Betty R. Ferrell, PhD, RN


January 07, 2013

Case Presentation: A Woman With Advanced Ovarian Cancer

Cynthia J. is a 49-year-old married mother of 3 college-age children who was diagnosed 1 year ago with stage IV ovarian cancer. Cynthia has been treated with aggressive surgery and chemotherapy; she has responded well to treatment with a significant reduction in tumor size.

She was admitted to the hospital today with nausea and vomiting and what appears to be a bowel obstruction. She is dehydrated, rates her abdominal pain at 8 out of 10, and appears emotionally and physically exhausted. A nasogastric tube is placed, and she is started on intravenous fluids, analgesics, and antiemetics. Her medical oncologist also orders a palliative care consult.

The nurse returns to the bedside and reviews the orders with Cynthia's family, because she is now sleeping. After reviewing the plans for symptom management, the nurse mentions that the palliative care team will also be coming by. Cynthia's 20-year-old son looks shocked and distressed at the mention of palliative care. Cynthia's husband interrupts and informs the nurse that she should cancel the palliative care consult because "Cynthia will be much better after she gets some fluids on board. She wants to keep going on with more chemo. She's a fighter."