CANCER OF THE UTERUS

• Uterine cancer or endometrial cancer is the most

common gynecological cancer.
• It develops in the body of the uterus, which is a
hollow organ located in the lower abdomen.
• Most endometrial cancers are adenocarcinomas.
• Endometrial cancer originates in the inner lining
(endometrium) of the uterus, accounts for about 90%
of uterine cancers.
• Uterine sarcoma originates in an outer layer of
muscle tissue (myometrium) and accounts for less
than 10% of cases.
 CAUSES AND RISK FACTORS

• The cause of uterine cancer is unknown

• Age (more common after age 50)
• Family history of uterine cancer
• Personal history of breast, colorectal, or ovarian
cancer
• Prior pelvic radiation therapy
• Early menarche ( beginning menstruation before age
12)
• Hormone replacement therapy
• Late menopause (after age 52)
• Nulliparity or low parity
• Endometrial hyperplasia
• Obesity, diabetes or high BP
• Use of tamoxifen
• A high –fat diet
 CLINICAL MANIFESTATIONS
• Early uterine cancer usually is asymptomatic.
• Most cases of endometrial cancer develop in
postmenopausal women, whose periods have stopped.
• Abnormal vaginal bleeding is the most common
symptom.
• Any bleeding after menopause
• Prolonged periods or bleeding between periods.
• An abnormal, non bloody discharge from
vagina
• Painful or difficult urination
• Pelvic pain
• Pain during intercourse
• Advanced uterine cancer may cause weight
loss, loss of appetite, and changes in bladder
and bowel habits.
 DIAGNOSTIC EVALUATION
• Pelvic exam
• Pap test
• Endometrial biopsy
• Dilation and curettage
• Exploratory laparotomy
• MRI scan and CT scan
• Transabdominal ultrasound
• Transvaginal ultrasound
 MANAGEMENT
• 1. Surgical Treatment:
• Most common treatment
• Hysterectomy
• Hysterectomy with bilateral salpingo-
oopherectomy
• Lymph nodes in the area should also be
removed during surgery
• 2. Radiation Therapy:
• Before surgery to shrink the tumor or after surgery
to destroy any cancer cells that remain in the area.
• 3. Hormone Therapy:
• Progesterone
• GnRH agonists.
• 4. Chemotherapy:
• Carboplatin
• Cisplatin
• Doxorubicin
• Paclitaxel (taxol)
 NURSING MANAGEMENT:
HYSTERECTOMY
• PREOPERATIVE NURSING
INTERVENTIONS:
• Assist patient to seek information on stage of
cancer and treatment options. Explain about
side effects of radiation and chemotherapy.
• Administer analgesics and tell patient that
heavy lifting, strenuous exercise and sexual
intercourse may increase pain.
• Encourage small, frequent, bland meals/liquid
nutritional supplements as able.
• Preparing skin for surgery: Skin preparation
may include cleansing the lower abdomen,
inguinal areas, upper thighs and vulva with
germicide for several days before the surgical
procedure.
• POSTOPERATIVE NURSING
INTERVENTIONS:
• Observe the patient for sign of shock. check
wound dressing regularly. if there is a wound
drain checks amount and type of drainage
regularly.
• Hemorrhage may occur within 24 hours, the
nurse should observe for signs of internal and
external bleeding.
• Give appropriate analgesic drugs as
prescribed.
• Encourage frequent changes of position in bed.
Activity decreases pain by increasing
circulation and reducing muscle tension.
• Monitor stool characteristics and frequency.
• Ensure adequate hydration with IV fluids.
• Encourage the patient to ambulate a soon as
possible.
• Administer antiemetics as prescribed when
require for nausea and vomiting.
• Measure and record urinary output until patient
void sufficiently.
• Patient may require catheterization if unable to
pass or unable to empty bladder completely.
• Monitor temperature, take regular urine
specimens for culture and check wound for signs
of inflammation or any abnormal discharge.
• Encourage that patient has antiembolitic
stockings.
• Encourage leg exercises and early mobilization.