Presented by:
Ms. Elizabeth M.Sc (N)
Asst. Professor,
Dept of MSN
NNC, GNSU.

Uterine Cancer
It may refers to any of several different types of cancer which occurs in
uterus, namely:
• Endometrial cancer – originates from cells in the gland of
endometrium
• Cervical cancer – arise from transformation zone of the cervix, lower
portion of the uterus.

Risk factors
• Increased estrogen
• Obesity
• Older age
• Genetics
• Viral infection (HPV)

Symptoms
• Bleeding or watery discharge from vagina
• Back Pain
• In later stages of the disease, women may feel pelvic pain and
experience unexplained weight loss.

Pathophysiology
• Endometrial cancer forms when there are error in normal
endometrial cell growth.
• 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 Parameters
Transvaginal Ultrasound: An ultrasound uses sound waves to create a
picture of internal organs. If the endometrium looks too thick, the
doctor may decide to perform a biopsy.
Hysteroscopy: It allows to do a visual examination of the endometrium
of uterus.

Biopsy: Testing for endometrial cancer or endometrial hyperplasia.
CT Scan and MRI: Both are used to measure the tumor’s size.
CA 125 Blood Test:

Treatment
Once cancer has been diagnosed, treatment strategy depends on the
extent (stage) of your cancer.
Stages of endometrial cancer include:
• Stage I cancer is found only in uterus.
• Stage II cancer is present in both the uterus and cervix.
• Stage III cancer has spread beyond the uterus, but hasn't reached the rectum
and bladder. The pelvic area lymph nodes may be involved.
• Stage IV cancer has spread past the pelvic region and can affect the bladder,
rectum and more-distant parts of your body.

Surgery
• Hysterectomy: Removal of uterus
• Lymph node dissection: Removal of lymph nodes near the tumor if
the cancer has spread beyond the uterus.

Radiation Therapy
The radiation therapy is most often given after surgery to destroy any
cancer cells remaining in the area but rarely given before surgery to
shrink the tumor.

Hormone Therapy
• Hormone therapy for uterine cancer often involves the hormone
progesterone, given in a pill form.
• An AI is a drug that reduces the amount of the hormone estrogen in a
woman's body by stopping tissues and organs other than the ovaries
from producing it with other types of treatment.

Hormone therapy may also be used for women who cannot have
surgery or radiation therapy or in combination.

Chemotherapy
• The chemo often includes the combination of Doxorubicin+ Cisplatin+
Paclitaxel.
• Pazopanib blocks angiogenesis and stop the growth of cancer cell.

Vaccination
• The World Health Organization (WHO), as well as public health
officials in Australia, Canada, Europe, and the United States
recommend this vaccination against HPV.
• Both vaccines protect against the two HPV types (HPV-16 and HPV-
18) that cause 70% of cervical cancers.

• Both vaccines are given as a series of three injections over a six-
month period.
• The second dose is given one to two months after the first dose, and
the third dose is given six months after the first dose

Nursing Management
• Monitor for adverse effects of radiation therapy such as fatigue, sore throat, dry
cough, nausea, anorexia.
• Monitor for adverse effects of chemotherapy; bone marrow suppression, nausea
and vomiting, alopecia, weight gain or loss, fatigue, stomatitis, anxiety, and
depression.
• Realize that a diagnosis of breast cancer is a devastating emotional shock to the
woman. Provide psychological support to the patient throughout the diagnostic
and treatment process.
• Involve the patient in planning and treatment.
• Describe surgical procedures to alleviate fear.

Nursing Management
• Prepare the patient for the effects of chemotherapy, and plan ahead for alopecia,
fatigue.
• Administer antiemetics prophylactically, as directed, for patients receiving
chemotherapy.
• Administer I.V. fluids and hyperalimentation as indicated.
• Help patient identify and use support persons or family or community.
• Suggest to the patient the psychological interventions may be necessary for
anxiety, depression, or sexual problems.
• Teach all women the recommended cancer-screening procedures