Gynecologic Cancers

SITE-SPECIFIC CANCER SERIES Gynecologic Cancers Edited by Lois Almadrones-Cassidy, RN, MS, FNP, MPA Oncology Nursing Society Pittsburgh, Pennsylvania ONS Publishing Division Publisher: Leonard Mafrica, MBA, CAE Director, Commercial Publishing: Barbara Sigler, RN, MNEd Managing Editor: Lisa M. George, BA Technical Content Editor: Angela D. Klimaszewski, RN, MSN Staff Editor: Amy Nicoletti, BA Copy Editor: Laura Pinchot, BA Graphic Designer: Dany Sjoen Site-Specific Cancer Series: Gynecologic Cancers Copyright © 2010 by the Oncology Nursing Society. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by an information storage and retrieval system, without written permission from the copyright owner. For information, write to the Oncology Nursing Society, 125 Enterprise Drive, Pittsburgh, PA 15275-1214, or visit www.ons.org/publications. Library of Congress Control Number: 2009934463 ISBN: 978-1-890504-86-1 Publisher’s Note This book is published by the Oncology Nursing Society (ONS). ONS neither represents nor guarantees that the practices described herein will, if followed, ensure safe and effective patient care. The recommendations contained in this book reflect ONS’s judgment regarding the state of general knowledge and practice in the field as of the date of publication. The recommendations may not be appropriate for use in all circumstances. Those who use this book should make their own determina- tions regarding specific safe and appropriate patient-care practices, taking into account the personnel, equipment, and practices available at the hospital or other facility at which they are located. The editors and publisher cannot be held responsible for any liability incurred as a consequence from the use or application of any of the contents of this book. Figures and tables are used as examples only. 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Readers relying on precise information should check the original English version. Printed in the United States of America Oncology Nursing Society Integrity • Innovation • Stewardship • Advocacy • Excellence • Inclusiveness Contributors Editor Lois Almadrones-Cassidy, RN, MS, FNP, MPA Retired Clinical Nurse Specialist, Gynecologic Oncology Memorial Sloan-Kettering Cancer Center New York, New York Chapter 1. Overview Chapter 14. Long-Term Symptom Management Authors Paula J. Anastasia, RN, MN, AOCN® Jane Duffy-Weisser, MS, RN, ANP-BC Gynecology-Oncology Clinical Nurse Specialist Adult Nurse Practitioner, Gynecologic Medical Oncology Cedars-Sinai Medical Center Nurse Practitioner Coordinator for NP/Hospitalist Services Los Angeles, California Memorial Sloan-Kettering Cancer Center Chapter 7. Epithelial Ovarian Cancer, Fallopian Tube New York, New York Carcinoma, and Primary Peritoneal Carcinoma Chapter 11. Vulvar and Vaginal Cancers Kathleen Appollo, RN, BSN, OCN® Dorothy Dulko, PhD, RN, AOCNP® Clinical Research Nurse, Gynecologic Oncology Ambulatory Cancer Center and Advanced Practice Nursing Memorial Sloan-Kettering Cancer Center Director New York, New York Department of Hematology Oncology Chapter 14. Long-Term Symptom Management Dartmouth-Hitchcock Medical Center Lebanon, New Hampshire Karen Bess, RN, MaEd, MSN Chapter 9. Gynecologic Sarcomas Affiliate Assistant Professor, Goldfarb School of Nursing Barnes-Jewish College Kathleen Farley-Omerod, RN, MS, APN/CNS, AOCN® St. Louis, Missouri Breast Health Advanced Practice Nurse Chapter 10. Trophoblastic Disease Central DuPage Hospital Winfield, Illinois Frances Cartwright-Alcarese, PhD, RN, AOCN® Chapter 3. Prevention and Early Detection of Cancers of Director of Nursing, Oncology Services the Cervix, Ovaries, and Endometrium New York University Langone Medical Center New York, New York Chapter 2. Anatomy, Physiology, and Pathophysiology iii GYNECOLOGIC CANCERS Sheryl Redlin Frazier, RN, MSN, OCN® Kathleen A. O’Connor, RN, BSN Clinical Learning Consultant Clinical Nurse IV–Ambulatory Services Nursing Education and Development Memorial Sloan-Kettering Cancer Center Vanderbilt University Medical Center New York, New York Nashville, Tennessee Chapter 13. Acute Symptom Management Chapter 6. Endometrial Cancer Janette O’Sullivan, CNM, RN, MS Eileen Fusco, MSN, APRN-BC, AOCNP® Midwife, Private Practice Nurse Practitioner, Radiation Medicine Adjunct Lecturer, Nursing North Shore-Long Island Jewish Health System Kingsborough Community College New Hyde Park, New York Brooklyn, New York Chapter 3. Prevention and Early Detection of Cancers of Chapter 2. Anatomy, Physiology, and Pathophysiology the Cervix, Ovaries, and Endometrium Chapter 4. Preinvasive Disease of the Cervix, Vulva, and Sharon Schwartz, MSN, CRNP Vagina Nurse Practitioner, Gynecologic Surgery Fox Chase Cancer Center Randy E. Gross, MS, RN, NP, WHNP-BC, ACNS-BC, Philadelphia, Pennsylvania AOCNP® Chapter 5. Invasive Cervical Cancer Nurse Practitioner, Gynecologic Medical Oncology Service Memorial Sloan-Kettering Cancer Center Blanca Vasquez-Clarfield, MA, RN New York, New York Nurse Leader, Women’s Oncology Unit Chapter 14. Long-Term Symptom Management Memorial Sloan-Kettering Cancer Center New York, New York Catherine Hydzik, RN, MS, AOCN® Chapter 11. Vulvar and Vaginal Cancers Manager/Clinical Nurse Specialist Memorial Sloan-Kettering Cancer Center at Sleepy Hollow Nasrin Vaziri-Kermani, RN, CPSN Sleepy Hollow, New York Ambulatory Office Practice Nurse Chapter 13. Acute Symptom Management Office of Chief, Plastic and Reconstructive Surgery Memorial Sloan-Kettering Cancer Center Virginia R. Martin, RN, MSN, AOCN® New York, New York Clinical Director, Ambulatory Care Chapter 12. Pelvic Exenteration and Reconstruction Fox Chase Cancer Center Philadelphia, Pennsylvania Terry L. Wood, PhD, RN Chapter 8. Nonepithelial Ovarian Cancer Clinical Assistant Professor Southern Illinois University, Edwardsville Altagracia (Grace) I. Mota, RN, MSN, OCN® Edwardsville, Illinois Nursing Professional Development and Education Manager Chapter 10. Trophoblastic Disease Coordinator, Nurse Residency Program Memorial Sloan-Kettering Cancer Center New York, New York Chapter 12. Pelvic Exenteration and Reconstruction iv CONTRIBUTORS Disclosure Editors and authors of books and guidelines provided by the Oncology Nursing Society are expected to disclose to the participants any significant financial interest or other relationships with the manufacturer(s) of any commercial products. A vested interest may be considered to exist if a contributor is affiliated with or has a financial interest in commercial organizations that may have a direct or indirect interest in the subject matter. A “financial interest” may include, but is not limited to, being a shareholder in the organization; being an employee of the commercial organization; serving on an organization’s speakers bureau; or receiving research from the organization. An “affiliation” may be holding a position on an advisory board or some other role of benefit to the commercial organization. Vested interest statements appear in the front matter for each publication. Contributors are expected to disclose any unlabeled or investigational use of products discussed in their content. This information is acknowledged solely for the information of the readers. The contributors provided the following disclosure and vested interest information: Kathleen A. O’Connor, RN, BSN, Society of Gynecologic Nurse Oncologists, board member v Contents Preface ......................................................................................... ix Chapter 5. Invasive Cervical Cancer ....................................... 47 Introduction ........................................................................... 47 Chapter 1. Overview ................................................................... 1 Types of Cervical Cancer and Histology ............................... 47 Introduction ............................................................................. 1 Signs, Symptoms, and Diagnosis of Cervical Cancer ........... 47 References ............................................................................... 2 Cervical Cancer Staging ........................................................ 51 Treatment ............................................................................... 51 Chapter 2. Anatomy, Physiology, and Pathophysiology............ 3 Special Situations .................................................................. 57 Introduction ............................................................................

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