UTERINE

CANCER
 It is also known as endometrial cancer, is a type of cancer
that originates in the lining of the uterus, which is called the
endometrium. The uterus is a female reproductive organ
where a fertilized egg implants and grows during pregnancy.
Uterine cancer typically occurs when the cells in the
endometrial lining begin to grow uncontrollably, leading to
the formation of a tumor.
ETIOLOGY
• Endometrial overgrowth (hyperplasia)
• Obesity
• Having never been pregnant
• Early menses
• Menopause after age 55
•Tamoxifen use (a drug used to treat cancer)
• Family history of uterine cancer
• Older age
• Lynch syndrome
 TYPES OF UTERINE CANCER

1. Endometrial Cancer

Develops in the endometrium, the inner lining of your uterus. It’s one of the most common
gynecologic cancers affecting your reproductive system.
 TYPES OF ENDOMETRIAL CANCER
A. Serous adenocarcinoma
- Cancer is more likely to spread to the lymph nodes and elsewhere in the body.

B. Adenosquamous carcinoma
- A rare cancer, much like endometrial adenocarcinoma, that lines the outer layer of the
uterus.

C. Uterine carcinosarcoma
- Cancer cells resemble endometrial cancer and sarcoma but pose a high risk of spreading to
the lymph nodes and throughout the body.
Etiology OF ENDOMETRIAL CANCER

- Taking tamoxifen for breast cancer.

- Having radiation therapy to any pelvic organs.

- Having had more menstrual cycles.

- Having increased exposure to estrogen without added

progesterone.
 TYPES OF UTERINE CANCER

2. Uterine Sarcoma

Develops in the myometrium, the muscle wall of your uterus. Uterine sarcomas are very rare.
 TYPES OF UTERINE SARCOMA
A. Uterine leiomyosarcoma
- The most common kind of uterine sarcoma in the uterine myometrium, the muscular wall,
that makes up 2% of uterine cancers.

B. Endometrial stromal sarcomas

- This cancer develops in connective tissue that supports the uterus and represents less than
1% of all uterine cancers. However, this type of cancer is typically slow growing.

C. Undifferentiated sarcoma
- Comprises less than 1% of all uterine cancers, undifferentiated sarcoma is like endometrial
stromal sarcoma but grows and spreads more quickly.
Etiology OF UTERINE SARCOMA

• Radiation therapy to the pelvic area (cancer can

occur 5-25 years following treatment).

• Being African American, which makes you twice

as likely to develop uterine sarcoma as white or
Asian women.

• History of retinoblastoma.
ANATOMY AND PHYSIOLOGY

Normal:
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY
 PATHOPHYSIOLOGY

Endometrial cancer forms when there are errors in normal endometrial cell growth.
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. These abnormal cancer cells have many genetic abnormalities that cause
them to grow excessively.
DIAGNOSTIC TESTS

1. Pelvic Examination

2. Endometrial Biopsy

3. Dilation and Curettage

4. Transvaginal Ultrasound

5. Computed Tomography Scan

6. Magnetic Resonance Imaging

7.Biomarker Testing of the Tumor.

CLINICAL MANIFESTATIONS
Vaginal bleeding between periods before menopause.

Vaginal bleeding or spotting after menopause, even a slight

amount.

Lower abdominal pain or cramping in your pelvis, just below your

belly.

Thin white or clear vaginal discharge if you’re postmenopausal.

Extremely prolonged, heavy or frequent vaginal bleeding if you’re

older than 40.
 Staging

Stage 1 - Cancer that is confined to the uterus.

Stage 2 - Cancer that has spread to the cervix.

Stage 3 - Cancer that has spread to the vagina, ovaries, and/or lymph nodes.

Stage 4 - Cancer that has spread to the urinary bladder, rectum, or organs located far from the uterus, such as the lungs or bones.
 MEDICAL MANAGEMENT

Focused Ultrasound Surgery

A noninvasive treatment doesn't involve surgical cuts called incisions. It also doesn't involve
tools being placed in the body. With uterine fibroids, a procedure called MRI -guided
focused ultrasound surgery (FUS) is: A noninvasive treatment option that preserves the
uterus.
 SURGICAL MANAGEMENT

Hysterectomy and Prolapse Repair

uterine prolapse may be treated by removing your uterus in a surgical

procedure called a hysterectomy.
 DRUG OF CHOICE
Pembrolizumab:
It can be used to treat uterine tumors with dMMR if other previous treatments have not
worked. A combination of lenvatinib (Lenvima), a targeted therapy drug, and
pembrolizumab is also approved to treat advanced endometrial cancer.

Chemotheraphy Drugs:
• Cisplatin (Platinol)
• Carboplatin (Paraplatin)
• Paclitaxel (Taxol)
• Topotecan (Hycamtin)
PREVENTIVE MEASURES

• HPV Vaccines

• Safe sex

• Don't smoke
NURSING MANAGEMENT

• Preoperative Nursing Care

• Intraoperative Nursing Care

• Post-operative Nursing Care

OvARIAN
Cancer
It is the uncontrolled growth of
abnormal cells in the ovaries.
ETIOLOGY
- Inerited a faulty gene, such as the BRCA genes or those linked to
Lynch syndrome
- Have endometriosis or diabetes
- Started your periods at a young age or went through the
menopause late (over 55), or have not had a baby – because these
things may mean you’ve released more eggs (ovulated more)
- Are taking hormone replacement therapy (HRT)
- Are overweight
 TYPES OF OVARIAN CANCER
Epithelial Ovarian Cancer
- Most common type of ovarian cancer. About 85% to 90% of these cancers involve the cells that cover the outer surface of the
ovary. They commonly spread first to the lining and organs of the pelvis and abdomen and then to other parts of the body.

Germ cell tumors

- These make up less than 2% of all ovarian cancers. They begin in the reproductive cells that are a woman's "eggs". Teenagers
and women in their 20s are more likely to develop this type of ovarian cancer.

Stromal cell tumors

- These represent about 1% of all ovarian cancers. They form in the tissues that support the ovaries. This type of cancer is
often found in the early stages. Vaginal bleeding is one of the most common.
TYPES OF OVARIAN CANCER
ANATOMY AND PHYSIOLOGY
ANATOMY AND PHYSIOLOGY

Normal:
ANATOMY AND PHYSIOLOGY
 PATHOPHYSIOLOGY
The pathophysiology of ovarian cancer included the concept that it begins with the
dedifferentiation of the cells overlying the ovary. During ovulation, these cells can be
incorporated into the ovary, where they then proliferate. Ovarian cancer typically spreads to
the peritoneal surfaces and omentum. Spread can occur by local extension, lymphatic
invasion, intraperitoneal implantation, hematogenous dissemination, or transdiaphragmatic
passage. Intraperitoneal dissemination is the most common and recognized characteristic of
ovarian cancer. Malignant cells can implant anywhere in the peritoneal cavity but are more
likely to implant in sites of stasis along the peritoneal fluid circulation.
DIAGNOSTIC TESTS

1. Pelvic Examination

2. Imaging Tests.

3. Blood Tests. (CA-125 Blood Test)

4. Surgery (Hysterectomy and Bilateral Salpingo-Oophorectomy

and even Debulking Surgery.)

5. Genetic Testing.
CLINICAL MANIFESTATIONS
• Pelvic or abdominal pain or cramping.
• Feeling full quickly after starting to eat or lack of appetite.
• Indigestion or upset stomach.
• Nausea.
• Feeling like you have to urinate more frequently or urgently than
normal.
• Unexplained exhaustion.
• Bloating and/or constipation.
• Increase abdominal girth or abdominal swelling.
• Pain while having sex.
• Weight loss.
• Difficulty breathing.
 Staging
Stage 1 - Tumor limited to ovaries. (one or both) or fallopian tube(s).

Stage 2 - Tumor involves one or both ovaries or fallopian tubes with a pelvic extension below pelvic brim or primary peritoneal cancer.

Stage 3 - Tumor involves one or both ovaries or fallopian tubes, or primary peritoneal cancer, with microscopically confirmed peritoneal
metastasis outside the pelvis and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes.

Stage 4 - Distant metastasis, including pleural effusion with positive cytology; liver or splenic parenchymal metastasis; metastasis to
extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity), and transmural involvement of
intestine.
MEDICAL MANAGEMENT

• Surgery (Cryosurgery)

• Chemotherapy

• Radiation therapy.
DRUG OF CHOICE (CHEMOTHERAPY)

• Cisplatin (Platinol)

• Carboplatin (Paraplatin)

• Paclitaxel (Taxol)

• Topotecan (Hycamtin)
PREVENTIVE MEASURES

1. If you're 26 or younger, get an HPV vaccine if you

haven't been vaccinated already.

2. Don't smoke.

3. Use condoms during sex.

NURSING MANAGEMENT

• Preoperative Nursing Care

• Intraoperative Nursing Care

• Post-operative Nursing Care

THANK YOU
FOR
Listening