REPRODUCTIVE CANCERS: A. CERVICAL CANCER: Arises from squamocolumnar cells (transition junction)...

cause unknown but assoc w/: early & frequent sexual contact, early pregnancy, Herpes simplex 2, human papilloma virus, cytomegalovirus. (need annual PAP) a. s/s- painless vaginal bleeding breakthrough, spotting, after sex or douching, may be foul smelling as dx progresses; leg pain, swelling one leg, unexplained weight loss, dysuria, rectal bleeding, chest pain, cough b. will have two PAP smears before other testing done...endocervical curettage for biopsy c. Tx: Laser therapy- when curettage is normal, slight discharge 6-12wks heal i. Cryosurgery- no tampons, or sexual intercourse until vaginal discharge disappears ii. Radiation- strict bed rest, flat or slight elevation, no movement in bed to prevent dislodgment implant & chemotherapy iii. Surgery: conization- need follow up care cause new lesions can develop 1. Hysterectomy if client does not wish children B. OVARIAN CANCER-leading cause death cause diagnosed in advanced stage, BRCA-1 highest risk a. s/s- abdominal pain, swelling, bloating & other GI disturbances, urinary frequency/incontinence, abdominal mass, unexpected weight loss, vaginal bleeding b. Ultrasound, CT scan detect, level ovarian antibody CA-125, exploratory laparotomy diagnose & stage dx. c. Tx: chemo& radiation therapy, total abdominal hysterectomy w/ bilateral oophrectomy tx choice all stages ovarian CA C. ENDOMETRIAL CANCER-an adenocarcinomas a. s/s- postmenopausal bleeding, low-back, abdominal, pelvic pain, watery, serosanguineous discharge b. definitive dx= D&C w/ endometrial biopsy c. tx: radiation therapy- bed rest, foley catheter, low residue diet, encourage fluid intake; chemotherapy, progesterone therapy for stage I-II CAs estrogen dependant; surgery:

total abdominal hysterectomy w/ bilateral oophrectomy stage I, radiacal hysterectomy w/ lymph node dissection stage II