CERVICAL CANCER.
CERVICAL CANCER.
• Def. Cancer of the uterine cervix is a
neoplasm(can spread to other part of the body)
that can be detected in the early it is curable
stage and can be detected by performing the
Papnicolaou test (Pap smear).
• Cervical cancer is almost always caused by human
papillomavirus (HPV) infection.
• Incidence is high in women aged 35 yrs or older
who:
 Began sexual activity in puberty and
 Have had multiple partner
Other risk factors includes:
• Low socio – economy status.
• Poor prenatal and postnatal care.
• Women with multiple genital infections e.g.
herpes, trichomonas infection, gonorrhea etc.
• Cigarette smoking.
PROTECTIVE AGAINST INVASIVE CERVICAL
CANCER.
• Take beta carotene food(group of red, yellow
and orange pigment).
• Eat carrots and green vegetables.
• Take food rich in Vitamins C and A.
• Types of barrier contraception.(condom)
• Partner to go for circumcision
PATHOPHYSIOLOGY.
• Abnormal bleeding is the most common sign.
• Initially bleeding is thin, watery, blood- tinged
vaginal discharge.
• Progresses to spotting and
frank(spontenously) bleeding
• Other signs and symptoms are:
• Prolonged or intermittent menstrual periods
• Contact bleeding after intercourse
• Anemia in presence of chronic blood loss
Advance signs are:
• Odour
• Pain in the lower back, legs and groin
• Lower extremity edema
• Difficult voiding, urgency, or hematuria
• Rectal tenesmus(feeling of incomplete
defecation) and rectal bleeding
• When symptoms appear, the CA has usually
progresses beyond its early stages.
• Squamous cell CA (arises from the surface lining
of the ectocervix, ) accounts for 95% of all
invasive tumor.
• Adenocarcinoma of the cervix(arises within
glands located in the endocervix spreads by
direct extension to:
 The vaginal wall.
 Laterally into the parametrium toward the pelvic
wall.
 Antero-posteriorly into the bladder and rectum.
 Metastases to the pelvic lymph nodes are more
common than those to distant nodes.
Risk factors
• Smoking.
• High number of full-term pregnancies.
• Long-term use of oral contraceptives.
• Women who have used oral contraceptives
("the Pill") for 5 years or more have a greater
risk of cervical cancer than women who have
never used oral contraceptives. The risk is
higher after 10 years of use.
MULTIDISPLINARY PLAN
• Surgery
• Radiation therapy
• Chemotherapy
NURSING ASSESSMENT ( signs and
symptoms)
• Perineal area:
Unusual bleeding or vaginal discharge
Prolonged or intermittent menstruation
periods
Contact bleeding after intercourse
Skin irritation or excoriation
Malodorous discharge(smelling)
Signs and symptoms (cont.)
• Hematology signs
Anemia
Fatigue
• Renal signs:
Difficult voiding
Urgency
• Intestinal signs
Rectal tenesmus (desire to defecate)
Bleeding
• Comfort:
Pain in lower back, legs, and groin
Lower extremity edema
Prevention
• Identify the risk factors that increase cervical cancer:
• HPV Infection
• The most common cause of cervical cancer is infection
of the cervix with human papillomavirus (HPV.
• HPV infections that cause cervical cancer are spread
mainly through sexual contact.
• Women who become sexually active at a young age
and who have many sexual partners are at a greater
risk of HPV infection and developing cervical cancer.
• Immunization
• Preventing HPV infection by
 Avoiding sexual activity:
 Using barrier protection or spermicidal gels:.
• Getting an HPV Vaccine:. The vaccines protect
against infection with these types of HPV for 6
to 8 years.
• It is not known if the protection lasts longer. The
vaccines do not protect women who are already
infected with HPV.
• Screening
• Regular pelvic exams and Pap tests help find
abnormal cells in the cervix before cancer
develops.
• Diet
• These may include eating fruits and
vegetables, exercising, quitting smoking, or
taking certain medicines, vitamins, minerals,
or food supplements.