cervical cancer

Question 1

cervical cancer incidence

Answer 1

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

Question 2

etiology cervical cancer

Answer 2

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

Question 3

HPV

Answer 3

Most common STD in the US

Over 100 different strains, 20 strains affect genitalia

Question 4

cervical caner risk factors

Answer 4

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

Question 5

cervical cancer patho

Answer 5

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

Question 6

Pre-invasive (cervical Cancer)

Answer 6

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

Question 7

invasive (cervical Cancer)

Answer 7

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

Question 8

cervical cancer clinical manifestations

Answer 8

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

Question 9

cervical cancer primary prevention

Answer 9

Safe sex practices: (abstinence, monogamy, condoms)

Gardasil (HPV vaccine): give in a series of 3 injections; For use in ages 9-26 years

Question 10

cervical cancer secondary prevention

Answer 10

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

Question 11

Cervical cancer diagnostics

Answer 11

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

Question 12

cervical cancer management

Answer 12

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

Question 13

cervical cancer noninvasive management

Answer 13

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

Question 14

cervical cancer invasive management

Answer 14

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

Question 15

cervical cancer pelvic exenteration

Answer 15

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

Question 16

cervical cancer chemotherapy

Answer 16

Rarely used

In advanced disease, may be used to decrease tumor size

Question 17

cervical cancer radiation therapy

Answer 17

External beam (5-6 weeks)

Question 18

cervical cancer intracavitary implants (brachytherapy)

Answer 18

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

Question 19

Radiation Safety

Answer 19

Time
Distance
Shielding

Question 20

intracavitary implants nursing implications

Answer 20

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)

Question 21

cervical cancer nursing diagnoses

Answer 21

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