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Pelvic Cancer


Presentation

  • Immuno-compromised and elderly patients do not present typically for many of the diagnoses described above.[cancertherapyadvisor.com]
  • Clinical presentation and confirmation of recurrence Patients with recurrent cervical cancer after radiation therapy usually present with bleeding, hematuria, or pelvic pain. [8] In some cases, the first sign of recurrence is the discovery of hydronephrosis[emedicine.medscape.com]
  • In Stage 0, cancer cells are present on the top layer of the cervix only. They have not gone into deeper layers of the cervical tissue or other organs. The remaining stages are called invasive cancer.[acog.org]
  • You will be alone in the examination room during the CT scan, unless due to specific circumstances you require someone present. The radiographer will always be able to see, hear and speak with you through a built-in intercom system.[materprivate.ie]
  • Reassurance from the physician should be provided to alleviate patient fears that a more serious condition is present.[fascrs.org]
Lymphedema
  • Lymphedema treatment may include massage therapy, compression garments and exercises. What the results mean Each lymph node removed is examined to see if it contains cancer. A negative lymph node has no cancer cells.[cancer.ca]
  • This information explains how to reduce your risk of lymphedema of the legs. About Lymphedema Lymphedema is abnormal swelling that can develop in your legs after your lymph nodes have been removed or injured.[mskcc.org]
Foul Smelling Discharge
  • Tell the healthcare team if you have these side effects or others you think may be from a pelvic lymph node dissection: pain, discomfort or tenderness in the lower abdomen constant, increasing or foul-smelling discharge a collection of lymph fluid (lymphocele[cancer.ca]
Pathologist
  • The pathologist’s report includes the type of cancer, the number of lymph nodes removed and the number of lymph nodes that have cancer cells.[cancer.ca]
Abdominal Pain
  • “Evaluation of acute abdominal pain in adults”. Am Fam Physician. vol. 77. 2008 Apr 1. pp. 971-8. Longo, DL, Fauci, AS, Kasper, DL. “Harrison's Principles of Internal Medicine”. 2008. McCormack, WM. “Pelvic inflammatory disease”.[cancertherapyadvisor.com]
  • It is helpful in identifying the causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum.[hopkinsmedicine.org]
  • pain Unexplained urination problems, including trouble starting or stopping urinating A pelvic MRI may be done in both males and females who have: Abnormal findings on an x-ray of the pelvis Birth defects of the hips Injury or trauma to the hip area[medlineplus.gov]
Nausea
  • […] endometriosis from pelvic inflammatory disease Pregnancy: Sx: Amenorrhea, nausea and vomiting, breast tenderness, urinary frequency and urgency Labs: Urine pregnancy test, urinalysis, CBC, serologic testing for syphilis, rubella, varicella, Rh type,[cancertherapyadvisor.com]
  • Some symptoms of pelvic mass may include: Pelvic pain (most comon) Swelling or a bloated feeling of the abdomen Frequent urination due to pressure on the bladder Nausea and or vomitting Pelvic Mass Causes Some of the most common causes of a pelvic mass[hoag.org]
  • A person should seek medical help immediately if the pain is severe or they experience nausea or vomiting, fever, or loss of consciousness. It is best to contact a doctor with any questions or concerns about new or chronic pelvic pain.[medicalnewstoday.com]
Acute Abdomen
  • If the patient exhibits any sign of rebound or involuntary guarding, this is highly concerning for an acute abdomen and surgery should be consulted immediately.[cancertherapyadvisor.com]
Thrombosis
  • […] others you think may be from a pelvic lymph node dissection: pain, discomfort or tenderness in the lower abdomen constant, increasing or foul-smelling discharge a collection of lymph fluid (lymphocele) near the incision a blood clot in the leg (deep vein thrombosis[cancer.ca]
Flushing
  • Dysmenorrhea: Sx: Menstrual pain with ovulatory cycles, wave-like cramping pelvic pain that may radiate to back or inner thigh, associated nausea and vomiting, headache, flushing Labs: Urine pregnancy test Imaging: Laparoscopy is often needed to differentiate[cancertherapyadvisor.com]
  • You will likely have a warm, flushed sensation during the injection of the contrast material and a metallic taste in your mouth that lasts for at most a minute or two.[materprivate.ie]
Night Sweats
  • Systemic symptoms such as fever, chills, night sweats, weight loss, appetite changes. Surgical history. Adhesions may be causing the pain or may represent another post-operative complication. Recent trauma.[cancertherapyadvisor.com]
Headache
  • Dysmenorrhea: Sx: Menstrual pain with ovulatory cycles, wave-like cramping pelvic pain that may radiate to back or inner thigh, associated nausea and vomiting, headache, flushing Labs: Urine pregnancy test Imaging: Laparoscopy is often needed to differentiate[cancertherapyadvisor.com]
Salpingitis
  • The most common lumen in this region include fallopian tubes (salpingitis), ureters/urethra (nephrolithiasis), and uterus (dysmenorrhea).[cancertherapyadvisor.com]
Cervical Motion Tenderness
  • During the bimanual exam, cervical motion tenderness and adnexal tenderness are most commonly associated with pelvic inflammatory disease (salpingitis, tubo-ovarian abscess).[cancertherapyadvisor.com]
Adnexal Tenderness
  • During the bimanual exam, cervical motion tenderness and adnexal tenderness are most commonly associated with pelvic inflammatory disease (salpingitis, tubo-ovarian abscess).[cancertherapyadvisor.com]
Urinary Retention
  • retention) Pyelonephritis – symptoms usually persist for Sx: Dysuria, hematuria, flank pain, abdominal pain, fever, urinary urgency/frequency, nausea, vomiting Labs: Leukocytosis with left shift, positive urinalysis ( nitrites, leukocyte esterase, WBC[cancertherapyadvisor.com]
Renal Insufficiency
  • Laboratory tests Complete blood count (leukocytosis indicating infection, HELLP, ectopic pregnancy, Hbg/Hct -blood loss anemia) Basic metabolic profile (renal insufficiency, BUN:creat ratio may suggest pre-renal versus renal versus post renal etiology[cancertherapyadvisor.com]

Workup

  • […] frequency, urgency, dysuria), afebrile, pain with a full bladder Labs: Urinalysis, Urine Culture, Blood culture, CBC with differential, Syphilis, HIV, Endocervical culture Imaging: Abdominal Ultrasound or cystoscopy in men as it is rare and warrants workup[cancertherapyadvisor.com]
Pseudomonas
  • IV antibiotics (covering Gram negative rods including pseudomonas) if infection is suspected. Early goal directed therapy with fluid resuscitation and cardiovascular stabilization.[cancertherapyadvisor.com]

Treatment

  • They use the stage along with other information about the type and grade of the cancer to make treatment decisions and give a prognosis. Depending on the result, your doctor will decide if you need more tests, any treatment or follow-up care.[cancer.ca]
  • Managing bladder late effects There are things you can do and different treatments that can help manage bladder changes. Bowel changes Late bowel effects of pelvic radiotherapy are usually managed or treated successfully.[macmillan.org.uk]
  • “Sexually transmitted diseases treatment guidelines, 2006”. MMWR Recomm Rep. vol. 55. 2006. pp. 1-94. Sleisenger, MH, Feldman, M, Friedman, LS, Brandt, LJ.[cancertherapyadvisor.com]
  • Treatment Options Because numerous disorders can lead to the formation of a pelvic mass, it’s important to diagnose the cause of the mass before an appropriate treatment plan can be determined.[hoag.org]
  • Treatment options under clinical evaluation: The development of new instrumentation for endourological treatment of upper tract transitional cell cancer has provided new options for regional management of these cancers.[cancer.gov]

Prognosis

  • 501 genes associated with favourable prognosis.[proteinatlas.org]
  • The latter category indicates a more pervasive tumor diathesis and generally a less favorable prognosis.[cancer.gov]
  • Besides the T-stage, the proximity of tumor to mesorectal fascia also affects the prognosis in cases of rectal cancer as tumor within 1 mm of this fascia, also known as circumferential resection margin (CRM) is associated with significantly increased[colorectal-cancer.imedpub.com]

Etiology

Epidemiology

  • “Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update”. Epidemiol Rev. vol. 12. 1990. pp. 199-220. Donaldson, CK. “Acute Gynecologic Disorders”. Radiol Clin North Am. vol. 53. 2015 Nov. pp. 1293-307.[cancertherapyadvisor.com]
Sex distribution
Age distribution

Pathophysiology

  • “Sleisenger & Fordtran's Gastrointestinal and liver disease: pathophysiology, diagnosis, management”. 2010. Copyright 2017, 2013 Decision Support in Medicine, LLC. All rights reserved.[cancertherapyadvisor.com]

Prevention

  • You may be given: antibiotics to prevent infection pain-relieving medicine instructions on caring for and dressing the wound information about how to manage the drainage bag and tube advice on how much and which types of activity you can do after surgery[cancer.ca]
  • How can I prevent human papillomavirus infection? A vaccine is available that can prevent infection with HPV. The vaccine protects against the HPV types that are the most common cause of cancer, precancer, and genital warts.[acog.org]
  • Food and Drug Administration approved a vaccine which prevents infection by the HPV 16 and 18. Studies have shown that the vaccine appears to prevent precancerous lesions and early-stage cervical cancer.[proteinatlas.org]
  • "The cervical cancer epidemic that screening has prevented in the UK". Lancet. 364 (9430): 249–56. doi : 10.1016/S0140-6736(04)16674-9. PMID 15262102. Pimenta, Jeanne M; Galindo, Claudia; Jenkins, David; Taylor, Sylvia M (21 November 2013).[en.wikipedia.org]
  • Moisturize your skin often to prevent chapping and chaffing. Keep the area between your toes clean and dry to prevent infections. Don’t walk barefoot. Make sure your footwear fit you well to avoid blisters.[mskcc.org]

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