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.

1. OVARIAN CANCER
Amal Ammar
Raghad Abutair

2. Outline :
• Definition .
• Signs and symptoms.
• Risk factors.
• Epidemiology.
• Pathophysiology.
• Diagnosis and screening
• Prevention.
• Management
• Reference .

4. Definition:
It’s an abnormal cells that
forms in an ovary.
• Most of these tumors are
benign and never spread
beyond the ovary. It can be
treated by removing the
ovary or the part of the
ovary that contains the
tumor.
• Malignants are potentially
ovarian tumors can spread
(metastasize) to other parts
of the body and can be fatal.

6. Types of ovarian cancer
• The ovaries are made up of 3 main kinds of cells. Each
type of cell can develop into a different type of tumor:
• Epithelial tumors start from the cells that cover the outer
surface of the ovary. Most ovarian tumors are epithelial
cell tumors.
• Germ cell tumors start from the cells that produce the
eggs (ova).
• Stromal tumors start from structural tissue cells that hold
the ovary together and produce the female hormones
estrogen and progesterone.

7. Signs and symptoms:
• abdominal bloating, pressure, and pain
• abnormal fullness after eating
• difficulty eating
• an increased urge to urinate
Other symptoms, such as:
• fatigue
• indigestion
• heartburn
• constipation
• back pain
• menstrual irregularities
• painful intercourse

8. Risk factors:
• Age.
• Inherited gene mutation
• The gene mutations that cause Lynch syndrome, which is
associated with colon cancer, also increase a woman's risk of
ovarian cancer.
• Estrogen hormone replacement therapy, especially with long-
term use and in large doses.
• Age when menstruation started and ended. If you began
menstruating before age 12 or underwent menopause after age
52, or both, your risk of ovarian cancer may be higher.
• Never being pregnant.
• Fertility treatment.
• Smoking.
• Use of an intrauterine device.

9. Epidemiology :
• According to the American Cancer Society, it is the 8th most common
cancer among women in the United States .
• However, it is the 5th most common cause of cancer deaths in
women, ovarian cancer has the highest rate of deaths.
• Each year, more than 22,000 women in the U.S. are diagnosed with
ovarian cancer and around 14,000 will die.
• Tragically, the overall 5-year survival rate is only 46 percent in most
developed countries (it is lower for more advanced stages).
• However, according to the National Cancer Institute, if diagnosis is
made early, before the tumor has spread, the 5 year survival rate is
94 percent.

10. Pathophysiology:
• Ovarian cancer forms when errors in normal ovarian cell
growth occur. Usually, when cells grow old or get
damaged, they die, and new cells take their place. Cancer
starts when new cells form unneeded, and old or
damaged cells do not die as they should. The buildup of
extra cells often forms a mass of tissue called a growth or
tumor.
• Ovarian tumor markers :
• BRCA1, BRCA2, and CDK12

11. Enjoy

12. Diagnosis:
• It starts with a pelvic examination.
• Imaging tests, such as ultrasound or CT scans, of the
abdomen and pelvis. These tests can help determine the
size, shape and structure of your ovaries.
• Blood test, which can detect a protein (CA 125) found on
the surface of ovarian cancer cells.
• Surgery to remove a tissue sample and abdominal fluid
to confirm a diagnosis of ovarian cancer. Minimally
invasive or robotic surgery may be an option. If cancer is
discovered, the surgeon may immediately begin surgery
to remove as much of the cancer as possible.

13. Prevention:
• Factors that decrease risk include hormonal birth control,
tubal ligation, and breast feeding.
• People with strong genetic risk for ovarian cancer may
consider the surgical removal of their ovaries as a
preventative measure.
• This is often done after completion of childbearing years.
This reduces the chances of developing both breast
cancer (by around 50%) and ovarian cancer (by about
96%) in people at high risk.
• However, these statistics may overestimate the risk
reduction because of how they have been studied.

14. Treatment :
• Treatment of ovarian cancer usually involves a combination of surgery
and chemotherapy.
• Surgery
• Treatment generally involves removing both ovaries, the fallopian
tubes, the uterus as well as nearby lymph nodes and a fold of fatty
abdominal tissue (omentum) where ovarian cancer often spreads.
Your surgeon also will remove as much cancer as possible from your
abdomen.
• Less extensive surgery may be possible if your ovarian cancer was
diagnosed at a very early stage. For women with stage I ovarian
cancer, surgery may involve removing one ovary and its fallopian
tube. This procedure may preserve the ability to have children.
• Chemotherapy
• After surgery, you'll likely be treated with chemotherapy to kill any
remaining cancer cells. Chemotherapy drugs can be injected into a
vein or directly into the abdominal cavity or both.
• Chemotherapy may be used as the initial treatment in some women
with advanced ovarian cancer.

15. Management:
• Targeted therapy (biotherapy)
• Radiation therapy
• The choice of treatment depends largely on the type of
cancer and the stage of the disease.
• Other factors that could play a part in choosing the best
treatment plan might include : general state of health,
whether the pt. plan to have children, and other personal
considerations.

16. Staging ovarian cancer
• The cancer's stage helps determine your prognosis and
your treatment options.
• Stages of ovarian cancer include:
• Stage I. Cancer is found in one or both ovaries.
• Stage II. Cancer has spread to other parts of the pelvis.
• Stage III. Cancer has spread to the abdomen.
• Stage IV. Cancer is found outside the abdomen.

18. advanced ovarian
• Advanced ovarian cancer means that the
cancer
• 1- has spread from the ovary to another part
of the body. Stage ( 2 to 4 )as advanced.
• 2- cancer that has come back after treatment
(recurrence).
• Unfortunately ovarian cancer that comes
back after treatment can't usually be cured.
But treatment may control it for many
months or sometimes years.

19. Common areas ovarian cancer may
spread to or spread from
- secondary cancer (metastatic cancer ) , Includes:
• the lining of the abdomen, the bowel and bladder, lymph
nodes, lungs, and liver.
• Cancers that have spread to another part of the body,
such as the lungs.

20. Nurses role :
Nursing Assessment .
• Irregular vaginal bleeding and vaginal discharge.
• Increase in abdominal pain and pressure
• Bowel and bladder dysfunction.
• Vulvar itching and burning.
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.
• Imbalance nutrition: Less than body requirements

21. Nursing Interventions
• Teach women the importance of having routine screenings for cancer of the
reproductive system. (pap smear, and pelvic exam)
• Teach women about the risk factors of the reproductive system.
• Teach women about menopause signs and symptoms after bilateral
oophorectomy.
• Teach women about hormone replacement therapy and the side effects.
• Manage client's pain related to chemotherapy .
• Monitor for infection .
• Teach client how to prevent DVTs after surgery, i.e. frequent changes in
positions, leg exercises to promote circulation.
• Provide additional education and help the patient find a support group.
• Explain the need for increased intake of fruits, vegetables, and whole grains.
Also, a decreased fat intake of <30% of calories.
• Administer anti nausea (antiemetic) medications as needed.
• Assess patient for body image changes as a result of disfiguring treatment.

22. Coping and support
Encourage the pt. to :
• Find someone to talk with. You may feel comfortable
discussing your feelings with a friend or family member, or
you might prefer meeting with a formal support group.
Support groups for the families of cancer survivors also
are available.
• Let people help. Cancer treatments can be exhausting.
Let people know what would be most useful for you.
• Set reasonable goals. Having goals helps you feel in
control and can give you a sense of purpose. But choose
goals that you can reach.
• Take time for yourself. Eating well, relaxing and getting
enough rest can help combat the stress and fatigue of
cancer.

24. Reference :
• http://www.cancerresearchuk.org/about-cancer/ovarian-
cancer.
• http://www.medicalnewstoday.com/articles/159675.php.
• http://www.webmd.com/ovarian-cancer/.
• https://www.cancer.org/cancer/ovarian-cancer.html.