A case study on ovarian cancer

Authors Avatar by sihim390gmailcom (student)

A case study on ovarian cancer

Patient Auntie Ley (Call A.L. in below) has epithelial ovarian cancer in stage IIIC. This means metastasis occur that cancer cell has already spread to peritoneal cavity and lymphatic system by transportation of peritoneal fluid and lymph severally. (Lengyel, 2010) According to her family history, her brother and father got colorectal cancer and bladder cancer respectively. It is decided that the genetic mutation about the cancer suppressor gene such as BRCA-1 & 2 are the mainly contributing factor. (Clark, 2012), (Ramus, 2010) Some epigenetic factors such as using talcum powder on genital part and times of having ovulation are also considered.( Fleming et al., 2006), (Karageorgi, 2011) She discovered having cancer because of abdominal pain and ascites. The tumor induces ovarian torsion to cause acute abdominal pain and excites angiogenesis to increase the permeability of surrounding blood vessel to cause ascites. She is diagnosed by CT, PET and MRI scan to find out the location and size of tumors. Blood test is also included in the diagnosis to test the tumor markers such as CA-125. (American Cancer Society, 2012) After the disease is confirmed, a series of nursing interventions about the pain and hormones management and even the sex life of A.L. were processed. (LeMone, 2012)

There are two parts of the treatment, debulking and chemotherapy. Debulking contains total abdominal hysterectomy, omentectomy and partial oophorectomy. It prevents the spread of cancer and enhances the effectiveness of chemotherapy. (Cancer Research UK, 2012), (Wakabayashi, Lin, & Hakim, 2008) Chemotherapy contains two combinations of drugs, the new combination of Carboplatin & Gemcitabine for the recurrence, the traditional combination of Carboplatin & Paclitaxel for primary. (Stan Kaye, 2010) Carboplatin and Gemcitabine are genotoxic and antimetabolite respectively. They interfere with the DNA replication in mitosis. Carboplatin prevent the unzipping of DNA by forming cross-link within it. It is a kind of DNA damage and trigger P53 gene for apoptosis of cancer cell. (Springhouse, 2004) Gemcitabine react with Deoxycyidine Kinase in cell to give a substance to inhibit the polymerase to form sister DNA strands. It also induces DNA fragmentation, so as apoptosis. (Meredith A. Morgan, 2008) Paclitaxel is a spindle inhibitor. It stabilizes and influences the microtubules forming spindle fiber just before metaphase to stop the cell division. In other pathway, the accumulation of stabilized microtubules cause ER stress and follow by a series of Caspase formation which induce apoptosis. (Arnal and Wade, 1995), (Caplow, Ruhlen, & Shanks, 1994) and (Rowinsky, 1997)

Join now!

Despite it is rare to have allergic reaction toward chemotherapeutic drugs, there are several anti-allergic drugs must be given to patients before chemotherapy as serious reaction can be fatal. (Springhouse, 2004) They mainly work as an agonist for cell receptor. And there are some specific side-effects of chemotherapeutic drugs due to their characteristics that require nursing intervention. Before infusion, patient’s kidney and liver function must be checked to match the needs of the metabolism and excretion of different drug. During infusion, Gemcitabine can cause pulmonary toxic and Paclitaxel can cause abnormal cardiac conduction. So the pulmonary and cardiac function ...

This is a preview of the whole essay