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OVARIAN CANCER
• It is the malignant neoplastic growth of the
ovary.
Incidence
• Ovarian cancer constitutes about 15 to 20
percent of genital malignancy.
• It is more prevalent in USA but less in Japan
and India
ETIOLOGY
• Advanced age
• Nulliparity – woman who has never given
birth
• Infertility
• Personal history of breast or colon cancer
• Genetic
• Early menarche
• Late menopause.
• High fat diet.
• Obesity.
• Use of perineal talcum powder or hygienic sprays.
• Older than 30 years at first pregnancy.
• Hormone replacement therapy for more than 10 years.
Classification
• Epithelial cancer - Malignant epithelial
tumors are both cystic and solid types.
• Germ cell tumors - Commonly occur in
young women
• Specialized stromal cell cancers - Usually
involve one ovary
• Cancers metastatic to the ovaries are called
Krukenberg tumors.
Clinical features
- Feeling of abdominal discomfort or pain
which the patient may express as gas,
indigestion, bloating, swelling or cramps.
- Nausea, diarrhea, constipation
- Loss of appetite
- Feeling full even after a light meal
• Sudden loss of weight
• Urinary frequency or incontinence
• Abnormal vaginal bleeding
• Pelvic pain, back pain
• Fatigue and pallor
• Edema of leg or vulva
• Respiratory distress due to ascites or pleural
effusion
Diagnostic measures
• Cytology examination of fluid collected from
abdominal paracentesis
• Chest X ray to exclude pleural effusion and chest
metastasis
• Barium enema to detect any lower bowel malignancy.
• Ultrasound abdomen and pelvis
• CT scan – retroperitoneal lymph node assessment
• MRI – to detect the involvement of lymph nodes
• PET scan
• Tumor markers - CEA, CA125, AFP, HCG, placental
alkaline phosphatase.
Staging Of Ovarian Cancer
• Stage I – limited to the ovaries
• Stage IA – one ovary is involved
• Stage IB – both ovaries involved
• Stage IC – Both ovaries involved with rupture of
ovarian cyst, malignant ascites
• Stage II – spread to adjacent pelvic structures
• Stage IIA – spread to uterus or fallopian tubes
• Stage IIB – Spread to pelvic peritoneum
• Stage III – spread to upper abdomen
• Stage IV – distant spread beyond the
abdomen, liver, lung etc.
Pathophysiology
• Epithelial type : serous or mucinous type’ the
epithelial type originates from cells on the
surface of the germinal epithelium
• Non epithelial type: germ cell type[ ova]
• Direct metastasis
• Lymphatic spread
• Peritoneal spread helps in the wide spread
Management
• Surgical management
• Chemotherapy
• Radiation therapy
• Immunotherapy
• Adjuvant therapy
Surgical management
• total abdominal hysterectomy with bilateral
salpingio-oophrectomy.
• Chemotherapy:
 Alkylating agents (melphelan, cyclophosphamide,etc.)
 Platinum compounds (cisplatin, carboplatin)
 Taxame derivatives (paclitaxel, docetaxel)
 Combination chemotherapy.
• Radiotherapy:-
Very little scope. Total abdomino peritoneal
irradiation is employed.
Radioactive isotopes.
• Immunotherapy - combination of BCG,
corynebacterium parvum or alpha interferon
• NURSING
MANAGEMENT
• Acute pain
• Fatigue
• Deficient fluid volume
• Imbalanced nutrition
• Situational low self-esteem
• Risk for infection

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ovarian cancer.ppt

  • 2. • It is the malignant neoplastic growth of the ovary.
  • 3. Incidence • Ovarian cancer constitutes about 15 to 20 percent of genital malignancy. • It is more prevalent in USA but less in Japan and India
  • 4. ETIOLOGY • Advanced age • Nulliparity – woman who has never given birth • Infertility • Personal history of breast or colon cancer • Genetic • Early menarche
  • 5. • Late menopause. • High fat diet. • Obesity. • Use of perineal talcum powder or hygienic sprays. • Older than 30 years at first pregnancy. • Hormone replacement therapy for more than 10 years.
  • 6. Classification • Epithelial cancer - Malignant epithelial tumors are both cystic and solid types. • Germ cell tumors - Commonly occur in young women • Specialized stromal cell cancers - Usually involve one ovary
  • 7. • Cancers metastatic to the ovaries are called Krukenberg tumors.
  • 8. Clinical features - Feeling of abdominal discomfort or pain which the patient may express as gas, indigestion, bloating, swelling or cramps. - Nausea, diarrhea, constipation - Loss of appetite - Feeling full even after a light meal
  • 9. • Sudden loss of weight • Urinary frequency or incontinence • Abnormal vaginal bleeding • Pelvic pain, back pain • Fatigue and pallor • Edema of leg or vulva • Respiratory distress due to ascites or pleural effusion
  • 10. Diagnostic measures • Cytology examination of fluid collected from abdominal paracentesis • Chest X ray to exclude pleural effusion and chest metastasis • Barium enema to detect any lower bowel malignancy.
  • 11. • Ultrasound abdomen and pelvis • CT scan – retroperitoneal lymph node assessment • MRI – to detect the involvement of lymph nodes • PET scan • Tumor markers - CEA, CA125, AFP, HCG, placental alkaline phosphatase.
  • 12. Staging Of Ovarian Cancer • Stage I – limited to the ovaries • Stage IA – one ovary is involved • Stage IB – both ovaries involved • Stage IC – Both ovaries involved with rupture of ovarian cyst, malignant ascites • Stage II – spread to adjacent pelvic structures
  • 13. • Stage IIA – spread to uterus or fallopian tubes • Stage IIB – Spread to pelvic peritoneum • Stage III – spread to upper abdomen • Stage IV – distant spread beyond the abdomen, liver, lung etc.
  • 14. Pathophysiology • Epithelial type : serous or mucinous type’ the epithelial type originates from cells on the surface of the germinal epithelium • Non epithelial type: germ cell type[ ova] • Direct metastasis • Lymphatic spread • Peritoneal spread helps in the wide spread
  • 15. Management • Surgical management • Chemotherapy • Radiation therapy • Immunotherapy • Adjuvant therapy
  • 16. Surgical management • total abdominal hysterectomy with bilateral salpingio-oophrectomy.
  • 17. • Chemotherapy:  Alkylating agents (melphelan, cyclophosphamide,etc.)  Platinum compounds (cisplatin, carboplatin)  Taxame derivatives (paclitaxel, docetaxel)  Combination chemotherapy.
  • 18. • Radiotherapy:- Very little scope. Total abdomino peritoneal irradiation is employed. Radioactive isotopes. • Immunotherapy - combination of BCG, corynebacterium parvum or alpha interferon
  • 20. • Acute pain • Fatigue • Deficient fluid volume • Imbalanced nutrition • Situational low self-esteem • Risk for infection