OVARIAN CANCER

 

Ovarian cancer is the 8th most prevalent disease in women worldwide and the 7th most common cancer overall.

 

I. BACKGROUD:

With 5,395 new cases reported in 2020, it is the fifth most common kind of cancer in women in the Philippines. It is the 7th highest cause of cancer mortality in the nation, having been responsible .

According to studies, ovarian cancer is the primary cause of cancer-related fatalities among women. More people have passed away from it than from any other cancer of the female reproductive system. Older women seem to develop this type of cancer the most. Ovarian cancer is diagnosed in more than half of women aged 63 or older. Ovarian growths are occasionally identified in women under the age of 30, and the majority of them are benign cysts filled with fluid.

Ovarian cancer has a 49% five-year overall survival rate. This indicates that, five years after diagnosis, roughly 49% of ovarian cancer patients are still living.

II. INTRODUCTION:

Cancer is a condition in which the body's cells that are abnormal develop uncontrollably. Even if it later spreads to other body areas, cancer is typically termed after the area of the body where it first develops. 

Ovarian cancer is a potentially lethal malignancy that develops in or on the ovary and involves abnormal growth of cells that has the potential to invade or spread to other body parts. When this process starts, this type of cancer doesn't exhibit any symptoms or only unclear ones; however, as the cancer advances, these symptoms become more obvious.

The ovaries are a common place for tumor growth to begin. Some are benign which means that they are therefore not cancerous. Although benign tumors do not spread, they can still become quite large and produce symptoms. One ovary or a portion of an ovary can typically be removed to treat them. A malignant (cancerous) tumor is ovarian cancer. Untreated malignant tumors have the potential to enlarge and spread to other body organs.

There are multiple layers of cells that make up the ovary. Each of these layers is susceptible to cancer. These are the most prevalent forms of ovarian cancer.

In ovarian cancer, there are four stages. In this cancer staging system, the least severe is the lowest number. The more serious the condition, the higher the number. In stage I, the cancer is found in one or both ovaries; stage II, the cancer gas spread to other parts of the pelvis; stage III, the cancer has spread to the abdomen and in stage IV, the cancer us found outside the abdomen.

III. CAUSE

The exact cause of ovarian cancer is still UNKNOWN.

IV. RISK FACTORS

Ovarian cancer can occur in everyone who has ovaries. Women, trans males, non-binary individuals, and intersex people with ovaries are all included in this. After having your ovaries surgically removed, you cannot get ovarian cancer.

You might be more likely to get ovarian cancer if you:

• older age (the age is 60 years old)
• family history of ovarian cancer
• inherited gene changes
• started your periods at a young age or went through the menopause late (over 55)
• have not had a baby
• have diabetes
• have endometriosis
• being overweight or obese
• have never used any hormonal contraception, such as the pill or an implant
• uses alcohol and drugs

V. SIGNS AND SYMPTOMS

        Before any symptoms appear, ovarian cancer can grow and disperse throughout your abdomen. This may make early detection hard.

Here are some symptoms of ovarian cancer:

1. abdominal bloating or swelling
2. quickly feeling full when eating
3. weight loss
4. discomfort in the pelvic area
5. fatigue
6. back pain
7. changes in bowel habits, such as constipation
8. frequent need to urinate

 

VI. DIAGNOSTIC PROCEDURES

a) Pelvic exam- it is to check for any abnormal growths or enlarged organs

b) Imaging tests

• Pelvic ultrasound.
• MRI (magnetic resonance imaging).
• CT scan (computed tomography).
• PET scan (positron emission tomography)

c) Blood tests- they will be testing your blood and look for CA 125, high level of CA 125 indicates as a sign of cancer

d) Surgical evaluation-doctors can diagnose ovarian cancer during surgery

e) Laparoscopy- a small incision in your abdomen is used to insert a thin camera (laparoscope). The surgeon can evaluate the cancer, conduct staging biopsies, and, in some cases, remove ovarian tumors using the scope as a guide and extra ports to hold equipment.

f) Laparotomy- surgeon makes a large cut down the middle of your abdomen to to look inside your abdomen and pelvis to find out if ovarian cancer has spread.

 

LAPAROSCOPY

 

VII. MEDICAL AND SURGICAL MANAGEMENT

        The main treatment for ovarian cancer are chemotherapy and surgery.

•  For surgery the patient may undergo:

a. Bilateral salpingo-oophorectomy (BSO)- both ovaries and the fallopian tubes are removed

b. Abdominal hysterectomy- removal of uterus through an opening in womb

c. Total abdominal hysterectomy bilateral salpingo-oophorectomy (TAHBSO)- removal of entire uterus, the ovaries, fallopian tubes, and the cervix

• Chemotherapy- doctors may recommend chemotherapy either before or after surgery. Chemotherapy are drugs designed to target and kill cancerous cells.
• Targeted therapy- this cancer treatment uses drugs to identify and attack cancer cells. Targeted therapy changes the way cancer cells grow and divide.
• Hormone therapy- some ovarian cancers use hormones to grow. This type of therapy blocks hormones, slowing or stopping the growth of cancer.
• Radiation therapy- providers rarely use radiation therapy for treatment of ovarian cancer.

 

VIII. NURSING MANAGEMENT

a) Assess and monitor the patient’s physical and emotional status.

b) Keep track of laboratory, pathology and imaging studies.

c) Administer the ordered medications, fluids and cancer treatments, such as chemotherapy.

d) Help patients understand the disease and their treatment plan.

e) Communicate with the doctors and other clinicians on the patient’s behalf.

f) Help the patient plan for and manage symptoms throughout treatment.

g) Monitor for infection.

h) Encourage the patient to let people help and take time for yourself.

i) Assess patient for body image changes as a result of disfiguring treatment.

j) Provide additional education and help the patient find a support group.

IX. WAYS TO REDUCE THE RISK OF GETTING OVARIAN CANCER

        There is no way to prevent ovarian cancer completely but there are ways to reduce the risk of getting the cancer. Here are some of the ways:

1) Eat healthy food.

2) Maintain a healthy lifestyle by getting some physical activity every day, but do not get too tired.

3) Educate the patient the importance of taking oral contraceptives since taking birth control pills may reduce ovarian cancer risk.

4) Avoid the use of carcinogen substances.

5) Tubal ligation  blocks or cuts the fallopian tubes, while a hysterectomy removes the uterus with or without the cervix. Having both a tubal ligation and a hysterectomy may lower the risk of certain ovarian cancers.

6) A woman's risk is lower if she has already given birth to a child at term before turning 26.

7) Educate the patient about breastfeeding for a year or more can moderately lower risk of ovarian cancer.

 

Presented by: PRECIOUS MARIE RIPUYO (BSN 2A)

REFERENCES:

Ovarian cancer. (n.d.). Cancer Research UK. https://www.cancerresearchuk.org/about-cancer/ovarian-cancer

Ovarian cancer - Symptoms and causes - Mayo Clinic. (2021, August 31). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941

Ovarian Cancer: Symptoms, Diagnosis & Treatment. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer

The heart of health care: Oncology nursing. (n.d.). Cancer Treatment Centers of America. https://www.cancercenter.com/community/blog/2020/07/heart-of-health-care-oncology-nursing#:~:text=Assessing%20and%20monitoring%20the%20patient's,clinicians%20about%20the%20treatment%20plan

Velayo, C. L., et al. (2022). Improving diagnostic strategies for ovarian cancer in Filipino women using ultrasound imaging and a multivariate index assay. Cancer Epidemiology, 81, 102253. https://doi.org/10.1016/j.canep.2022.102253