Vaginal Cancer

Vaginal cancer (BC) is a neoplastic cell disease vaginal canal. Because the primary vaginal cancer is rare, usually secondary VC, such as choriocarcinoma metastasis (cancer of the cervix, or surrounding organs). VC often extended into the bladder and rectum, treatment is difficult. Approximately 85% to 90% of squamous cell vaginal cancer that started in the epithelium lining the upper part of the vagina near the cervix. Less common are adenocarcinomas, arising in women over 50 years diethylstilbestrol (DES) in utero were exposed to melanoma (14% 5-year survival), which tend to reduce or outside the vagina may affect or sarcomas deep in the vaginal wall.

Pr. BC is rare and only 3% of gynecological malignancies. It is most often found in the upper third of the back of the vagina. The vagina has a thin wall and enlarged lymph drainage, cancer, and varies depending on the proximity to the lymphatic system and the depth of tumor involvement. Phase 0 VC is limited to epithelial tissues (96% 5-year survival). Phase 1 VC is limited to the vagina (73% 5-year survival). Phase 2 includes subvaginal GP tissue, but not to the pelvic wall (58% 5 - year survival). BC Stage 3 extends the vagina (36% 5-year survival). Stage 4 or VC outside the pelvis, the bladder or rectum (36% 5-year survival).

Low survival due to advanced disease at diagnosis, treatment problems, because the proximity of major structures and rare disease that prevents the best treatment. It is estimated that in 2005, 2140 new cases are diagnosed by general practitioners in the United States and 810 women die from the disease.

The reason venture capital is not known, although the ingestion of DES, is a remedy for some time to devote to women to reduce abortion is defined as a possible cause. Risk factors include previous vaginal cancer, vulvar and cervical cancer and age. Women who have cancer of the cervix should be reviewed periodically to assess vaginal lesions. Other risk factors include exposure to DES in utero, improper use of membranes (less cleaning, sometimes unable to ensure a proper assessment), radiation, trauma, exposure to carcinogenic chemicals in some sprays and showers, the history of human papillomavirus and smoking.

Care Plan assessment and physical examination
Entire reproductive history of the patient and the patient's mother is important. Evaluation of patients for all risk factors. Whether the patient's mother was pregnant with DES increased patient. Providing a comprehensive history of physical symptoms. One of the symptoms of GP were spontaneous vaginal bleeding after intercourse or pelvic exam. Nature of watery vaginal discharge may also attend. Other symptoms include pain, urinary or rectal symptoms, itching, dyspareunia (pain during sex), and groin masses. Ask the patient about any pain. Assessment of the use and efficacy of analgesics for pain relief. Document location, time, duration and intensity of pain. The patient may also describe the retention of urine or frequent urination, and the damage is near the bladder neck.

Inspection of bleeding or vaginal discharge, a special attention to the characteristics and amount of bleeding is essential. Palpation of the groin of a number of tables. The internal pelvic examination may reveal ulcers vaginal lesions.

A thorough assessment of each woman's perception of the disease process and management mechanisms are needed. Changes in sexual habits and physical stressors on current patients. The gender of the patient should be included in determining the level of support they can provide for them. Her partner may be worried about the potential loss of their partner or fear of changing patterns of sexuality.

Primary nursing plan nursing diagnosis: Altered sexuality patterns of tissue damage, pain and changes in body structures.

Care plan interventions and treatment
Often the treatment of choice for radiation risk is accept either external or internal lighting (brachytherapy). Treatment decisions are based on the degree of injury and the age and condition of the patient. Patients with untreated, the malignant area removed but the vagina is maintained. Laser surgery is often at levels 0 and 1 patients in the later stages of the disease is treated with surgery or radiotherapy. The type of surgery or radiation, depending on the extent of the disease, the patient's desire a functional vagina and the location of the damage created be maintained. Radical hysterectomy can be accomplished by removing the upper vagina and pelvic lymph node dissection. Most patients received external pelvic radiotherapy, a common culture, which will diminish before surgery or internal radiation cavity. Internal exposure to radium or cesium in the vagina can be administered for 2-3 days. Current survival was similar in patients with venture capital from them with radiotherapy or surgery.

Cooperative management includes analgesics for postoperative pain relief and careful assessment for signs of postoperative infection or poor healing of wounds. For abbreviations, consult your doctor for a patient to the renewal of physical and sexual activity and schedule
whether the patient understands any restrictions.

Patient care venture capital is challenging, because the interaction between physical and emotional needs of the patient. If a woman pain or surgery or disease process, found a method of pain such as images and breathing techniques to manage the discomfort. A woman may be depressed and angry. Let the patient's anger and sorrow, to speak without fear of prejudice or discourage. Provides a private place for her to discuss his concerns about the nurse or significant other. Provide a list of support groups for the patient and her partner.

Learn all women should be alert to signs of risk, unusual discharge or bleeding. Encourage all women older than 18 years research, including examination of gynecologic search. Women should be informed of genital self-breast examination, while they are performing self-examination should be done. Teach them a mirror for the review of changes in female anatomy and all lesions, ulcers report, bruises or the presence of constant itching.

Nursing guidelines for discharge planning and home care
Explain all procedures, wounds or skin care continued at home. If the patient has an internal radiation, it teaches a stent or dilator used to a narrowing of the vaginal intercourse also prevent vaginal stenosis prevention. To teach the patient to sexual activity or limit activities to resume, such as counting or sequence. He emphasizes the importance of inspections, which may include procedures such as X-ray computed tomography (CT), ultrasound (U.S.) or magnetic resonance imaging (MRI). If the patient is vaginal reconstruction, to teach her about having to use a lubricant during intercourse. I also said that because the neural circuits, it can feel like it was hip stroked during sexual intercourse.

More female GPs vaginal bleeding or signs of infection (fever, poor wound healing, fatigue, dehydration, perfume), for entry. Discussion of utility models to deal with the patient, if not before. Encourage her to her problems and needs with family and friends to open. Imagine that the reference to the American Cancer Society, if necessary.

Training and girls preteenage fear of examinations at least once a year from menarche, despite the absence of symptoms of venture capital. Safe sex reduces the risk of infection with human papillomavirus (HPV), which is a factor contributing to the development of venture capital.