Women who have ovarian cancer, may have these symptoms:

• Enlargement of the abdomen
• Pelvic or abdominal pain or discomfort
• Unexplained weight gain or weight loss
• Ongoing unusual fatigue
• Unexplained changes in bowel habits
• Persistent digestive disturbances (stomach discomfort, gas, distention)
• Urinary symptoms such as frequency or urgency

Women with endometrial cancer may have these symptoms:

• Abnormal uterine bleeding or discharge (most common symptom)
• Difficult or painful urination
• Pain during intercourse
• Pain in the pelvic area

Ovarian Cancer

Physical exam: A thorough physical examination with attention to the abdomen to palpate for tumor or abnormal fluid accumulation (ascites).

Pelvic exam: An annual rectovaginal exam should be done on women age 35 and above. A Pap test will be done at the time of a vaginal exam, however, a Pap test is not done to diagnose ovarian cancer. The Pap test detects cervical cancer.

Blood test: A CA-125 tumor marker blood test which determines the level of a substance found on the surface of ovarian cancer cells and on some normal tissues. If a woman is at high risk for ovarian cancer or has an abnormal examination, the level of this tumor marker may be determined. This test is not definitive and would not be used alone to diagnose ovarian cancer.

Transvaginal Ultrasound: This test may be performed for those women at high risk or with an abnormal pelvic examination.

Biopsy: A biopsy with the removal of tissue must be performed to determine whether a woman has ovarian cancer. This may be done by laparatomy or laparoscopy.

Endometrial Cancer

Physical exam: If a woman has symptoms that suggest cancer of the uterus, a thorough physicial examination to assess general health of patient should be performed.

Pap test: Although a Pap test will be conducted, cells from inside the uterus usually do not show up on a Pap test. Therefore a biopsy will be obtained to assess this.

Transvaginal ultrasound: To assess for thickening of the uterus which may indicate the need for a biopsy.

Biopsy: A biopsy is obtained to assess tissue from the uterine lining. A woman may need to have a dilation and curettage (D & C) performed to obtain this biopsy

Ovarian Cancer includes the following histologies:

Epithelial

• Serous
• Mucinous
• Endometrioid
• Clear cell
• Transitional
• Undifferentiated

The majority of epithelial tumors are found in postmenopausal women, however epithelial tumors of low malignant potential are a histologic variant that is less aggressive and is found in younger women and often confined to the ovary at diagnosis.

• Germ cell
• Sex cord-stromal
• Uterine Cancer
• Adenocarcinoma
• Adenosquamous carcinoma
• Clear cell carcinoma
• Uterine papillary serous carcinoma
• Leiomyosarcoma
• Endometrial stromal sarcoma

Nursing Diagnosis-Ovarian Cancer

• Knowledge deficit r/t ovarian cancer
• Risk for fluid volume excess
• Altered bowel elimination
• Disturbed body image
• Nausea
• Acute pain
• Chronic pain
• Risk for ineffective sexuality pattern
• Anticipatory grieving

Nursing Diagnois-Uterine Cancer

• Acute pain
• Chronic pain
• Anxiety
• Knowledge deficit r/t uterine cancer
• Risk for ineffective sexuality pattern
• Anticipatory grieving