Date post: | 16-Dec-2015 |
Category: |
Documents |
Upload: | leona-blankenship |
View: | 217 times |
Download: | 3 times |
Cancer Definition & Significance
A group of more than 200 diseases characterized by unregulated growth of cells.
Cancer is the 2nd leading cause of death in the U.S. (CAD is # 1).
An estimated 30% of Americans now living will experience cancer at some point in their lives.
Cancer Con’t…. Two major dysfunctions present in the
process of CA are:> Defective cellular proliferation
(growth) > Defective cellular differentiation The natural history of CA is an orderly
process occurring in 3 phases over time: > Initiation-genetic change occurs-altering growth &
function > Promotion-the altered cell continues to
undergo additional malignant changes.> Progression-involves the continued
growth of the cell containing the malignant phenotype.
Cancer Classification
Anatomic site (tissue of origin & behavior of tumor> Carcinomas-grown from epithelial cells;usually solid
tumors (skin,stomach, colon,breast)
> Sarcomas - arise from muscle, bone, fat, or connective tissue-may be solid.
> Lymphomas & leukemias- arise from lymphoid tissue(infection-fighting organs)& grow from bld.forming organ.
Histologic analysis (Grade 1- IV) Extent of disease (Clinical staging 0-IV)
> Stage 0: CA in situ > Stage 1: Localized tumor growth> Stage 11: Limited local spread> Stage 111: Extensive local & regional spread> Stage IV: Metastasis
Comparison of Benign & Malignant Tumors
Malignant BenignCell type Abnormal from
those of original tissues
Close to those of original tissues
Growth Rapid;infiltrates surrounding tissues in all directions
Slow & noninfiltrating
Encapsulated
Infrequent Frequent
Metastasis Through blood,lymph,or new tumor sites
Remains localized
Cancer Risk Factors
EndogenousAge- incidence increases with
age. Genetic heritage- exhibit a inheritance pattern.
Hormonal factors – influence the process of carcinogenesis.
Immunologic factors – malignant cells are antigenically different and should be recognized & destroyed by an intact immune system.
Cancer Risk Factors
External:Drugs and Chemicals- are proven carcinogen
Radiation- both ionizing & ultraviolet can cause CA.Tobacco- single most lethal known carcinogen
Nutrition- high in fat & calories.Viruses- several viruses have shown to
cause CA. Sexual practices- multiple partners are associated with cancer in females.
Psychological factors – life stressors can cause CA
Cancer Diagnosis-General
Cytology studies- (e.g. PAP smear) CXR Serum studies (e.g. CBC, liver
function test, oncofetal antigens) Proctoscopic exam Radiographic studies (e.g.
mammogram) CT/MRI Biopsy
Cancer Early warning signs
Change in bowel or bladder habits Any sore that does not heal Bleeding or unusual discharge Lump or thickening in breast or
elsewhere Indigestion or difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness
Cancer Treatment
Goal(s): Cure, Control, Palliation Treatment: > Chemotherapy > Radiation > Biologic Response Modifiers > Surgery
Cancer Chemotherapy- General
Effect of chemo is at the cellular level1. Interrupting cell life-modifies or interferes
with DNA synthesis.2. Eradicate cells, both normal & malignant, that
are in the process of cell reproduction.
PO & IV administration most common Adverse effect classified as:
> Acute:N/V, allergic reactions, disrhythmias> Delayed: mucositis, alopecia, bone
marrow suppression. > Chronic: damage to organs (e.g. heart, liver, kidneys & lungs)
Cancer Radiation- General
The major target of the radiation effect is DNA
Administration accomplished by:> External radiation-gamma rays, linear
accelerator > Internal radiation- isotopes, radium needles
Side effects include:> Fatigue
> Anorexia> Bone marrow suppression> Skin reactions> Pulmonary effects > GI effects > Reproductive effects
Radiation Therapy Implementation
Maintain bedrest when radiation source in place
Administer ROM exercises Observe for untoward effects:dehydration Observe & report skin eruption, discharge,
abnormal bleeding. Observe frequently for dislodging of
radiation source (linen & dressing) Notify MD if N/V, diarhea, frequent
urination or bowel movements or temp. above 100 F.
CancerBiologic Response Modifiers- General
Agents that modify the relationship between the host & the tumor
Classified as: > Interferons > Interleukins > Monoclonal Antibodies > Tumor necrosis Factor > Colony- Stimulating Factors
Common side effect: flu-like symptoms
Cancer Surgery
Classified as:> Cure & control: removal of
localized CA tissue: Primary site and site of metastasis. > Supportive care: insertion of therapeutic devices
> Palliation of symptoms: surgery to promote quality of life. > Rehabilitative management: reconstructive surgery.
Psychological Care for the Cancer Patient
Develop a collaborative relationship with the patient.
Always be honest with the client. Assist to cope with pain Provide general comfort measures Do not undermedicate for cancer pain Support family as they move through the
grieving process Introduce the hospice concept-provides
care for the terminally ill pt. & family.
Oncologic Emergencies
Sepsis- life-threatening & common death in pts, with CA.
DIC-triggered by many illnesses, including CA.Caused by sepsis from cancer cells. Strict adherence to aseptic technique.
SIADH- excessive amts. Of water are reabsorbed by the kidney & put into systemic circulation. Caused hypoNA. & some degree of fluid retention. Mild S/S-weakness, muscle cramps, anorexia, fatigue.
Oncologic Emergencies Superior Vena Cava Syndrome- is
compressed or obstructed by tumor growth.S/S- edema of the face, periorbital edema, tightness of the shirt or blouse collar(Stoke’s sign). High-dose radiation the most common tx.
Tumor Lysis Syndrome- large quantities of tumor cells are destroyed rapidly. TLS is a positive sign that CA tx. is effective. S/S-hyperuricemia. Hydration-3L to 5L of fluid.
Oncologic Emergencies
Spinal Cord Compression- when a tumor directly enters the spinal cord or when the vertebral column collapses from tumor entry. S/S- back pain, tingling; loss of urethral, vaginal, & rectal sensation, muscle weakness. Tx-palliative-high dose radiation-reduce the size of the tumor.
Hypercalcemia- CA in bones causes the bone to release calcium into the bloodstream. S/S-fatigue, anorexia, N/V, constipation, & polyuria.