How to approach

[Jade_47402]

Hey everybody,

Iam an ANRP student who recently finished my PEDS rotation and today I had a 20 yr old female who had signs and symptoms that put cervical cancer in her differential diagnosis. While speaking to her she stated she had never had a pap done bc obgyn stated that she didn't need until she was 21 . When I spoke with the DR he agreed that she is a high risk candidate and should be seen by obgyn and get a pap .while in the office with the dr and the pt I suggested that when the pt goes to see her ob DR make sure she tells them of the different types of cancer that runs In her family specifically the cervical cancer , I said this bc she had neglected to say anything before today's visit. Any ways she went home and started crying and should told her mother that we said she had cervical CA . The DR stated that we didn't do anything wrong but some times pts hear what they want . So my question is how do you aproach a pt were CA is a possible diagnosis ?

Sorry for the long post but i would appreciate any advice

[YoutubeTheNP]

I have a script. In your case, and i don't know exactly what you saw to think about cervical cancer but I say look here is what I'm seeing, xyz. Now this could be one of many things. It could be nothing, but it could be something serious like cancer. So here is what I want you to do. Follow up with your gyn within the next week or two and get a pap.

Just out of curiosity is there a reason you can't send one off where you work??

[Jules A, MSN]

As a student I have to wonder if this would be better to discuss with your school contact? I'm surprised a student was given this task and hope you understood what you were reporting and were comfortable doing that.

[Rnis, BSN, DNP, APRN, NP]

Why wouldn't you guys just do the pap? Those are guidelines for routine screening, if they are having s/s that would change the situation. I don't know that I would tell them their symptoms concern me for cervical cancer...just that their symptoms warrant a more indepth exam/testing

I have a spiel I give to young girls when I do their pap before they have even got their results. I always say "if your pap comes back abnormal, don't panic. that is not all that uncommon because the majority of us have been exposed to HPV. Often young women's bodies are able to fight and clear the virus on their own so depending on the results we often just monitor you a little closer for a few years. even if your body does not clear the virus, If cell changes are caught early we can stop cervical cancer before it occurs....which is exactly why doing routine screening is so important.

young women especially worry about their health in this area. I try to really focus on the importance of routine screening to nip any issue in the bud quickly. I have found that giving this talk during the pap has stopped panic return office visits the following week when the pap comes back as ASCUS or LSIL.