I’m working on a nursing discussion question and need an explanation and answer to help me learn.
Kelliann Giufurta.
Module 6 Discussion: Case Study 2
Diagnostic Testing for the Patient
Persistent pain in the lower abdomen among women should be taken seriously because it may be caused by more serious conditions such as ovarian cancer, cysts, masses, or tumors. Despite many years of extensive research, there is yet to be an effective screening test for ovarian cancer. Currently, there are two tests that are in place, the CA-125 blood test and transvaginal ultrasound (TVUS). They are used together with pelvic examinations to determine ovarian cancer. Just like its name, the CA-125 test seeks to determine the amount of a protein of the same name, the CA-125, in the blood. If the level of CA-125 is found to be high, there is a likelihood of it being ovarian cancer (van Nagell Jr et al., 2018). However, this test has many drawbacks since other conditions such as endometriosis and pelvic inflammatory disease also elevated CA-125. The other test, TVUS, relies on sound waves to explore the ovaries, uterus, and fallopian tubes. While it can establish the mass, it cannot determine whether it is cancerous or not.
Differential Diagnoses
Three differential diagnoses in this case would be ovarian cancer (C56.9), endometriosis (N80.9), and ovarian cysts (N83.20) (Uphold & Graham, 2018). Ovarian cancer is a cancer that originates from the ovaries. Endometriosis occurs when there is an abnormal growth of tissue outside the uterus, and such tissue is usually like the one that would typically be found inside the uterus. Though sometimes this disorder may extend beyond the pelvic organs, it commonly involves pelvic tissue, fallopian tubes, and the ovaries. Ovarian cysts entail pockets or sacs that are filled with fluid and are typically found inside or on the surface of the ovaries.
Management Plan
A combination of chemotherapy, surgery, systemic treatment, and radiation therapy can be used for the treatment. This is if the case is determined to be cancer. However, the specificity of the treatment approach should solely depend on the stage of the cancer, as well as on its genomic profile. A visit to the gynecologic oncologist would typically be the first step the patient should take. It is also advisable that when selecting the healthcare facility for the treatment, the patient should try as much as possible to find a cancer center that is “high volume” when it comes to the treatment of ovarian cancer. Such centers have better and more extensive experience when it comes to handling such cases.
Treatment Examples for A Patient with A Stage IIB Ovarian Cancer
A patient with Stage IIB ovarian cancer would undergo surgery as the first intervention. Staging and debulking would be the underlying rationale for such a surgery. One option here would be bilateral salpingo-oophorectomy, which would entail the full removal of the ovaries or the fallopian tubes, and this would depend on the extent of the cancer. It can also include the removal of the uterus which is known as a hysterectomy. At least six cycles of chemotherapy should be executed after the removal of all possible cancerous tissue. Paclitaxel would typically be combined with carboplatin in this case. In certain cases, intraperitoneal (IP) chemotherapy is preferable (Nandy et al., 2018).
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