Cancer Flashcards
What is Cancer
Group of more than 200 diseases
Characterized by uncontrolled and unregulated growth of cells
Occurs in people of all ethnic groups and all ages
Tumors can be classified as?
benign or malignant neoplasms
Benign neoplasm
Well differentiated
Usually encapsulated
Expansive mode of growth
Progression of cancer
Characterized by
Increased growth rate of tumor
Invasiveness
Metastasis
Most frequent sites of metastasis are
lungs
brain
bone
liver
adrenal glands.
The pathogenesis of cancer metastasis.
To produce metastases, tumor cells must detach from
the primary tumor and enter the circulation, survive in the circulation to arrest in the capillary bed, adhere
to capillary basement membrane, gain entrance into the organ parenchyma, respond to growth factors,
proliferate and induce angiogenesis, and evade host defenses.
Metastasis process begins with?
rapid growth of primary tumor.
Develops its own blood supply
Critical for survival and growth of tumor
Tumor angiogenesis is formation of blood vessels within tumor.
Certain segments of primary tumor can detach and invade surrounding tissues.
Detached cells can invade lymph nodes and vascular vessels to travel to distant sites.
Most mobile tumor cells do not survive.
Surviving tumor cells must create an environment conducive to growth and development.
Tumors can be classified by
Anatomic site
Histology
Grading severity
Extent of disease
Staging
Four grades of abnormal cells
Grade 1
Grade 2
Grade 3
Grade 4
Grade I
Cells differ slightly from normal cells and are well differentiated.
Grade II
Cells are more abnormal and moderately differentiated
Grade III
Cells are very abnormal and poorly differentiated.
Grade IV
Cells are immature and primitive and undifferentiated.
Cell of origin is difficult to determine.
Clinical staging classifications
0: Cancer in situ
1: Tumor limited to tissue of origin; localized tumor growth
2: Limited local spread
3: Extensive local and regional spread
4: Metastasis
Lifestyle habits to reduce risks:
Avoid or reduce exposure to known or suspected carcinogens.
Cigarette smoke, excessive sun exposure
Eat a balanced diet.
Exercise regularly.
Obtain adequate rest.
Have a regular health examination.
Change perceptions of stressors.
Know seven warning signs of cancer.- C-Change in habits(bowel or others)-A- a sore not healing, U-Unusual bleeding/discharge,T-Thickening of lump, I-Indigestion, O- Obvious change in wart mole, N-Nagging cough
Practice recommended cancer screenings.
Practice self-examination.
Seek medical care if cancer is suspected.
Diagnoses of Cancer
Patient may experience fear and anxiety.
Nurse should
Give clear explanations, repeat if necessary
Give written information for reinforcement
Actively listen to patient’s concerns
Diagnostic plan includes
Health history
Identification of risk factors
Physical examination
Specific diagnostic studies
PET/CT/MRI
Biopsy-Benign or malignant/Staging
Surgical Therapy
Prevention
Cure or control
Supportive- Feeding tubes, surgical fixation of bone.
Palliative
Treatment
Pain control- around the clock analgesics- Don’t wait until pain starts. Should also have medcation for break through pain
Chemo
Radiation
Radiation Therapy for Cancer
Purpose – Destroy cancer cells with minimal damaging effects of surrounding normal cells; maintain safe environment
Local treatment
Exposure – Amount of radiation delivered
Radiation dose – Amount of radiation absorbed
Side Effects of Radiation Therapy
Acute and long-term site-specific changes
Vary according to site
Local skin changes and hair loss
Altered taste sensations
Fatigue- may last for months or years
Bone marrow suppression
Patient-Centered Collaborative Care
Provide accurate information to help patients cope
Skin care needs during radiation therapy-Loose clothing, avoid harsh fabrics, Use mild soaps and lotions without perfume
Do not remove temporary ink markings
Avoid skin irritation
Avoid exposure to direct sunlight
Follow radiation-oncology department’s policy for skin care product use-
Nutritional support
Care for xerostomia (dry mouth)
Teach about risk for fractures (for bone exposed to radiation)
Exercise and sleep interventions for fatigue
Chemotherapy
Treatment of cancer with chemical agents
Used to cure and increase survival time
Adjuvant therapy = Chemotherapy + surgery or radiation
Cytotoxic effects exerted on healthy cells and cancer cells
Chemotherapy Drugs
Alkylating agents
Antimetabolites
Antimitotic agents
Antitumor antibodies
Topoisomerase inhibitors
Miscellaneous chemotherapeutic agents
Treatment Issues
Dosage
Administration
Extravasation- Look up
Vesicants- Chemo drugs that cause blistering-
Extravasation
- Most important nursing intervention is prevention*
- If IV site is swelling then stop, check F/C, better to have central sites
Health Care Provider Safety
Specific protocol for handling chemotherapy drugs, or excreta from patients receiving IV chemotherapy-
Same precautions with oral chemotherapy & IV-
PPE
Eye protection
Masks
Double gloves (or “chemo” gloves)
Gown
Double flush when they go to the bathroom
Patient-Centered Collaborative Care: Protection from Side Effects
Infection risk
Anemia, thrombocytopenia risk
Infection risk
Bone marrow suppression
Neutropenia
Decreased immune function –older population at higher risk
Anemia, thrombocytopenia risk
Bone marrow suppression
Impaired clotting
Patient-Centered Collaborative Care: Protection from Side Effects
Chemotherapy
Mucositis
Alopecia
Cognitive changes
Chemotherapy side effects prevention
Chemotherapy-induced nausea and vomiting (CINV)-Give anti-emetics 1 hour before chemotherapy
Chemotherapy-induced peripheral neuropathy (CIPN)
Mucositis side effects prevention
saline solution rinses not antiseptic they are more irritating, soft toothbrush, no hydrogen peroxide anesthetic gel before meals-to decreased pain
Alopecia side effect prevention
wigs, hat, scarves to help keep up self esteem
Biologic and Targeted Therapy
Biologic therapy – derived from living organisms
- Have direct antitumor effects
- Restore, modulate host immune system mechanism
- Interfere with cancer cell’s ability to metastasize or differentiate.
Targeted Therapy- work at sites that are on cell surface, intracellular level or extracellular domain
Less damage to normal cells as compared to chemotherapy
Interfere with cancer cells and are less damaging to regular cells then chemotherapy
Hematopoietic Stem Cell Transplantation
Bone marrow transplantation
Peripheral stem cell transplantation
