Cancer FINAL Flashcards
Patho of cancer
o Defect in cellular proliferation - Cancer cells divide in an indis-criminate, unregulated
manner and exhibit significant variations in structure and size.
o Defect in cellular differentiation - Cancer can arise from any cell in the body that can
evade the normal regulatory controls of proliferation or growth and cellular
differentiation
Types of tumors
o Benign: encapsulated neoplasm that remains localized in the tissue of origin and is
typically not harmful.
o Malignant: nonencapsulated neoplasm that invades surrounding tissue. Depends on the
stage of the neo-plasm as to whether metastasis (spreading to distant body parts) occurs.
Common sites for metastasis
brain, liver, lungs, adrenals, spinal cord, & bone
Causes of cancer
- Chemical agents
- Radiation - Two forms of radiation, ultraviolet and ionizing
- Viral
- Genetic
Cancer prevention
a. Diet – Risks with low fiber, high fat/preservatives, smoked foods, salt-cured foods containing increased nitrates. Diets high fiber, fresh fruits/vegetables, low preservatives reduce the risk.
b. Stress – Decrease stress, or perception of stress, improve ability to manage stress
c. Carcinogens – Cigarette smoking, tanning beds, sun exposure
d. Weight – obesity associated with uterine, gallbladder, breast, & colon cancer. At least 30
minutes of moderate to vigorous exercise 5 days/week
e. Sleep – 6-8 hours of sleep a night is best
f. Alcohol – minimize of abstain
A diet high in fat may be a factor in the development of breast, colon, and prostate cancers.
True or False
True
High fiber diets may reduce the risk of colon cancer.
True or False
True
Seven warning signs of cancer
CAUTION
Changes in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump n the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change n wart or mole
Nagging cough or hoarseness
Therapy goals
A. Prophylaxis: to provide treatment when no tumor is detectable but when client is known to be at
risk for tumor development, spread, or recurrence.
B. Cure: Client will be disease-free and live to normal life expectancy.
C. Control: Client’s cancer is not cured but controlled by therapy over long periods of time.
D. Palliation: to maintain as high a quality of life for the client as possible when cure and control are
not possible.
Labs for different types of cancer
- Carcinoembryonic antigen (CEA)
- Alpha‑fetoprotein (AFP)
AFP- liver and testicular
PSA- prostate
CEA- lung, breast, stomach, colon, ovaries, pancreatic
General nursing implications
A. Observe for adverse effects.
B. Dosage is usually based on client’s body weight and height using the body surface area
calculation.
C. Monitor client and laboratory values for evidence of bone marrow suppression: infection from loss
of neutrophils, bleeding from loss of thrombocytes, and anemia from loss of erythrocytes.
D. Avoid contact with skin when preparing chemotherapy medications that are vesicants.
E. Do not administer a vesicant through a hand or wrist intravenous site; most are administered via a
CVAD.
F. General side effects of antineoplastic agents are nausea, vomiting, diarrhea, anorexia, alopecia,
hyperuricemia, nephrotoxicity, and bone marrow suppression.
G. Monitor renal and hepatic function to evaluate ability of client to break down and excrete
chemotherapeutic agents.
Med Classes
- Alkylating Agents: Kill cells by alkylation of the DNA; all are dose limiting by bone marrow
suppression. - Platinum Compounds: Have a similar action as the alkylating agents and are cell-cycle
nonspecific. - Antimetabolites: Disrupt critical cellular metabolism; cell-cycle specific; dose limited by bone
marrow suppression - Antitumor Antibiotics: Interfere with DNA synthesis; are not used to treat infections; poor GI
absorption, given IV. - Mitotic Inhibitors: Prevent cell division
- Hormonal Agents: Mimic or block the action of hormones.
- Aromatase Inhibitors: Used to treat estrogen receptor (ER) positive breast cancer in
postmenopause. - Immunostimulants: Biologic response modifiers that alter the host response to cancer cells.
- Targeted Drugs: Bind with specific molecules that drive tumor growth.
- Hematopoietic Growth Factors: Used to support cancer client.
The therapeutic ratio is the guiding principle of chemotherapy. What does that mean?
The aim is to administer an
antineoplastic agent dose large enough to eradicate cancer cells but small enough to limit
adverse effects to safe and tolerable levels
Severe reactions to chemotherapy
Numerous severe reactions to chemotherapy such as stomatitis, alopecia, bone marrow depression, nausea, and vomiting
Nursing care
-Maintain client at optimum psychosocial level
-Maintain nutrition
-Maintain healthy, intake skin
-Maintain normal elimination pattern
-Prevent and/or decrease infectious process
-Decrease hematologic complications
-Relieve pain
-Recognize complications specific to radiation and chemotherapy