Background: Gynecological Cancers affect over 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. 

Case: A 71 year old woman has a history of uterine carcinoma for 10 years as well breast cancer for 1 year. She lost two children to cancer:  A daughter from breast cancer and a son from testicular cancer.  She lives with her husband and was admitted to the hospital with the diagnosis of abdominal pain and 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 DVT with lower extremity cellulitis and multiple additional issues resulting from a severely immunocompromised state.  This patient 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 patient and her family, frequent collaborative healthcare team meetings were held to coordinate her care.   A nutritionist was consulted even prior to the patient’s surgery due to her weakness and nausea and vomiting.  The nutritional support she received extended throughout her hospitalization.  An extensive medical team of experts in addition to her gynecology oncologists were consulted on her care including pulmonary, infectious disease, nephrology, gastroenterology, interventional radiology and urology.  Nursing was instrumental in facilitating resources from the hospital including the Gynecology Oncology Nurse Navigator, wound ostomy specialist, social worker, case management, and even animal assisted therapy .  The Life with Cancer team gave emotional and educational support to both the husband and her family. The patient’s goal was to return home with her husband. She was discharged from the hospital to her own home after 103 days with support from specialized home health nurses, as well as palliative care services.

 Conclusion: 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.

 Keywords: Gynecologic oncology, Women’s Cancer,  Multidisciplinary teams, Palliative care