CANCER

Predisposing Factors Precipitating Factors

Pathophysiology Clinical Manifestations Diagnostic Exams Treatment Prevention

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CA nC ER

CA NC ER

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CANCER
Predisposing Factors Precipitating Factors

Pathophysiology Clinical Manifestations Diagnostic Exams Treatment Prevention

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CANCER
-a malignant neoplasm or abnormal mass of the tissue

Predisposing Factors
Age- 65 and above Genetics Gender

Precipitating Factors
Dietary factors Physical ctivity Occupation Urban vs Rural residence Stress

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exposure to carcinogen damages DNA anything that penetrate a cell, gets into the nucleus and damages the DNA. additional assaults to the

cells results in further genetic damage.

cells are increasingly malignant in appearance and behavior and develop into 6/4/12 invasive cancer.

cancer cells move from primary location by breaking off from the original group and establishing remote colonies. These additional tumors are called Metastatic/ Secondary additional assaults to the Tumors. cells results in further genetic damage.
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bre ast skin

lun g

live r colo n

cervi cal

laryn geal
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prost atic

Clinical Manifestations
C -change in bladder and bowel A habits U sore that does not heal -a T-unusual bleeding/ discharge I-thickening of lump in the breast/ elsewhere O -indigestion/ difficulty in N swallowing A -obvious change in wart/ mole L
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-nagging cough/ hoarseness

Diagnostic Exams

Biopsy
-obtaining tissue sample for analysis of cells to be malignant
1. 2. 3. 4.

Needle Incisional Exicional Staging

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Diagnostic Exams Needle -aspiration of the cells in a fluid/ in a very soft tissue, X-ray & MRI to guide the needle 2. Incisional -removing wedge of suspected tissue from a
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Diagnostic Exams
3. Exicional -completely removing an entire lesion without removing any adjacent normal tissues 4. Staging -performing multiple needle/ incisonal biopsies in tissues 6/4/12

Diagnostic Exams
AFP (alpha-feto protein) liver CEA (carcinoembryonic-antigen) lungs HCG(human chorionic cervix gonadotropin) Prostatic Acid Phosphatase prostate PSA prostate HPV(human papilloma virus) cervix Barium enema colon Colonoscopy colon
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Treatment
Surgical Interventions Radiation Therapy Chemotherapy Immunotherapy Bone Marrow Transplantation

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Surgical Interventions
Cytoreductive Surgery
-rebulks removing the part of the tumor and leaving a known amt. of gross tumor , cant result in a cure but chance that other therapy can be successful.

Palliative Surgery
-reduce pain by such interrupting nerve pathways/ implanting pain 6/4/12

Radiation Therapy
Teletherapy
-external radiation, pose no hazards, distant treatment -radiation source is external to the client -client is not radioactive NURSING RESPONSIBILITIES

keep area dry and wash H20, no soap 6/4/12

Radiation Therapy
Brachytherapy
-internal radiation, short/ close
therapy -radiation source comes indirect -client is not radioactive
2 Types of Brachytherapy
1. Unsealed Radiation Source -can be excreted on urine, blood, sweat and vomitus because it circulates in the body 6/4/12

material thus the radioisotope cannot circulate throughout the clients body

NURSING RESPONSIBILITIES
Use Ducimeter badge Use long forceps Save all linens and dressings after 24 hrs. Instruct client to flush toilet 2 6/4/12 times.

Chemotherapy
-destroys the malignant ca cell
excessive destruction of normal cells
3 Types of Chemotherapy
1. 2. 3.

Adjuvant Neo Adjuvant Combination

Classification of Chemotherapy
Alkalyting 2. Antimetabolite 6/4/12 3. Antitumor Antibiotic
1.

3 Types of Chemotherapy
Adjuvant
-to eliminate remaining submicroscopic Ca cells that are suspected to be still present Neo Adjuvant -given as pre op to reduce the bulk or to lower down the stage of tumor making it amenable for surgery. Neo Adjuvant 6/4/12

Classification of Chemotherapy
Alkalyting
-to create defects on tumor DNA, inhibits cell division Ex: Cisplatin S/E: n/v, cystitis, stomatitis
-closely reesemble normal metabolytes that can fool Ca cells into using the antimetabolites in cellular reaction 6/4/12

Antimetabolites

NURSING RESPONSIBILITIES
In case of anaphylactic reaction: Stop the drug admin and maintain airway patency Place in supine position if not C/I Monitor v/s q2mins until the client is stable Chemo drug escape from the veins Top infusion & withdraw as much as possible Dont remove the cannula Inform the physician when flushing the NSS 6/4/12

Prevention

Breast >40yrs. annual mammogram, clinical breast exam and monthly SBE 20-39 yrs. old- breast exam evey 3 yrs. & monthly SBE Colon and rectum fecal occult blood- every yr. flexible sigmoidoscopy6/4/12 every 5 yrs.

Prostate

digital exam annually

50 or 45 yrs old PSA and

Cervix

40 yrs (sexually active)- Pap Smear & Pelvic Exam 21-70 yrs old should undergo HPV test vaccine

Oral Exam and Skin Exam

20- 40 yrs. old- every 3 yrs.

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Nursing Care Plans

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Nursing Diagnosis:

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Goal

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NURSING INTERVENTIONS

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Nursing Diagnosis
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Goal

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