OVARIAN CANCER

By: Mrs. JENNIFER O. ASIO, RN, MN

Anatomy
and
Physiology of
the Ovaries
 • Leading cause of gynecological
Cancer cancer deaths in the United States
• Despite careful physical

of the examination, ovarian tumors are

often difficult to detect because
they are usually deep in the pelvis.

Ovary • Transvaginal ultrasound and CA-

125 antigen testing may be
reassuring for women who have a
high risk for this condition.
• One woman in 70 will
develop ovarian cancer in her
lifetime.
• The incidence of this type of
cancer increases after 40
years of age and peaks in the
early 80s; the median age of
affected women is 63 years. Epidemiology
• Mutations of BRCA1 and
BRCA2 increase risk; the
lifetime risk for women with
these mutations is 28% to
40%.
• A woman with ovarian cancer has a threefold to fourfold
increased risk of breast cancer, and a woman with breast
cancer has an increased risk of ovarian cancer.
• A family history, older age, low parity, and obesity may
increase risk of ovarian cancer.
• Genetic testing is indicated when three or more cases of
closely related family members have premenopausal
breast cancer or ovarian cancer.
Clinical • increased • urinary urgency
Manifestations abdominal girth • indigestion
• pelvic pressure • flatulence
• bloating • increased waist
• back pain size
• constipation • leg pain
• abdominal pain • pelvic pain.
• Any enlarged ovary must
be investigated.

• Ovarian tumors are Assessment

classified as benign if
there is no proliferation or and
invasion, borderline if Diagnostic
there is proliferation but
no invasion, and Findings
malignant if there is
invasion.
 • Surgical staging, exploration,
and reduction of tumor mass are
the basics of treatment.
Surgical
Management • Surgical removal is the
treatment of choice
• The surgical removal of
the uterus to treat cancer,
dysfunctional uterine
bleeding, endometriosis,
nonmalignant growths.
• Can be supracervical or
subtotal
• A total hysterectomy
involves removal of the Hysterectomy
uterus and the cervix.
• Radical hysterectomy
involves removal of the
uterus as well as the
surrounding tissue.
• I Cancer is contained within the ovary (or ovaries).
• II Cancer is in one or both ovaries and has involved
other organs (ie, uterus, fallopian tubes, bladder, the
sigmoid colon, or the rectum) within the pelvis.
• III Cancer involves one or both ovaries, and one or
both of the following are present: (1) cancer has Stages of
spread beyond the pelvis to the lining of the
abdomen; (2) cancer has spread to lymph nodes. Ovarian
• IV The most advanced stage of ovarian cancer. Cancer
is in one or both ovaries. There is distant metastasis to Cancer
the liver, lungs, or other organs outside the peritoneal
cavity; ovarian cancer cells in the pleural cavity are
evidence
Methods:
➢External Radiation Therapy - destroys cancerous
cells at the skin surface or deeper in the body.
➢Intraoperative Radiation Therapy - this direct-
view irradiation may be used when para-aortic
nodes are involved or for unresectable
Radiation
(inoperable) or partially resectable neoplasms. Therapy
➢Internal (Intracavitary) Irradiation - these
devices are not loaded with radioactive material
until the patient returns to her room.
 • Chemotherapy
• Liposomal therapy
• Combination IV and intraperitoneal
Medical chemotherapy
• Liposomal preparations
Management • Intraperitoneal drug administration
• Anti-cancer vaccines
• Monoclonal antibodies directed against cancer
antigens
• Gene therapy
• Antiangiogenic treatments
 • Emotional support, comfort
measures, and information, plus
attentiveness and caring.
• IV fluids prescribed to alleviate fluid
and electrolyte imbalances
Nursing • Parenteral nutrition
Management • Providing postoperative care after
intestinal bypass to alleviate any
obstruction, controlling pain, and
managing drainage tubes.
Thank You!