Advanced ovarian cancer as a risks of primary multiple malignant tumors after the treatment of extra genital cancer
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- non-pregnant and depends on the stage of the disease. Most common ly cancer in pregnant women is being treated the same as in
- nonpregnant and depends on the stage of the disease. The combination of cervical cancer and pregnancy is the most common disease among oncogynecology .
- take place after birth. Women receiving chemotherapy should not breast feed. Hematologic cancer is the second most common cancer in pregnancy. The combination of Hodgkin
- CHAPTER ХІV EMERGENCY AND URGENT SITUATIONS IN ONCOLYNECOLOGY
- Large fraction external beam radiation therapy for haemostasis с, ligation of arteria hypogastric and a rterial embolisation are performed
- CHAPTER ХV QUALITY OF LIFE IN PATIENTS WITH ONCOGYNECOLOGICAL DISEASES
CHAPTER ХІII PREGNANCY AND CANCER The problem pregnancy and cancer can be divided into: a combination of pregnancy and malignant disease of the female genitalia and combination of pregnancy and extra genital malignant tumors. The combination of vulva cancer and pregnancy is very rare. In invasive carcinoma, the treatment in pregnant women is the same as in non-pregnant and depends on the stage of the disease. Most commonly cancer in pregnant women is being treated the same as in non-pregnant, with some peculiarities. The combination of vagina cancer and pregnancy is extremely rare. In invasive carcinoma, the treatment is like with nonpregnant and depends on the stage of the disease. The combination of cervical cancer and pregnancy is the most common disease among oncogynecology. Treatment strategy depends on gestational age, stage of disease, size of the lesion, the patient's desire to keep the pregnancy. Possible operations are organ-saving operation and chemotherapy with platinum and paclitaxel. Ovarian cancer rarely occurs. Prevalent is epithelial cancer in stages I. Organ-saving operation is carried out in a volume salpingo-oophorectomy. Postoperative chemotherapy is administered. Endometrial cancer during pregnancy is uncommon. Hormone therapy to maintain the uterus is possible. Breast cancer is the most common cancer during pregnancy. The incidence is approximately 1 in every 3000 pregnancies. Modified radical mastectomy is the treatment of choice. Adjuvant chemotherapy is carried out after the first trimester. Radiotherapy is desirable to take place after birth. Women receiving chemotherapy should not breast feed. Hematologic cancer is the second most common cancer in pregnancy. The combination of Hodgkin disease and cancer is 1 in 6,000 pregnancies. There are also acute leukemia and non-Hodgkin's lymphoma. Use of chemotherapy during the second and third trimester appears to be relatively safe and used polychemotherapy. The combination of colon cancer and pregnancy is very rare. Usually the diagnosis is late. Treatment is primarily surgical, like in non-pregnant women. Malignant melanoma and pregnancy is a rare combination. Surgical removal of the tumor edges remains adequate standard primary treatment. Preservation of fertility is an important aspect in the lives of survivors after treatment for cancer. CHAPTER ХІV EMERGENCY AND URGENT SITUATIONS IN ONCOLYNECOLOGY Emergency conditions in oncogynecology are quite common. Bleeding in cancer is the third most common cause of death in patients with advanced metastatic disease, organ failure, due to invasion of tumor or infection. Acute genital bleeding is the most dramatic condition associated with oncogynecological disease in which for a very short period of time a great blood loss is achieved. Most commonly seen in patients with advanced cervical cancer and vaginal cancer. In inoperable patients healing tactic is to make a vaginal tampon, which aims to reduce blood loss while applying a different, more effective treatment. Large fraction external beam radiation therapy for haemostasisс, ligation of arteria hypogastric and arterial embolisation are performed. Bleeding from the genitourinary and gastrointestinal systems is also observed in patients with oncogynecological diseases, solid coverage of the bladder or rectum of the tumor process. Malignant pleural effusion is a clinical and markedness of advanced incurable condition. Pleural effusion are drained with further pleurodesis. Malignant ascites is a clinical and markedness of the advanced state due to miliary carcinosis by peritoneum. It was found that ovarian cancer is the most common cause - 37.7%. Paracentesis combined with systemic chemotherapy and intra-abdominal application of cytostatics are performed. The most frequent primary tumors that lead to intestinal obstruction are ovarian and uterine tumors. The surgical option is removal of colostomy or possible bowel resection with anastomosis. Ureteral obstruction is most common in cervical cancer and ovary cancer. Urinary outflow procedure (placement of benches in a ureter, percutaneous or open nefrostoma) is performed. In oncogynecology ovarian torsion is rarely observed. In neoplastic vesico-vaginal and recto-vaginal fistulas remove stoma. Bone metastases are caused by haematogenous dissemination. When fracture accrues, the patient is immobilized. Radiotherapy and bisphosphonates are used. About ¾ of patients experience pain at some point during their illness. Treatment of pain meets the principles of pain management in cancer patients. WHO analgesic ladder is used. CHAPTER ХV QUALITY OF LIFE IN PATIENTS WITH ONCOGYNECOLOGICAL DISEASES Quality of life in cancer is the difference, or the gap, that exist, at particular point in time, between the hopes and expectations of the individual and the individual,s present experiences. Quality of life is a multidimensional concepts that focused on how disease and its treatment affect the individual. Multiplicity of factors influences quality of life: mental and emotional state, physical or functional ability, frequency and severity of side effects, global life satisfaction, social status, sexuality, spiritual or religions well being and financial well being. Overall studies indicate that survivors after gynecologic cancer do not have impaired QoL in the long term. In general, the patients are highly satisfied with the follow-up program. The patients’ greatest concern is fear of recurrence. The most frequent reported unmet need is help in dealing and living with the fear of recurrence. It seems that psychosocial status at time of diagnosis is determining for QoL and well-being in the long term. It is extremely important to optimize the follow-up program and move focus to life quality. There is a need for an evidence-based strategy regarding follow-up for low-risk gynecologic cancer patients. EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-core 30), NCCN Distress Thermometer, Hospital Anxiety and Depression Scale (HADS), Watts Sexual Functioning Questionnaire (WSFQ), Cancer Rehabilitation Evaluation System (CARES), Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Gynaecologic Leiden Questionnaire (LQ), The Female Sexual Function Index (FSFI), PFDI-20 are used to determine the quality of life in patients with cancer. In addition the use of PROMIS (Cancer Patient-Reported Outcomes Measurement Information System) problems of sexual function and intimacy, which are associated with cancer treatment, affect and are affected by fatigue treatment-related hair loss, weight gain or weight loss and loss of organs or scars. The type and radicality of surgical treatment for gynecologic cancer can influence sexual function and play a significant role in QOL. Каталог: assets -> files -> Nauka-SDO Nauka-SDO -> Конкурс за заемане на академична длъжност „Професор по научната специалност Nauka-SDO -> На избрани нерецензирани научни трудове Nauka-SDO -> Списък публикации Nauka-SDO -> Специализирана болница за активно лечение по онкология-еад Nauka-SDO -> Рецензия от проф. Д-р н. Гаврилова дм Изтегляне 1.05 Mb. Сподели с приятели:
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