Gynecologic Oncology Patients: It Takes a Village
Article first published online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, page S164, June 2012
How to Cite
Freund, E. A., Hooper, J. and Schmehl, P. (2012), Gynecologic Oncology Patients: It Takes a Village. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S164. doi: 10.1111/j.1552-6909.2012.01363_3.x
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- gynecologic oncology;
- women's cancer;
- multidisciplinary teams;
- palliative care
Gynecologic cancers affect more than 80,000 new women each year. Uterine cancer is the fourth most common cancer in women, preceded only by lung, breast, and colon cancer. In order to comprehensively and holistically care for these women and their families, the primary healthcare team must utilize a multidisciplinary team approach.
A 71-year-old woman has a history of uterine carcinoma for 10 years and breast cancer for 1 year. She lost two children to cancer: a daughter to breast cancer and a son to testicular cancer. She lived with her husband and was admitted to the hospital with the diagnosis of abdominal pain, nausea, and vomiting. Upon further evaluation she was diagnosed with advanced metastatic uterine carcinoma extending into both the bowel and the liver. During her hospital stay she had multiple procedures, including an exploratory laporatomy and tumor debulking with the creation of a colostomy. She subsequently developed an entercutaneous fistula, a deep vein thrombosis with lower extremity cellulitis, and multiple additional issues resulting from a severely immuno-compromised state. The woman and her husband were determined to “beat this cancer,” and she continued to receive chemotherapy during the first two and half months of her hospitalization.
In order to meet the multidimensional needs of this woman and her family, frequent collaborative healthcare team meetings were held to coordinate her care. A nutritionist was consulted prior to her surgery due to her weakness, nausea, and vomiting. The nutritional support she received extended throughout her hospitalization. An extensive medical team of experts in addition to her gynecologic oncologists was consulted on her care including, pulmonary, infectious disease, nephrology, gastroenterology, interventional radiology, and urology. The nursing team was instrumental in facilitating resources from the hospital including the gynecology oncology nurse navigator, wound ostomy specialist, social worker, case management, and animal assisted therapy. The Life with Cancer team offered emotional and educational support to both the husband and family. The woman's goal was to return home with her husband. She was discharged from the hospital to her home after 103 days with support from specialized home health and palliative care services.
Nurses are the catalysts for facilitating multidisciplinary teams involving resources from the entire healthcare arena. These teams assist in meeting the patient's needs and improving outcomes.