gynecological issues.
The document discusses palliative surgery for terminally ill patients. It defines terminally ill patients as those with an incurable diagnosis and less than a few months to live. Palliative surgery aims to improve quality of life and relieve symptoms of advanced disease, rather than cure the condition. Common symptoms in these patients like pain, weakness, vomiting, and bowel obstruction are discussed along with potential causes and treatments. Surgical procedures that may provide palliative benefit are also outlined. The document concludes by listing the American College of Surgeons' 10 principles of palliative care, which focus on respecting patient autonomy, communication, symptom relief, and discontinuing futile treatments.
This document discusses older adult survivorship issues. Key points include: the aging population is growing and older adults account for over half of cancer cases; physiological changes in aging can impact cancer treatment and outcomes; comprehensive geriatric assessments should be conducted prior to treatment; guidelines recommend adjusting treatment based on goals and function rather than age alone; and common geriatric syndromes like falls, polypharmacy, and pain management need special consideration in older cancer survivors.
Ovarian cancer forms from abnormal cell growth in one or both ovaries. Most cases are epithelial cell tumors. Symptoms include abdominal bloating and pain. Risk factors include age, family history, and never being pregnant. It is often diagnosed late since symptoms are vague, but earlier detection improves prognosis. Treatment typically involves surgery to remove the ovaries and chemotherapy. Nursing care focuses on managing pain, preventing infections and blood clots, and providing education and support.
Ovarian cancer forms from abnormal cell growth in one or both ovaries. Most cases are epithelial cell tumors. Symptoms include abdominal bloating and pain. Risk factors include age, family history, and never being pregnant. It is often diagnosed late since symptoms are vague, but earlier detection improves prognosis. Treatment typically involves surgery to remove the ovaries and chemotherapy. Nursing care focuses on managing pain, preventing infections and blood clots, and providing education and support.
menstrual manipulation for adolescents with disabilityMini Sood
A presentation of aspects of menstrual care in adolescents including those with disability. Slides for medical students who may encounter young patients who are unable to mange their menses efficiently
Late onset menopause, or delayed menopause, refers to the cessation of menstrual periods and reproductive function occurring at an older age than the average onset of menopause, which is typically around 51 years old. When menopause occurs after the age of 55, it is considered late onset. This phenomenon is relatively rare, affecting a small percentage of women, and is influenced by various factors including genetics, lifestyle, and environmental factors.
Hospice care and palliative care: Is there a difference between the two, and if so, what?
Many people still think that palliative care means hospice care. But today, hospice is only a small part of palliative care.
The goal of palliative care is to prevent or treat the symptoms and side effects of a disease; and it should be part of the picture from the first day a serious illness is diagnosed.
Dr. Jim Meadows, Director of Hospice and Palliative Care at Tennessee Oncology, will discuss this important topic. How does a family and a health care team best work together to guide a patient through a terminal illness? How does everyone continue to support quality, patient-centered, end-of-life care?
I didn't know this option of Palliative care existed prior to my mother's passing earlier this year of colorectal cancer. However, I do now know about it and want to share it with all of you
This document summarizes the side effects of ovarian cancer treatment presented by Dr. Robert J. Morgan Jr. It discusses:
- Side effects of surgery depending on a woman's age, including immediate surgical menopause or menopausal symptoms.
- Menopausal symptoms like hot flashes, sleep issues, vaginal dryness, and mood changes.
- Treatment options for menopausal symptoms including hormones, lifestyle changes, and alternatives.
- Side effects of chemotherapy including nausea, fatigue, neuropathy, and myelosuppression. Ways to manage toxicities are discussed.
- Hormonal therapies and targeted agents used and their potential side effects.
Gynecological Oncology Navigation by Penny Daugherty, RN, MS, OCN, ONN-CGPennyDaughertyRNMSOC
This session defines the various diagnoses classified as gynecological malignancies and address the discreet nuances of each disease, as well as recognition and management of specific side effects associated with individual syndromes. Conventional and targeted therapies are reviewed as well as discussions assisting patients in the selection of integrative approaches to care.
A 38-year-old woman presents with upper abdominal pain worse after meals but no other symptoms. Her H. pylori test is positive. The doctor treats her empirically with Prevpac. A year later, she reports frequent heartburn. Lifestyle modifications and PPI treatment are recommended. She does not need an endoscopy unless symptoms fail to improve.
The document discusses the importance of nutrition for cancer patients and provides guidance for nutrition interventions. Key points include:
1) Nutrition screening and assessments are important to identify patients at risk of malnutrition and help guide appropriate nutrition support and interventions.
2) Symptoms from cancer and its treatments like chemotherapy and radiation can profoundly impact dietary intake, leading to malnutrition if not properly managed.
3) Nutrition interventions like seeing a dietitian have been shown to help patients do better and improve outcomes. This may include enteral nutrition for patients unable to meet their nutritional needs.
This document provides an overview of cancer terminology, statistics, risk factors, causes, diagnostic tests, staging, grading, and common treatments. It discusses who is most likely to get cancer and lists some of the most common cancer types by gender. The document outlines cancer classification systems and explains staging and grading. It details various diagnostic tests and tumor boards. Common treatments discussed include surgery, chemotherapy, radiation therapy, stem cell transplantation, and targeted therapies. The document covers side effects of different treatments and ways to mitigate them. It provides examples of common cancers and their typical treatment approaches.
Breast cancer awareness.ppt presentation from other authorswatisheth8
Breast cancer forms in the cells of the breast. It occurs when cells grow uncontrollably and form tumors. Risk factors include being a woman over 50, family history, early menstruation, late menopause, obesity, alcohol use, and lack of physical activity. Symptoms may include breast lumps, nipple changes, or discharge. Diagnosis involves physical exams, mammograms, biopsies, and other tests. Treatment options include surgery, radiation, chemotherapy, hormone therapy, and palliative care depending on cancer stage and type. Side effects of treatment can impact quality of life.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
The presentation can be used for training of Doctors and Staff nurses on Emergency Obstetric care and MMR reduction strategies in Low Resource settings.
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You’ve been treated for uterine cancer. Now what? With surveillance strategies varying from doctor to doctor, it can be hard to know which advice you should follow. Dr. Jennifer Mueller, Head of the Endometrial Cancer Section, Gynecologic Oncology Service at Memorial Sloan Kettering Cancer Center, delves into surveillance guidelines, which tests to consider, and how to keep an eye out for any symptoms which could indicate recurrence.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
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2. The cancer journey can be a long, arduous one, and as a
result, cancer survivors usually cannot just pick up their
lives and resume where they left off before the cancer began.
Often, there are physical, emotional, cognitive, relationship,
and financial issues that will create what experts call, a “new
normal,” and cancer patients will need to learn to adjust
before they can get on with their lives.
NCCN.com Tip of the Month, August 2013
4. Survivorship Care: Ovarian Cancer
• High recurrence rate
• Provides a platform to openly discuss actual risks, address fear of
recurrence, and review s/s of recurrence to call with
• Introduce concept of chronic disease if cancer were to return
• Discuss clinical trial opportunities and maintenance therapies vs
observation
• Review role of CA 125 in surveillance setting
• Regaining and Improving Health and Strength
• Identify physical therapy needs
• Promote healthy habits
• Physical activity
• Smoking cessation
• Alcohol limitations
• Diet
• Maintenance of a healthy BMI
• Screening mammograms and colonoscopies
• Bone Health
5. It is important to remember that while you cannot control whether your cancer recurs,
you can control how much you let the fear of recurrence impact your life.
-cancer.net
6. How do you know which symptom is significant?
Is this unusual to you?
Is there a clear explanation for your symptom?
Is it persistent?
Has it lasted greater than 2 weeks?
7. Symptoms to Report to Your Gynecologic Oncologist
Pulmonology
• Abnormal shortness of breath
• A non productive cough that lasts longer than 1-2 weeks
Gastrointestinal
• Pain, pressure or cramping that lasts longer than 1-2 weeks (abdominal, pelvic, rectal, hip and or back)
• Abdominal bloating or distention
• Nausea and/or vomiting that does not resolve
• Unintentional weight loss greater than 5 pounds
• Unexplained weight gain greater than 5-10 pounds
• Blood in stool
• Difficult bowel movements or constipation that lasts longer than 1-2 weeks despite treatment
Urological
• Difficult or painful urination not associated with a urinary tract infection
• Abnormal leaking of urine
• Blood in urine
Gynecological
• Vaginal bleeding or abnormal vaginal discharge
• Painful intercourse
8. Common Late term treatment related side effects
•Fatigue
•Chronic Pain
•Neuropathy
•Cognitive Problems
•Sexual Dysfunction
•Insomnia
•Urinary incontinence
•Skin, hair, and nail changes
•Osteoporosis
•Lymphedema
•Depression, Anxiety, and Fear of Recurrence
•Second cancers
9. In general, gynecologic oncology long term treatment effects can be characterized as issues
involving one of two domains of quality of life (QOL): physical and emotional (psychological)
Common Physical Long Term Effects in Gynecologic
Cancer Survivors
Neurotoxicity — Persistent neurotoxicity is an important quality of life issue for long-term survivors
and is most commonly due to the adverse effects of chemotherapy. Presentation of neurotoxicities
can be as follows:
• Muscle cramps
• Ringing in ears or trouble hearing
• Discomfort in feet
• Upper extremity discomfort
• Trouble walking
• Numbness and weakness in the hands or feet
Cognitive dysfunction — also known as chemobrain
Fatigue — Fatigue occurs in almost all patients treated for a gynecologic cancer and may persist after
completion of treatment.
Gastrointestinal toxicity — Women treated may have long-term issues with their gastrointestinal (GI)
system as a result of the previous disease, surgical treatment, and medical therapy. The presence of
GI symptoms correlates with lower QOL, worse emotional status, and greater fear of recurrence.
10. Common Physical Long Term Effects in Gynecologic
Cancer Survivors
Gynecologic effects
Loss of fertility — Most women treated for a gynecologic cancer experience surgically or
medically-induced infertility.
Sexual dysfunction — Sexual problems are reported by survivors and may be
secondary to menopausal symptoms, dyspareunia, or to a primary loss of desire. Issues
with sexual dysfunction are present even among women who continue to be sexually
active.
Menopause — For women who complain of bothersome menopausal symptoms as a
result of treatment, limited hormonal therapy may be an option. For women who can not
or would prefer not to take hormonal therapy, selective serotonin reuptake inhibitor (SSRI)
medications have been shown to be effective in treating menopausal symptoms.
Ancillary Services
• Sexual medicine
• Pelvic floor rehabilitation
• Onco-fertility
11. Common Psychological Effects in Gynecologic
Cancer Survivors
Depression — Depression can be a persistent issue for survivors
Anxiety — Although the data are limited, anxiety may be more problematic than depression for survivors. Anxiety may
be manifest in two specific ways in survivors:
• Fear of recurrence – More than half of survivors report a fear of disease recurrence, which may persist over time.
• Preoccupation with CA 125 values – Most survivors report anxiety regarding CA 125 testing, even in cases where
they have been disease free for several years
Guilt — Survivors may have guilt related to a number of issues:
• Guilt due to delay in diagnosis – Often times symptoms that herald a diagnosis of cancer are non-specific. Despite
this, some patients suffer from guilt when they are diagnosed (especially advanced stage disease) because the lack
of recognition of “early” symptoms may have resulted in a delay in diagnosis.
• Familial guilt – Survivors with a known BRCA mutation sometimes express feelings of guilt due to transmission of the
genetic mutation to their children or if they developed after opting against prophylactic surgery
• Survivors’ guilt – Survivors’ guilt can occur in some long term survivors who have witnessed others with similar
disease stage experience recurrence and then succumb to the disease.
Poor body image — Poor body image has been significantly associated with fatigue and sexual functioning, particularly
among women who were premenopausal at diagnosis. Some have even reported this as “feeling like a stranger in my
own body”.
Poor body image is primarily due to long-term effects of prior surgical treatment, including:
• Surgical scars
• Loss of the uterus and/or ovaries
• Presence of an ostomy (which in some women is permanent)
• Wound complications
12. Your healthcare team: Is it a well oiled machine?
The patient is the most important
member of a healthcare team at all
times; especially in survivorship.
It is important to have an existing and
ongoing relationship with not only the
oncologist but the primary care provider.
It is also important to ensure that both
providers that accurate and up to date
information.
◦ More and more attention is being
focused on the survivorship phase of
cancer and the need for a seamless
transition back to the primary care
provider. However not many facilities
have a process in place yet. Therefore
the patient needs to be an active
participant in the healthcare team.
Survivor:
Most valued
member of the
healthcare team
Primary
Care
Physician
Oncology
Team
14. Thank you!
Heather Augustyniak, RN, MSN, FNP-C
Survivorship and Gynecologic Oncology APP
Northwestern Medicine Regional Medical Group
Editor's Notes
As nurses, we have an important role in education patients about concerns.
Many survivors do not receive SCPs. During this presentation, we’ve identified various reasons for this and hopefully ways to help break down those barriers.
Barriers to providing SCPs (resources, time, commitment of the organization).
Education about the need and utilization of SCPs is important. Empowering patients to be involved in their care is key.
As oncology nurses, we have great opportunity to advocate for patients and enhance quality of care through effective survivorship care planning.