Med-Surg Immune System, part 13: Endometrial, Cervical, Ovarian, & Breast Cancer

by Cathy Parkes

In this video

Endometrial cancer

  • Risk factors for endometrial cancer
  • Signs and symptoms of endometrial cancer

Cervical cancer

  • Causes of cervical cancer
  • Signs and symptoms of cervical cancer
  • Preventing cervical cancer with the HPV vaccine
  • Screening for cervical cancer with pap smears

Ovarian cancer

  • Signs and symptoms of ovarian cancer
  • Warning about ovarian cancer

Treatment for cancers of the female reproductive system

  • Chemotherapy, radiation
  • Ablation
  • Surgeries: hysterectomy, salpingectomy, oophorectomy

Breast cancer

  • Screening for breast cancer
    • Baseline mammogram for early breast cancer screening
  • Signs and symptoms of breast cancer
  • Treatment for breast cancer
    • Medication
    • Chemotherapy, radiation
    • Mastectomies
  • Nursing care
  • Patient teaching

Full Transcript

Hi, I'm Cathy. And in this video, I will be covering cancers of the female reproductive system. Specifically, I'll be talking about endometrial cancer, cervical cancer, ovarian cancer, and I also will be discussing breast cancer. If you are following along with our Medical-Surgical Nursing Edition 2 deck, I am on card 30 in the immune system.

Let's first talk about endometrial cancer which is cancer of the inner lining of the uterus.

A key risk factor with endometrial cancer is prolonged exposure to estrogen without progesterone, and a key symptom of endometrial cancer is postmenopausal bleeding. So if your patient has gone through menopause and she's not getting her periods anymore, and suddenly she has a new onset of bleeding, that would be suspect.

Okay, next we have cervical cancer which is cancer of the cervix and it is typically caused by HPV.

A key symptom of cervical cancer is painless vaginal bleeding.

The good news is is that we can prevent many occurrences of cervical cancer with use of the HPV vaccine. With this vaccine, you get three injections over a six-month period of time, and that helps to prevent HPV which in turn helps to prevent cervical cancer.

In terms of screening, we do this. We screen for cervical cancer with pap smears. Pap smears are performed every 1 to 3 years, depending on the risk profile of the patient. We usually start doing pap smears about three years after sexual intercourse or by age 21.

Then lastly, we have ovarian cancer. This is where we have an epithelial tumor that grows on the surface of the ovaries and spreads rapidly.

So symptoms of ovarian cancer are very vague, like some GI disturbances. So this results in low survival rates because patients don't seek medical attention until it's too late. So one thing I want to mention in this video is that about a year ago I had a patient with ovarian cancer. And one of the Patient Care Assistants, unbeknownst to me, asked her, "Well why didn't you get your pap smears? You know, your annual pap smears?"

Well, there's all sorts of things wrong with that question, right? It's completely un-therapeutic. First of all, she asks why which is always wrong, right? And then accusing her of not doing preventative care and that's how she ended up with ovarian cancer. And then lastly, it's completely inaccurate, right? Because pap smears test for cervical cancer only. They screen for cervical cancer. They have nothing to do with ovarian cancer. So just keep that in mind. Definitely don't make that mistake when you get out there and start your nursing career.

Okay, in terms of treatment for these different types of cancer we can use chemotherapy, we can use internal or external radiation. So, internal radiation is called brachytherapy.

We can also use ablation therapy, and then we can perform surgery to remove the affected organ. A hysterectomy is removal of the uterus. A salpingectomy is removal of the fallopian tube. And an oophorectomy is removal of an ovary.

Now let's talk about breast cancer.

Screening for breast cancer is done through mammograms, and it's recommended that women get mammograms annually starting at age 40, in addition to monthly breast self-examinations. Now, if a woman is at higher risk for breast cancer because of a family history, like I am, then they may want to do a an earlier baseline mammogram. Which is something I had. So I had like a baseline mammogram at age 35, and then I started having my annual mammograms at age 40.

In terms of risk factors, genetics definitely play a role. Also, if a woman had early menarche, which means she had early onset of periods or late onset of menopause, those are risk factors for breast cancer. So basically the longer she was bleeding through those reproductive years, that does place her at higher risk. Other risk factors include long-term use of oral contraceptives as well as hormone replacement therapy, and then smoking and obesity are other risk factors.

In terms of signs and symptoms. Signs and symptoms of a cancerous breast tumor are that it is a firm, immobile, non-tender lump. So if you have a lump that shows up that hurts and that you can move around, then chances are it's not breast cancer because breast cancer will be kind of immobile and painless. Okay? In addition, if the patient has some dimpling over the skin of the breast or this peau d'orange appearance which is a way of saying that really the breasts, the skin over the breast, looks like the outside surface of an orange. Or if you have nipple retraction, nipple ulceration, or discharge. Those are all warning signs of breast cancer.

So basically, if you notice any change in the appearance of your breasts or your nipples then that's definitely something you would want to notify your provider about.

In terms of treatment. Hormone therapy can be used for breast cancer. So this one such medication is Tamoxifen. Chemotherapy can be used, as well as radiation, and then surgery may be required to remove the tumor through a lumpectomy or remove the whole breast which is called a mastectomy.

So if you are caring for a patient with a mastectomy, there's some important considerations you definitely need to keep in mind and some patient teaching you need to do. So first of all, you do not want to administer any injections, take blood, or take blood pressure on the affected side with the mastectomy. So at our hospital we usually put a big sign behind the patient's bed to remind people no blood pressures, blood draws, et cetera, on the left side.

So you definitely want to avoid doing any of those things on the side that is affected.

In terms of patient teaching, we want the patient to wear a sling when they're ambulating. They should wear loose clothing, so nothing tight over there. And they should perform arm and hand exercises to help prevent edema and to increase their range of motion.

Okay, so that is it for this video. When we come back, we will go over the remaining cancers in this playlist. So thank you so much for watching and I'll see you soon!

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