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• Heredity
• Stress
Psychological
Physical
• Unuse
• Overuse
• Abuse
• Specific
Theories of Cancer
Virus
Chemical / Physical Agent
Drugs
Hormones
Genetic Alteration
Defective Cell
Malignancy
Failure of Immune Response Theory
Potential
Cell Ab
(d e s
truc t
io n)
A
bA b
Immune system
fails
Ab
Classification
Tumor
•1 - small
• 2-3 - medium
• 4 - large
Node
•0 - no involvement
• 1-3 - moderate
•4 - extensive
Metastasis
•0 - no metastasis
•1 - metastasis
Warning Signs of Cancer
C - change in bowel or bladder habits
A - sore that does not heal
U - unusual bleeding or discharge
T - tumor
I - indigestion or difficulty in swallowing
O - obvious change in warts or moles
N - nagging cough or hoarseness of voice
U - unexplained anemia
S - sudden weight loss
Comparison of Benign & Malignant Neoplasm
Predisposing factors
• Heredity
• Pulmonary irritants
Poor prognosis
Pathophysiology
Irritation series of changes
tumor
Metastases – primary sites
Some tumors secrete
hormones:
• ADH – reabsorption of water
• ACTH – stimulates adrenal
glands to produce steroids
Symptoms may include:
• Cough
• Wheezing
• Shortness of breath
• Chest pains
• Hoarseness
• Dysphagia (compression of esophagus)
• Weight loss
Nursing Interventions
Adequate oxygenation
Prepare for surgery if tumor is small
enough to be removed
Prepare patient for planned
treatments
• chemotherapy
• radiation therapy
Analgesics as ordered
Maintain nutritional status
Provide emotional support
BLA DDER
CANCER
More common in males
Cause: unknown
Risks factor s
1. Exposure to ci garette
smoke
2. Pel vi c radi ati on
3. Use of
cycl ophosphami de
4. Chroni c cyst iti s
As ses sment
Development of f is tula
Collaborative
Management
Chem ot herapy
Thi otepa
Mitomyci n C
Do xorubi ci n (Adri amyci n)
Cycl ophosphami de
(cytoxan)
Ci spl ati n (Pl ati nol)
Met hotrexate
Radi ati on
Surgery
•Urinary Diversion
Surgeries
Ileal Conduit
Ureterostomy
Ureterosigmoidosto
my
Ileal Conduit
For CA
Bladder
Adult
Neurogenic
Bladder
Insterstitial
Cystitis
Irreparable
Important! Compl icati ons
External Obstructio n
uri ne le ak to Stoma
the ski n prol apse
Ski n care Cal cul i
Ureterostomy
Either or both
ureters are out
to the
abdominal wall
Ureteral stoma
is created
External
collection
device is
needed
Infection is a
Nephrostomy
To drain the
urine while
ureteral
inflammation
from trauma
or calculus is
present
Complications Important!
Infection DO NOT
(Pyelonephriti IRRIGATE!!!
s)
Blockage of
the catheter
Ureterosigmoidostomy
No external
collection
device
Passage of
flatus
includes leak
of urine
Infection is
possible
PROSTATE
CANC ER
Most comm on mal e Ca
(gender -s pecif ic)
Androgen – dependent
adenocarci nomas
Predisposing Factors
Genet ic tendency
50 y ears o f age
• Late puberty
• High frequency of sexual
experi ence
• History of multi pl e sexu al
partners
• High fertil ity
Diet
• ↑fat (alters cholesterol and
steroid metabolism)
Chemical carcinogens
• Air pollution
• Occupation-related
industries – fertilizer, rubber,
textile
batteries containing
Cadmium
Assessment
Hesistancy
Hematuria
Urinary retention
Stool changes
Pain radiating down hips and legs
Cytitis
Dribbling
Nocturia
Hard, enlarged prostate
Pain on defecation
phospatase
Elevated PSA (Prostatic
Specific Antigen)
Nursing Interventions
Early detection of tumor
• Ultrasound
• MRI
• X-ray
• CT Scan
Radiation therapy
Endocrine therapy - DES
(diethylstilbestrol) decreases
testosterone level)
Surgery: Prostatectomy
Hodgkin’s
Disease
malignant tumor of lymphatic
system
Ca use :
• Unknow n
• Vi ral associ ati ons
• Auto imm uni ty
Incid ence:
• Young adul t 15- 35
Pathophysiology
Proliferation of abnormal T-Cells
Obstruction in lymphatic flow
Metastases
Pain
Spleen
Fever
Liver
Weight Loss
Lungs
Malaise
Heart
Management
MO PP
• Watch out for BM
depressi on
ABVD
• Causes re d ur ine
Nursing Intervention
Support ive
•N/ V
•F & E
•Co mfort me asu res
Protection from infection
Maintain Tissue Integrity
Temperature
Prevent or decrease pain
others to cope
COLORECTAL
CANCER
Cause: Unknown
Predisposing Factors:
• Age above 40 years
• Predisposing Factors
√ low in fiber
√ high in fat, protein and refined
carbohydrates
Obesity
polyps
Family history of colon cancer
Compression on the
surrounding surface Primary sites
•Lungs
•Liver
•Ischemia
•Lymph nodes
• necrosis
•Renal veins
• hemorrhage
Signs and Symptoms
Abdominal pain
Hematuria
S/sx of shock
Nursing Interventions:
Monitor closely for:
• Fluid and electrolyte status.
• I&O
• Acid-base balance
Symptomatic
Prepare for possible surgery
Institute postop care