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Flashcards in cervical cancer Deck (21):
1

cervical cancer incidence

Over past 50 years, the incidence of cervical cancer has decreased drastically

2

etiology cervical cancer

HPV infection responsible for most cervical cancer (HPV strains 16 & 18)

3

HPV

Most common STD in the US
Over 100 different strains, 20 strains affect genitalia

4

cervical caner risk factors

1. Early initiation of sexual intercourse
2. Many sex partners
3. Infection (HPV, Herpes, Cytomegalovirus, HIV)
4. Smoking
5. Daughters of DES (Diethylstilbestrol)
6. Vitamin A & C deficiency
7. Nulliparity
8. Diabetes Mellitus
9. Use of oral contraceptives

5

cervical cancer patho

Preinvasive: limited to cervix
Invasive: in cervix and other pelvic structures

6

Pre-invasive (cervical Cancer)

CIN (Cervical intraepithelial neoplasia)
 Mild (CIN I)
 Moderate (CIN II)
 Severe to Carcinoma in Situ (CIN III)

7

invasive (cervical Cancer)

spreads usually by direct extension to uterus, pelvic wall, bladder, bowel

8

cervical cancer clinical manifestations

1. Asymptomatic
2. Classic Sx: Painless Vaginal Bleeding
3. Bleeding increases in frequency, duration, amount
4.Later: discharge, blood-tinged to foul
5. Later: leg and back pain
6. Unilateral vein swelling
7. Weight loss
8. Pelvic pain
9. Dysuria, hematuria
10. Rectal bleeding

9

cervical cancer primary prevention

Safe sex practices: (abstinence, monogamy, condoms)
Gardasil (HPV vaccine): give in a series of 3 injections; For use in ages 9-26 years

10

cervical cancer secondary prevention

Early detection: PAP Smear (Papanicolaou) within three years of onset of intercourse or by age 21
Every 1-3 years (if no risk factors)
Stop screening at 66 with adequate negative prior screening

11

Cervical cancer diagnostics

1. Colposcopy: view transformation zone and take biopsies of cervical tissue
2. HPV testing

12

cervical cancer management

noninvasive
invasive
hysterectomy
pelvic exenteration
chemo
radiation
intracavitary implants (Brachytherapy)

13

cervical cancer noninvasive management

Cryotherapy: probe placed against cervix to cause freezing of tissues
Laser therapy: use of beam causing tissues to vaporize

14

cervical cancer invasive management

Conization: cone-shaped area of cervix removed to determine extent of disease

15

cervical cancer pelvic exenteration

For recurrent cancer
Radical surgery: removes uterus, cervix, ovaries, fallopian tubes, vagina and depending on disease location, removal of bladder, urethra, nodes and/or colon, rectum and anus

16

cervical cancer chemotherapy

Rarely used
In advanced disease, may be used to decrease tumor size

17

cervical cancer radiation therapy

External beam (5-6 weeks)

18

cervical cancer intracavitary implants (brachytherapy)

1. Left in place for 24-72 hours
2. Private room (lead walls)
3. Bed rest
4. HOB flat or up 20 degrees
5. Foley catheter
6. Low-residue diet

19

Radiation Safety

Time
Distance
Shielding

20

intracavitary implants nursing implications

1. Analgesics for cramping
2. Usually discharge develops
3. Side Effects following: anorexia, malaise, vaginal bleeding, discharge (requiring douching afterwards)
4. Teaching: increased fluids, leg exercises to prevent DVTs (ankle circles, dorsiflexion, plantar flexion)

21

cervical cancer nursing diagnoses

1. Anxiety r/t disease prognosis, child bearing
2. Deficient knowledge
3. Altered comfort
4. Others