Endometrial cancer care measures

The occurrence of endometrial epithelial cancer known as endometrial cancer, Also known as the Palace of cancer. Many occurred in 50 women over the age of 40 under the age of fewer women see. Endometrial cancer incidence rate in recent years there is an upward trend in the country's incidence rate also rose. Endometrial cancer is not that the exact cause, but with the following factors: ① obesity, delayed menopause, cardiovascular disease, diabetes, high blood pressure is high risk factors, referred to as the Palace of cancer syndrome; ② with the long-term estrogen stimulation; ③ and the endometrial hyperplasia. Endometrial cancer mainly to adenocarcinoma, or about 80 percent to 90 percent, more lesions occurred in the bottom of the uterine endometrium, the uterine near the common, the lesions showed diffuse and can be localized. This was followed by diagonalization ① gland cancer, skin cancer, also known as adeno spine. Under the microscope, see adenocarcinoma Mission containing mature into good differentiation of benign squamous epithelium; ② scales adenocarcinoma also known as mixed carcinoma, a cancer adenocarcinoma and squamous cell carcinoma in two components; ③ clear cell carcinoma. [Transfer channels and clinical stage] Endometrial cancer development has been slow and sometimes 1 ~ 2 years lesions confined to the uterine cavity, at the beginning of tumors along the proliferation of endometrial growth, after the myometrial invasion, the uterine muscle slurry spread to tubal, ovarian, planting in pelvic and peritoneum, the uterus rectum Au, omental and adjacent bowel, but also the direct spread to the neck, cervical and vaginal violations. Direct transfer of ways to spread and lymph node metastasis based, hematogenous metastasis rare. Clinical stage: Clinical years under FIGO (International Federation of Obstetrics and Gynecology) 1982 amendments to the clinical stage of the new law phases are as follows: 0 adenomatous hyperplasia, or carcinoma in situ, histological findings of suspected malignant cancer (this period is not included in treatment of Statistics). Phase I cancer confined to the uterine body. Ⅰ a period of the uterine cavity length ≤ 8 cm. Ib of the uterine cavity length> 8 cm. According to histological classification, and Ib Ⅰ a period and the further divided into four sub-period: G1 highly differentiated adenocarcinoma. G2 moderately differentiated adenocarcinoma. G3 undifferentiated carcinoma. G4 undetermined level. Phase II of cervical cancer has been violated. Phase III uterine cancer spread to the outside (including vaginal proliferation), but not beyond the true pelvis. Stage IV cancer beyond the true pelvis or apparent violations of the bladder mucosa or straight. Ⅳ a carcinoid tumor nearby organs such as the rectum violations, bladder. B Stage IV cancer have distant metastases. [Nursing assessment] 1. Census or other reasons for the inspection found occasionally, and most of the very early lesions. 2. Showed irregular vaginal bleeding vaginal bleeding, not much of the general, but also for the performance of menstrual volume increased, the extension or menstrual bleeding by the interval. In postmenopausal patients showed sustained or intermittent bleeding. 3. Vaginal discharge fluid performance for a small number of patients Leucorrhea increase was serous or early serous bloody Leucorrhea, advanced merger occurs when purulent infection or of liquid discharge, and a foul smell. 4. Pain when the cancer advanced violations surrounding tissue or nerve pressure occurs when nearly lumbosacral pain and lower extremities, lower extremities and radiotherapy. Violations of cervical cancer when the cancer of the carotid blockage, leading to intrauterine empyema, showed lower abdomen pain and spasm-like pain. 5. Anemia, emaciation, the evil of quality, fever, illness and systemic failure performance has been advanced. 6. Laboratory (1) diagnostic curettage: Sub-up scraping for short, is the most commonly used endometrium method. Sub-up to scratch, by using small spoons scraping the neck ring scratch, re-entering the lumen detection endometrium, the scraps of the bottle should be well-marked, sent pathological examination. Endometrial cancer diagnosis must be based on pathological examination results. (2) cytology: After the dome from the vagina or cervical secretions from the mouth, or intrauterine straw with a special brush or intrauterine Add intrauterine absorb secretions for cytological examination to find cancer cells, cancer cells or to find suspicious patients, re-Sectional attending scratch. (3) uterine examination:-Add intrauterine womb can be directly observed endometrial, if tumor growth, can observe the location, lesion size, growth patterns, and send desirable endometrium of the seizure. [Nursing] 1. Patients with the psychological fear to the widespread use of non-technical language so that the patients can be heard understood and help patients of the disease and alleviate the anxiety and fear of surgery, confidence-building, can take the initiative to cope with treatment and care. 2. General nursing strengthen nutrition, should be given to high-calorie, high-protein, high-vitamin diet. 3. Surgery patient care (1) preoperative care for conventional preparations, including offal function tests and skin preparations. (2) Patients should be cautioned, surgical treatment is the first choice of treatment, as long as patients with systemic tolerance to be in a position, without taboos of surgery should be for exploratory laparotomy. Early in general for hysterectomy and bilateral resection of the annex. Phase II should be generalized total hysterectomy and bilateral pelvic lymphadenectomy for. For a period I found in patients with ascites cells have cancer or deep myometrial invasion, lymph node metastasis suspicious or positive, should be after surgery plus radiation in vitro with 60 CO linear accelerator or external irradiation. The Ib uterus greater than pregnancy two months, III and parts of stage IV patients in the preoperative irradiation plus or intracavitary irradiation 137 Cs, 192Ir, etc.. Radiotherapy After 1 ~ 2 weeks experts surgery. 4. Hormone therapy and other drugs Nursing (1) for advanced cancer, cancer recurrence, surgical resection or not young patients require reservations early reproductive function, may consider progesterone treatment. General dosage to China, such as Medroxyprogesterone 200 to 400 mg / day, acid progesterone 500 mg / day, at least 10 to 12 weeks to evaluate whether the preliminary results. In the course of treatment should pay attention to the observation side, the general reaction light, can cause, there edema, drug hepatitis. Patients should be told to stop will be getting better and better. (2) of tamoxifen - treated patients, it should be noted the observation of drug reaction, hot flashes, chills menopause syndrome similar to the response, as well as bone marrow suppression response. A small number of patients, there may be vaginal bleeding, nausea, vomiting. As a reaction to the report physicians. Tamoxifen is a non-steroidal anti-estrogen drugs, the general dose of 20 to 40 mg / day oral administration. Treatment can be long-term application or applications. 5. Chemotherapy drug therapy nursing care according to conventional chemotherapy, not commonly used in the advanced surgery, radiotherapy or relapse after treatment cases. Commonly used drugs 5 FU, CTX, MBC, etc.. 6. Traditional Chinese medicine treatment and care by Chinese Fu Shan Hebei Tumor Hospital, "Fu Shan God" series of anti-cancer agents request and patients adhere to medication, not interrupted. 7. Outpatients should popularize the knowledge of cancer prevention, especially for patients with high risk factors, women in menopause or menstrual disorders, postmenopausal women irregular vaginal bleeding, should be highly valued.