Professional Documents
Culture Documents
Cervical Cancer: Alabe - Aquino - Aquino - Bernardo - Binwag
Cervical Cancer: Alabe - Aquino - Aquino - Bernardo - Binwag
3
Prevalence
4
Causes/Risk factors
CAUSES/RISK FACTORS
■ HPV infection
■ Cigarette smoking
■ Younger age at first intercourse
■ Multiple sex partners
■ Immunodeficiency
6
Pathophysiology
5-MINUTE-VIDEO
Signs and Symptoms
● Abnormal Menstrual bleeding
● Menstrual bleeding that is longer and heavier than
usual
● Bleeding after Menopause
11
Pelvic examination
12
Pap test
13
Human papillomavirus (HPV) test
14
Endocervical curettage
15
Colposcopy
16
Diagnostic test
Screening
20
Staging
22
Stages
24
Stage I
■ Stage IA
○ Stage IA1: Less than
3 mm in depth
○ Stage IA2: 3 mm to
less than 5 mm in
depth
25
Stage IB
26
Stage II
■ Stage IIA
○ Stage IIA1: Less than 4 cm
wide
○ Stage IIA2: 4 cm or more in
width
■ Stage IIB
○ Tumor has spread to
parametrial area
○ Tumor does not reach pelvic
wall
27
Stage III
28
Stage III
29
Stage IV
30
Surgery treatment
Surgical Treatment
32
Stage IA
■ Conization
■ Total hysterectomy with or without bilateral salpingo-
oophorectomy
33
Stage IB and IIA Cervical Cancer
34
Stage IIB, III and IVA
36
Treatment for recurrent
cervical cancer
■ Immunotherapy
■ Radiation therapy and chemotherapy
■ Chemotherapy and targeted therapy
■ Chemotherapy as palliative therapy to relieve symptoms
caused by the cancer and improve quality of life
■ Pelvic exenteration
■ Clinical trials of new anti-cancer drugs and drug
combinations
38
Medications
Avastin (Bevacizumab)
40
Drug Name Mechanism of Contraindication Side Effects Nursing
Action Intervention
Generic Name: Binds to vascular Pregnancy Body as a Whole: Monitor for S&S of an
BEVACIZUMAB endothelial growth (category C), Asthenia , pain, wound infusion reaction
factor (VEGF) and dehiscence.
prevents the
lactation; nephrotic CNS: Syncope,
(hypersensitivity);
Brand Name: interaction of VEGF to syndrome; active headache, dizziness, infusion should be
Avastin its receptors on the bleeding; surgery confusion, abnormal interrupted in all
surface of endothelial within 28 d; dental gait. patients with severe
Classification: cells. This blocks work within 20 d. CV: DVT, infusion reactions and
MONOCLONAL endothelial cell Safety and hypertension , heart appropriate therapy
proliferation and new failure, intra-abdominal instituted.
ANTIBODY blood vessel formation
effectiveness in thrombosis,
in tumor cells. children are not cerebrovascular
Stock Dose: established. Monitor BP at least
events.
every 2–3 wk; if
25 mg/mL injection GI: Abdominal pain,
diarrhea , constipation, hypertension develops,
nausea, vomiting, monitor more
Recommended
anorexia, stomatitis, frequently, even after
Dose: dyspepsia, weight loss, discontinuation of
IV 5 mg/kg q14d flatulence, dry mouth, bevacizumab.
until disease colitis, gastrointestinal
progression perforation.
41
Drug Name Mechanism of Contraindication Side Effects Nursing
Action Intervention
42
Bleomycin Sulfate
43
Drug Name Mechanism of Contraindication Side Effects Nursing Intervention
Action
Generic Name: A toxic drug with History of Body as a Whole: Monitor patient closely for
BLEOMYCIN low therapeutic hypersensitivity or Hypersensitivity at least 24 h (vital signs,
(anaphylactoid
SULFATE index; intensely idiosyncrasy to reaction); mild febrile
auscultation of chest,
cytotoxic. By bleomycin; reaction careful observations).
Brand Name: unclear women of CNS: Headache,
Blenoxane mechanism, blocks childbearing age, mental confusion. Therapeutic effectiveness:
DNA, RNA, and pregnancy GI: Stomatitis, Favorable response, if
Classification: protein synthesis. A (category D), ulcerations of tongue any, is expected within 2
and lips, anorexia, wk for treatment of
ANTINEOPLASTIC; cell cycle-phase lactation. nausea, vomiting,
ANTIBIOTIC nonspecific agent. Hodgkin's or testicular
diarrhea, weight loss. tumor, and within 3 wk for
Widely used in Hematologic:
squamous cell cancers.
Stock Dose: combination with Thrombocytopenia,
30 units powder other leukopenia, (rare).
Respiratory:
Monitor vital signs. Febrile
chemotherapeutic reaction (mild chills and
Pulmonary toxicity
agents because it (dose and age- fever) is relatively
lacks significant related); interstitial common in patients
myelosuppressive pneumonitis, receiving bleomycin
activity. pneumonia, or therapy.
fibrosis.
44
Drug Name Mechanism of Contraindicati Side Effects Nursing Intervention
Action on
45
Hycamtin (Topotecan Hydrochloride)
46
Drug Name Mechanism of Contraindication Side Effects Nursing
Action Intervention
Generic Name: Antitumor Previous Body as a Whole: Lab tests: Obtain CBC
TOPOTECAN mechanism is hypersensitivity to Asthenia, fever, counts with differential
fatigue.
HYDROCHLORIDE related to inhibition topotecan, frequently; periodically
GI: Nausea, vomiting,
of activity of irinotecan, or other diarrhea, constipation, monitor ALT.
Brand Name: topoisomerase I, an camptothecin abdominal pain,
Hycamtin enzyme required analogs; acute stomatitis, anorexia, Assess for GI distress,
for DNA replication. infection; transient elevations in respiratory distress,
Classification: Topoisomerase I is pregnancy liver function tests. neurosensory
Hematologic: symptoms, and S&S of
ANTINEOPLASTIC, essential for the (category D), Leukopenia,
CAMPTOTHECIN relaxation of lactation. infection throughout
neutropenia , anemia, therapy.
AGENT; supercoiled double- thrombocytopenia.
TOPOISOMERASE stranded DNA, Respiratory: Dyspnea.
I INHIBITOR which enables Skin: Alopecia.
replication and
Stock Dose: transcription to
4 mg vials proceed. Topotecan
binds to the DNA-
topoisomerase I
complex.
47
Drug Name Mechanism of Contraindication Side Effects Nursing
Action Intervention
Recommended
Dose:
IV 1.5 mg/m2 daily
for 5 d starting on
day 1 of a 21 d
course. Four
courses of therapy
recommended.
Subsequent doses
can be adjusted by
0.25 mg/m2
depending on
toxicity
48
Keytruda (Pembrolizumab)
49
Drug Name Mechanism of Contraindication Side Effects Nursing
Action Intervention
50
Drug Name Mechanism of Contraindication Side Effects Nursing
Action Intervention
51
Nursing
problems & interventions
Nursing problems
53
Nursing interventions
54
Prevention
Primary Prevention
HPV vaccination
■ 9-13 years old (before they become sexually active)
56
WHO (March, 2016) recommended schedule for HPV vaccines:
Fun Fact:
*Male circumcision have shown a significant protective effect against
HPV transmission
57
Secondary Prevention
58
Tertiary Prevention
59
According to Department of Health (DOH)
60
Thank you and God bless!