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Possible treatment goals:
Curecomplete eradication of
malignant ds.
Control- prolonged survival &
containment of cancer cell growth
Palliation- relief of symptoms
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The primary method of treatment or
maybe prophylactic, palliative or
reconstructive
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Biopsy
performed to obtain a tissue sample for
analysis of suspected malignant cell
Mostly taken from actual tumor
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A. Excisional
For easily accessible tumors of the skin,
breast, upper & lower GIT & upper
respiratory tract.
Removes the entire tumor and
surrounding marginal tissues.
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B. Incisional
Performed if tumor mass is too large to
be removed.
Removes a part of the tumor.
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C. Needle method
performed to sample suspicious masses that are
easily accessible (breast, thyroid, liver & kidney).
Local anesthesia used
fine needle or core needle into a solid tumor
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To remove the entire tumor or debulking &
any involved surrounding tissue & regional
lymph nodes
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i. Local- removal of mass and a small margin
of normal tissue that is easily accessible.
ii. Wide or radical excisions (en bloc
dissection)- removal of primary tumor,
lymph nodes & adjacent structures.
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Electrosurgery Make use of electrical current to destroy the tumor cell.
Cryosurgery Used liquid nitrogen to freeze tissue thus causing cell
destruction.
Chemosurgery Combined topical chemotherapy & layer by layer
removal of abnormal tissue.
Laser surgery (light amplification by stimulatedemission of radiation)
Used of light & energy aimed at an exact tissue location &depth to vaporize cancer cells.
Stereotactic radiosurgery Single & highly precise administration of high dose
radiation used in some types of brain, head & neck
cancer.
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Removal of nonvital tissues or organs that
are likely to develop cancer.
Example: colectomy, mastectomy,
oophorectomy.
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Family history and generic predisposition
Presence or absence of symptoms
Potential risks and benefits
Ability to detect cancer at an early age
Patients acceptance of the post op outcome.
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If cure is not possible this treatment aims to
alleviate signs & symptoms and promote
patients comfort.
It is necessary to provide honest informative
information to avoid false hope and
disappointment .
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To improve function or obtain a more
desirable cosmetic effect
May follow curative & radical surgery
Maybe indicated for breast , head, neck &
skin cancer.
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Preop assessment General Preop nsg care
Provides health education
Provide emotional support Explain & clarify information that
physicians initially provided.
Assess patient response to surgery. Monitors possible complications.
Post op teachings
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Uses an ionizing radiation to interruptcellular growth.
Types of ionizing radiation:
Electromagnetic rays- x-rays & gamma rays
Particles
- electrons(beta particles), protons, neutrons, &alpha particles.
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It maybe used to:
Cure the cancer (hodgkins disease, testicular
seminomas, thyroid carcinomas, localized
cancers of the head & neck & cervical
cancer.
Control malignant disease
Prophylactic (prevent leukemic infiltration to
brain or spinal cord)
Relieve symptoms of metastatic disease
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1. During DNA synthesis & mitosis
2. Well oxygenated tumor
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An external beam radiotherapy directs
the radiation at the tumor from outside
the body.
The higher the energy the deeper the
penetration.
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Kilovoltage therapy devices
("superficial") X-rays are used for treating skin cancer and
superficial structures.
Linear accelerators & beatron machines
Higher energy X-rays are used to treat deep-seated
tumors (e.g. bladder, bowel, prostate, lung, or brain) with
less harm to the skin & less scattering of radiation to body
tissues.
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Gamma rays
Uses radioactive element (Cobalt 60) to deliver
radiation dose beneath the skin surface, sparing
skin tissue from adverse effects.
Particle beam radiation therapy
Accelerates subatomic particles through body
tissues.
Damages target cells as well as its pathway.
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Intraoperative radiation therapy
Delivering a single dose of high fraction radiation
to the exposed tumor bed while body cavity is
open during surgery.
Gastric, pancreatic, colorectal, bladder &
cervical cancers & sarcomas.
Precisely targeted to the diseased area and
avoid exposure of overlying skin and structures.
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Brachytherapy