The commonest cause of death in women with cancer cervix is?

BCCL kharkhanda Staff Nurse - 2015

Obstetrics & Gynaecology (E5)

Easy

Appeared in: BCCL kharkhanda Staff Nurse - 2015

Explanation

The most common cause of death in cervical cancer is renal failure, also known as uremia.
Cervical cancer spreads locally into the parametrium, the tissue surrounding the cervix.
The ureters, which transport urine from the kidneys to the bladder, pass through the parametrium.
The growing tumor compresses these ureters, causing an obstruction.
This obstruction leads to a backup of urine, causing swelling of the kidneys (hydronephrosis) and subsequent kidney failure.
Source SRC_12445 explicitly links Stage III cervical cancer to the development of hydronephrosis and identifies ureteral obstruction as a sign of disease progression.

Option A: Septicaemia, or widespread infection, can occur, especially if the tumor becomes large and necrotic (develops dead tissue). However, it is not the most common primary cause of death compared to the direct mechanical effects of the tumor.
Option C: Haemorrhage is a significant and often dramatic cause of death, occurring when the tumor erodes into major pelvic blood vessels like the uterine or iliac arteries. While common, it is generally considered second to renal failure in frequency.
Option D: Cachexia is a complex metabolic syndrome characterized by severe weight loss, muscle wasting, and weakness. While it is a common feature of advanced cancer and contributes significantly to morbidity and mortality, it is not typically the direct, terminal event. Organ failure, such as renal failure, is a more direct cause.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Causes of mortality in cervical cancer as background academic context rather than a clinical decision trigger.
Nurses caring for patients with advanced cervical cancer must prioritize monitoring for signs of renal failure. This includes strict intake and output monitoring, assessing for peripheral and sacral edema, and reviewing lab values like BUN and creatinine.
Pain management is another critical nursing role, as tumor extension into the pelvis can impinge on nerves, causing severe back and leg pain (sciatica).
Patient education should include reporting symptoms like decreased urination, new swelling in the legs, or persistent back pain, as these can indicate ureteral obstruction.

How to Approach the Question

First, identify the core of the question: it asks for the 'commonest' cause of death from a specific disease, 'cancer cervix'.
Next, consider the pathophysiology of cervical cancer. Recall or deduce how this cancer grows and spreads. It is known for extensive local invasion into adjacent pelvic structures.
Evaluate the options based on this pathophysiology. Think about what vital structures are located near the cervix.
The ureters pass very close to the cervix. Local tumor growth can easily compress them, leading to kidney failure (uraemia).
The tumor can also erode into large blood vessels, causing hemorrhage.
Large tumors can become infected, leading to septicaemia.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 65-67