LESSON PLAN

ON
CERVICAL CANCER

Ms. MANISHA ANGELINA DAVID

ASSISTANT PROFESSOR
SINPS
 Subject Medical Surgical Nursing

Oncology
Unit
Cervical cancer
Topic
B.Sc. Nursing IV Sem.
Group
Class room
Place
06.11.2023, 01 hour
Date & time
Lecture cum discussion
Teaching method

AV aids / instructional aids Power Point Tiles, Charts, Black Board

Regarding cancer and also know anatomy and physiology of female reproductive system.
Student Pre requisite

At the end of the class students will acquire adequate knowledge regarding cervix cancer, its causes,
types, pathophysiology, clinical manifestations, diagnostic evaluation, management (medical, surgical,
nursing). Cervical cancer is the third most common cancer in the women worldwide therefore it is one of
the most important topics to understand in the field of nursing in order to reduce mortality rate and
General Objective
incidences among women. Cervix cancer and their incidences. The students would be able to apply this
knowledge in clinical practice, hospitals, while providing health education and handling the clients with
cervix cancer.
 At the end of the class will be able to-
• Define cervical cancer
• Enlist the aetiology and risk factor of cervical cancer
• State down the pathophysiology of cervical cancer
Specific objective • Enumerate the clinical manifestation of cervical cancer
• Classify the stages of cervical cancer
• Elaborate the diagnostic evaluation of cervical cancer
• Explain the management of cervical cancer
• Enlist the nursing diagnostic of cervical cancer

Review of previous class Ask questions from students about previous class and clear doubts.

• Cervical cancer develops in a woman's cervix (the entrance to the uterus from the vagina).
• Almost all cervical cancer cases (99%) are linked to infection with high-risk human
papillomaviruses (HPV), an extremely common virus transmitted through sexual contact.
• Cervical cancer is the fourth most common cancer in women globally with an estimated 604 000
Introduction new cases and 342 000 deaths in 2020.
• The highest rates of cervical cancer incidence and mortality are in low- and middle-income
countries.
• This reflects major inequities driven by lack of access to national HPV vaccination, cervical
screening and treatment services and social and economic determinants.

S. No Time Specific Content Teaching learning Evaluation

objective activity
05 min. To define Cervical Cancer Teaching Activity: What is cervical
1 cervical cancer. Definition: - Cervical Cancer is malignant tumour of To define cervical cancer cancer?
the cervix. The tumour may develop from the surface with the help of PPT.
epithelium of the cervix or from epithelium lining of Students Activity:
the cervical canal. Students are listening
 Incidence: -
• New Cases estimated 604 000/ year
• Died from cervical cancer: 342 000 deaths
2 05 min To enlist the Aetiology and Risk Factor Teacher Activity: What are the
aetiological Aetiology: - Enlist the aetiology and aetiology and risk
factors of • Human papilloma virus risk factor of cervical factor of cervical
cervical cancer Infection with the common HPV is a cause of cancer. cancer
approximately 90% of all cervical cancers. About half
of the sexually transmitted HPV are associated with Learner’s Activity:
cervical cancer. Students are listening &
discussion
Risk Factor: -
• Early sexual activity
• Cigarette smoking
• Family history
• Nutritional deficiency (folate, carotene, vit. C)
• Obesity
• Poor immune system
• Age (30-39 & 60-69)
• diethylstilbesterol
05 min To state down Pathophysiology
3 the Due to etiological factor
pathophysiology
of cervical Entry of HPV
cancer
Virus enters in basal layers of the cervix

HPV infects the basal cells

 Damage the genetic material of the cell

Cells becomes pre-cancerous

Damaged cell continues to multiply

Invasion to the nearby tissue

Cervical cancer
4 05 min To enumerate Clinical manifestation:
the clinical ❖ Bleeding that occurs between regular
manifestation of menstrual periods
cervical cancer ❖ Bleeding after sexual intercourse, douching,
or a pelvic examination
❖ Menstrual periods that last longer and heavier
that before bleeding after going through
menopause
❖ Increased vaginal discharge
❖ Pelvic pain
5 05 min To classify the Stages of cervical cancer:
stages of Stage I- Cancer is confined to the cervix
cervical cancer Stage II- Cancer at this stage includes the cervix and
uterus, but has not spread to the pelvic wall or the
lower portion of the vagina
Stage III- Cancer at this stage has moved beyond the
cervix and uterus to the pelvic wall or the lower
portion of the vagina
 Stage IV- At this stage, cancer has spread to nearby
organs, such as bladder to other areas of the body,
such as the lungs, liver or bones.
6 05 min To explain the Diagnostic Evaluation:
diagnostic ➢ History collection
evaluation of ➢ Physical examination
cervical cancer ➢ PAP smear- routine screening for cervical
cancer abnormalities can detect early-stage
cancer and precancerous condition that could
progress to invasive disease. The process
begins with pap test, also known as pap smear
➢ HPV DNA test- Like the pap test, the HPV
DNA test involves collecting cells for lab
testing
➢ Colposcopy: It illuminates the cervix for
biopsy
➢ Cone Biopsy: A large area of tissue around
the cervix excised for examination
➢ Chest X-Ray
➢ CT scan
➢ MRI scan
Pelvic ultrasound
7 15 min To elaborate the Management:
management of Medical Management: -
cervical cancer Chemotherapy
 Chemotherapy is the use of chemicals
(medication) to destroy cancer cells.
Cytotoxic medication prevents cancer cells
from dividing and growing.
  Chemotherapy for cervical cancer, as well as
most other cancer, is to target cancers that
surgery cannot or did not remove, or to help
the advanced cancer.
 Cisplatin, a chemotherapy drug, is frequently
used in combination with radiation therapy.

Surgical Management:
Laser Surgery: A narrow beam of intense light
destroys cancerous and precancerous cells.
LLEP: Loop electro surgical excision procedure- a
wire loop has an electric current cut through tissue
removing cells from the mouth of the cervix.
Cryosurgery: Compressed nitrogen gas flows
through a cryo-probe making the metal cold enough
to freeze and destroys the abnormal cervical tissue.
Hysterectomy: Removal of the uterus

Nutritional Management
➢ Flavonoids are chemical compound in fruit
and vegetable that are thought to be leading
source protection against cancer. The
flavonoids-rich food are apples, black beans,
broccoli, Brussels, sprouts, cabbage, garlic,
onions, soy, spinach.
➢ Folate (a water-soluble vitamin B) reduce the
risk of cervical cancer in people with HPV.
Foods include Avocados, breads, lentins,
orange juice and strawberries.
 ➢ Carotenoids, a source of vitamin A, also
helpful in preventing cervical cancer risk.
Foods such as carrots sweet potatos and
pumpkin are rich in vit. A
8 Complication:
 Low blood count
 Uterine pain due to pyelonephritis
 Vesicovaginal fistula
 Menorrhagia
 Post-menopausal PV bleed
9 05 min. To enlist the Nursing Management
nursing
management of Nursing Diagnosis:
cervical cancer • Pain related to cancer & treatment effect as
evidence by pain scale and facial expression
• Imbalanced nutrition less than body
requirements related to anorexia, vomiting as
evidence by weight loss
• Impaired tissue integrity related to treatment
as evidence by mucositis
• Anxiety related to diagnosis of cancer as
evidence by talking with family member
• Risk for infection related to immune
suppression
• Impaired urinary elimination related to
surgical incision.
Nursing Intervention
• Assess patient condition
 • Give careful attention to post opt. bleeding
• Providing close monitoring and care for the
first 2-3 days
• Early ambulation
• Close monitoring the patient undergoing
cryosurgery for haemorrhage & hypothermia
• Instruct the patient to follow up visit
Prevention:
• HPV vaccine
If every female adheres to current HPV
vaccination programmes the total number of
female deaths from cervical cancer globally
will drop by hundreds of thousands each year
• Safe sex
• Cervical screening
• Have few sexual partner
• Delay first sexual intercourse
• Avoid smoking
Summary: Cervical Cancer is a cancer arising from the cervix it is due to the abnormal growth of cells that have the ability to invade or
spread to the outer parts of the body its usual onset is over 10 to 20 years and caused by HPV infection, smoking, weak immune system, birth
control pills etc. Early on typically no symptoms are seen later symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during
sexual intercourse.
Cervical screening followed by biopsy is the diagnostic method with regular cervical screening, HPV vaccine. As a risk of
cancer still exists, guidelines recommended containing regular PAP tests.

Conclusion: Worldwide, cervical cancer is both the fourth most common case of cancer and fourth most common cause of death from
cancer is women. PAP test screening every 3-5 years with appropriate follow-up can reduce the cervical cancer incidence upto 80 % and
reduced the number of cases and mortality from cervical cancer.
 As a nursing personal, encouraging the women to get screened are effective at increasing the likelihood they will do so. Educational material
also helps to increase awareness about cervical cancer.
Evaluation:
Q1: - Where is the cervix located in the body?
a) In the ovaries
b) The lower, narrow part of the uterus
c) In the chest
d) In the neck
Q2: - What is cervical cancer?
a) It is cancer of female reproductive tract
b) It is the cancer of brain
c) It is a STD
d) None of the above
Q3: - Which of these are risk factor for the cancer?
a) Smoking
b) Infection with an HPV
c) Infection with a virus that cause AIDS
d) All of the above
Q4: - Which of this test effectively screens for cervical cancer?
a) ECG
b) PAP test
c) Blood test
d) None of above
Q5: - When should women begin PAP test screening?
a) No later than age 12
b) At age 12
c) No later than 30
d) None of the above
Assignment: Assignment on radiation therapy & PAP test screening.

Bibliography:
• SUDDARTHI’S & BRUNNERS, Textbook of medical Surgical Nursing, 13th Edition, published by Wolters Kluwer (INDIA) Pvt.
Ltd, page no. 1667-1652
• CHINTAMANI, Levis’s Medical Surgical Nursing, Assessment & Management of Clinical Problems, Published by Elsevier, Page
no. 1367-69