Cellular Aberration Flashcards
Disease condition wherin the NORMAL cells becomes ABNORMAL and PROLIFERATES abnormally.
Cancer
Incidence of Cancer
-Cancer affects every age group though most cancer and cancer deaths occur in people older than 65 years old.
-Cancer ranks 3rd as the cause of morbidity in the Philippines
-Highest incidence of all cancer is Prostate Cancer
-Highest cancer incidence in males in order of frequency: Prostate, Lung, and Colorectal
-Highest cancer incidence in females in order of frequency: Breast, Lung, and Colorectal
Branch of medicine that deals with the study, detection, treatment, and management of cancer.
Oncology
Interphase
G1 – RNA & Protein Synthesis
S – DNA Synthesis
G2 – Pre mitosis
Mitosis Phase
Actual cell division
NEO
New
PLASIA
Growth
TROPHY
Size
OMA
Benign Tumor
Stasis
Location
A
Absence
ANA
Lack
Hyper
Excessive/increase
META
Change
DYS
Bad, impaired
SARCOMA
Malignant tumor in connective tissues
CARCINOMA
Malignant tumor in epithelial tissues
BLASTOMA
Malignant tumor that starts in immature cell
Immune System (low)
Cancer cells are already in the body but INACTIVE
Due to stressors:
Cancer cells ACTIVATED
Failure of Immune Response Theory
No cancer cells in the body
Due to exposure to CARCINOGENS:
Cancer cells DEVELOPS
Cell Transformation Theory
Atrophy
Absence/decrease in size
Hypertrophy
Excessive/increase in size
Hyperplasia
Excessive/Increase in growth
Metastasis
Change in location
Dysplasia
impaired growth
anaplasia
absence of growth
neoplasia
new growth
dystrophy
bad size
Types of Carcinogens
-Chemical Carcinogens
-Physical Carcinogens
-Viral Carcinogens
-Dietary Carcinogens
Chemical Carcinogens
Alcoholic beverages
Smoking
Asbestos
Benzene
Arsenic
Pesticides
Sunlight
Physical Carcinogens
Radiation
Chronic Irritation of Tissue – GERD
Viral Carcinogens
Human Papilloma Virus
Genital Herpes
Hepatitis B
Personal Factors Causing Cancer
Immune function
Age
Gender
Genetic risk
Race
Carcinogenesis
- Initiation
- Promotion
- Progression
Carcinogenesis:
Occurs when carcinogen damages DNA
Initiation
Carcinogenesis:
Occurs with additional assaults to the cell
Promotion
Carcinogenesis:
Cell proliferation
Progression
NORMAL CELLS vs CANCER CELLS
MITOSIS
Normal cells: Leads to 2 daughter cells
Cancer Cells: Leads to multiple daughter cells
NORMAL CELLS vs CANCER CELLS:
APPEARANCE
Normal Cells: Homogeneous in size, shape, and growth
Cancer Cells: Larger and grow more rapidly
NORMAL CELLS vs CANCER CELLS:
Apoptosis
Normal Cell: Present
Cancer Cell: Impaired
NORMAL CELLS vs CANCER CELLS:
Growth Pattern
Normal Cell:
Do not invade to adjacent tissue
Cannot grow outside environment
Cell death = Cell birth
Cancer Cell:
Invades to adjacent tissue
Able to migrate to another site
Cell death < Cell birth
Ability of cancer cells to spread from the original site of the tumor to distant organs
Cancer Metastasis
Modes of Metastasis
- Lymphatic Spread
- Hematogenous Spread
(+) Capsule (Well differentiated)
Slow to grow
High survival rate
Growth: Expansion
Affects surrounding tissues
(+) Pain –Due to compression of surrounding tissues.
Ideal Tx: Surgery
Benign
(-) Capsule (Poorly differentiated)
Rapid growing
Low survival rate
Growth: Metastasis / Invasion
Affects other organs
(+) Pain – Due to metastasis
Ideal Tx: Radiation / Chemo
Malignant
A nurse obtains health histories when admitting clients to a medical-surgical unit. With which client should the nurse discuss predisposition genetic testing?
a. Middle-aged woman whose mother died at age 48 of breast cancer
b. Young man who has all the symptoms of rheumatoid arthritis
c. Pregnant woman whose father has sickle cell disease
d. Middle-aged man of Eastern European Jewish ancestry
a. Middle-aged woman whose mother died at age 48 of breast cancer
The nursing instructor explains the difference between normal cells and benign tumor cells. What information does the instructor provide about these cells?
a. Benign tumors grow through invasion of other tissue.
b. Benign tumors have lost their cellular regulation from contact inhibition.
c. Growing in the wrong place or time is typical of benign tumors.
d. The loss of characteristics of the parent cells is called anaplasia.
c. Growing in the wrong place or time is typical of benign tumors.
A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching?
a. “Foods high in vitamin A and vitamin C are important.”
b. “I’ll have to cut down on the amount of bacon I eat.”
c. “I’m so glad I don’t have to give up my juicy steaks.”
d. “Vegetables, fruit, and high-fiber grains are important.”
c. “I’m so glad I don’t have to give up my juicy steaks.”
What is the purpose of staging cancer?
To determine specific treatment on specific stage
Cancer in situ (in place)
Stage 0
Cancer is limited in distal origin (Occupies space to surrounding tissues)
(Pain Starts)
Stage 1
Lymph node involvement
(Metastasis Starts)
Stage 2
Spread distal or regional
Stage 3
Wide spread metastasis
> 1st Priority: Pain Management
DOC: Narcotics (Morphine Sulfate)
> 2nd Priority: Spiritual Care
Stage 4
TNM Meaning
Tumor
Node
Metastasis
Tumor Classification
T0: No tumor found
Tis: Tumor in situ
T1: 0-2 cm
T2: 2-5 cm
T3: >5 cm
T4: Tumor has been broken
Tx: Tumor can’t be measured
Node Classification
Nx: Lymph node involvement cannot be assessed
N0: No lymph node involvement
N1: 1-3 nodes involved
N2: 4-6 lymph nodes involved
N3: >7 lymph nodes involved
Metastasis Classfication
M0: No metastasis
M1: Positive metastasis
WARNING SIGNS OF CANCER
Change in Bowel / Bladder Habits (Colon, Bladder)
A sore that does not heal (Skin Cancer)
Unusual bleeding (Leukemia)
Thickening of the lump (Hodgkin/Non Hodgkin)
Indigestion – Feeling bloated but walay mugawas
Obvious change in warts/moles (Skin Cancer)
Nagging cough (Laryngeal, Lung Cancer)
Unexplainable anemia (Leukemia)
Sudden weight loss
Prevention of Cancer Key Points
Prevention is a priority in oncology nursing because at least one third of all cancers are preventable
Cancer is also curable if detected and treated early
PREVENTION TEACHINGS
Reduce or avoid exposure to known or suspected carcinogens
Eat a balanced diet that includes fresh fruits and vegetables, whole grains, and adequate fiber
Limit Alcohol Intake
Participate in regular exercise
Maintain a healthy weight
Obtain adequate rest periods (6-8 hours per night)
Eliminate, reduce, or change the perception of stressors and enhance ability to cope
Have a regular physical exam
TREATMENTS
Oral Therapy
Radiation Therapy
CHImotherapy
D Bone marrow aspiration
Surgery – Most common mode of treatment
Reduces the size of tumor
Relieves obstruction
Targets: Cancer Cells
Radiation Therapy
Types of Radiation Therapy
Internal
External
Types of Internal
Sealed
Unsealed
(+) Container
Implants:
- Cobalt
- Cervical
Sealed
(-) Container
Oral & IV
Unsealed
Brachytherapy
Internal Radiation therapy
(+) Residual Radiation
Flush the CR at least 3 times
Lock the door at all times
Avoid exposure to child and pregnant
Internal Radiation Therapy
Uses beam of light (UV Rays)
S/E: Dermatitis (Temporary)
External
Teletherapy
External
(-) Residual Radiation
External
BETA Rays
Penetrates into the skin
Use: RUBBER GLOVES & LEAD APRON
Internal
GAMMA Rays
Penetrates into the bones
Use: LEAD APRON
External
Factors Affecting Exposure to Radiation
S hielding
T ime
D istance
Private room
Farthest room available
Avoid pregnant & children
Wear lead apron
Handling secretions & discharges:
1. Wear rubber gloves when handling bedpan
2. Flush the toilet at least 3 times
Patient with implants:
1. Bedrest – Flat/Supine position
2. Offer bed pan to maintain bed rest
3. Log roll to turn the patient
4. Patient facing opposite the door
5. Nurse must stand opposite to the implant
6. Sexual activity may resume 3 weeks after removal of implant.
In case of DISLODGE:
1. Pick up with long handled forcep
2. Place implant in LEAD CONTAINER
If not found:
1. Close the door and leave the room
2. Call the radiology department
Shielding
30 minutes per shift
5 mins per exposure
6 times per shift
Care only 1 patient at a time
Wear a dosimeter badge to measure exposure and amount of radiation
Time
Maintain at least 6 feet when not performing procedures.
Pwede mu doul if mag perform ug procedures.
Distance
Use of a vesicant drug to interrupt the cell cycle
Targets: Normal & Cancer Cells
Chemotherapy
Routes of Chemotherapy
ORAL - mouth
IM - muscle
IV - vein
Intracavitary – body cavities
Intrathecal – CSF pathway
Intraarterial - Arteries
Topical - Skin
Chemotherapy Drugs
-Alkylating Agents
-Antimetabolites
-Anti tumor Antibiotics
-Plant Alkaloids
-Corticosteroids
Cell Cycle Non-Specific Drugs
Alkylating Agents
Anti tumor antibiotics
Corticosteroids
Cell Cycle Specific Drugs
Antimetabolites (S Phase)
Plant Alkaloids (M Phase)
Alkylating Agents
Cyclophosphamide (Cytoxan)
Busulfan (Myleran)
Cisplastin (Platinol)
Mechlorethamine (Mustargen)
AE: Hemorrhagic Cystitis
- Route: PO on empty stomach
Cyclophosphamide (Cytoxan)
Myleran
- Taken at same time every day
- Route: PO on empty stomach
Busulfan (Myleran)
Platinol
AE: Tinnitus
Cisplastin (Platinol)
-Vesicant Drug
Mechlorethamine (Mustargen)
Antimetabolites
Fluorouracil (5 FU, Adrucil)
Methotrexate (Folex)
Mercaptoprine (Purinethol)
5 FU, Adrucil
Fluorouracil
- Follic Acid Antagonist
- Antidote: Leucovorin
Methotrexate
Purinethol
Maintenance for all leukemia
Mercaptoprine
Anti Tumor Antibiotics
Bleomycin (Blenoxane)
Doxorubicin (Adriamycin)
Bleoxane
Bleomycin
Adriamycin
- Needs cardiac monitoring
- Harmful to bone marrow
Doxorubicin
Plant Alkaloids
Vinblastine (Velban)
Vincristine (Oncovin)
Bone marrow friendly but can cause neuropathy
Plant Alkaloids
Velban
Vinblastine
Oncovin
Vincristine
Corticosteroids
Prednisone
Dexamethasone
COMPLICATIONS OF RADIATION & CHEMOTHERAPY
- Bone Marrow Depression
- Sterility
- Skin Problems
- Nausea & Vomiting
- Stomatitis
- Xerostomia
- Dryness of Vagina
- Alopecia
Bone Marrow Depression (radiation and chemotherapy)
low RBC
Aplastic Anemia
Bone Marrow Depression (radiation and chemotherapy)
low WBC
Prone to Infection
Bone Marrow Depression (radiation and chemotherapy)
Low Platelet
Risk for Bleeding
Bone Marrow Depression
Aplastic Anemia
-Blood transfusion
-Fatigue - do non-strenous activities with frequent rest
-Dyspnea - o2 administration
-Diet - increase iron intake
Bone Marrow Depression
Prone to Infection
-Place in private room
-Hand washing
-Avoid crowded place
-Avoid fresh fruits and vegetables
-Processed foods are okay
Bone Marrow Depression
Risk For Bleeding
-Avoid IM, but if given, apply pressure
-Avoid contact sports, pwede swimming
-Avoid anticoagulants
-Soft bristle toothbrush
-Use electric razor
-Wear non-slip slippers
-Avoid walking barefooted
Sterility (radiation only)
-Female: Oopherexy - Elevate ovaries para dili ma igo sa external radiation - Egg freezing
-Male: Orchiopexy - Elevate testes para dili maigo sa external radiation - Sperm banking
Skin Problems
Radiation
Dermatitis
Skin Problems
Chemotherapy
Extravasation
Skin Problems:
-Localized skin reaction
-Cold application
-Mark the area prior to therapy
-Wash with plain water and mild soap
-Avoid:
Lotion
Powder
Alchohol
-Pat dry; do not rub
-Avoid constrictive clothing
-Avoid direct sunlight on site
Dermatitis
Skin Problems:
-Redness
-Swelling
-Burning sensation on site
-Prior to administration:
1. Ensure IV patency
2. Maintain vision during administration
-When preparing, nurse must wear:
1. Mask
2. Goggles
3. Gown
4. Gloves
Extravasation
-Chemotherapy only
-Plan of care:
1. Give on empty stomach
2. Administer anti-emetics 30 minutes – 1 hour prior to chemo.
Nausea and Vomiting
-Indicates immunosuppression
-Management:
1. Assess for sore, blisters, discharges
2. Avoid alcohol-base products
3. Gargle with a pinch of salt
Stomatitis
Dryness of the mouth
Management:
1. Apply petroleum jelly
2. Offer ice-cold fluids (popsicles)
Xerostomia
Management:
1. Avoid alcohol-base products (feminine wash)
2. Apply KY jelly (water-based lubricant)
3. Apply cornstarch with water as mud pack
Dryness of Vagina
Temporary
Assure that it will grow 6 months after chemotherapy
But it may change qualities
Offer wig before alopecia occurs aron dili mahalata na wala nay buhok
Alopecia
A male client with nagging cough makes an appointment to see the physician after reading that this symptom is one of the warning sign of cancer. What is another warning sign of cancer?
Persistent nausea
Rash
Indigestion
Chronic Ache / Pain
Indigestion
In the client with terminal lung cancer, the focus of nursing care is on which of the following nursing intervention?
Prepare the client’s will
Provide pain control
Provide nutritional support
Provide emotional support
Provide pain control
Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics?
When therapy is completed
Immediately after nausea begins
With administration of chemotherapy
30 minutes before the initiation of therapy
30 minutes before the initiation of therapy
The staging of the client’s cancer by the TNM classification is T1,N3,M1. What is the nurse’s interpretation of this classification?
a. The client has two tumors that are non responsive to treatment.
b. The client has leukemia confined to the bone marrow.
c. The client has a 2 cm tumor with 1 regional lymph node involved and no distant metastasis.
d. The client has a small primary tumor, tumor extension into three lymph nodes, and one site of distant metastasis.
d. The client has a small primary tumor, tumor extension into three lymph nodes, and one site of distant metastasis.
The nurse is caring for a client receiving chemotherapy. Which of the client suggest he does NOT understand the side effects of therapy?
a. Using an electric razor
b. Eating a high protein diet
c. Taking his children to see santa at the mall
d. Calling a doctor if there is an increase in temperature
c. Taking his children to see santa at the mall
Complications Resulting From Cancer
- Malnutrition
- Altered Taste Sensation
- Infection
- Pain
Complications Resulting From Cancer:
Pain Management
Instruct to keep a pain management diary
Administer pain relievers: NSAID and OPIOIDs
Complications Resulting From Cancer:
Malnutrition Management
Soft, non irritating high protein, and high calorie foods
Avoid extremes of temperature, tobacco, alcohol, spicy foods, and other irritants.
Teach the patient to use nutritional supplements
Complications Resulting From Cancer:
Altered taste sensation management
Avoid foods that are disliked
Experiment with spices and other seasoning
Complications Resulting From Cancer:
Infection Management
Instruct patient to report temperature of 38c or greater
Avoid crowded places
Avoid people with illness
No live attenuated vaccines or avoid people who received it for at least 3 days from the day of vaccination
Unregulated growth of cancer cells in the breast tissue.
Estrogen-dominance cancer
Breast Cancer
Breast Cancer Risk Factors: (LONGFOE)
Late menopause (After 55 y/o)
Obese
Nullipara
Genetics
Female
Obese (fat)
Early menarche (Menstruation before 12 y/o
DIAGNOSTIC (BREAST CANCER):
-Detects tumor before it can be felt
-Uses low dose X-ray
-Baseline: 35-39 y/o
Yearly: 40 years old and above
-Pre-procedural teachings:
1. No chemicals to apply
2. Patient may experience discomfort during procedure
Mammogram
DIAGNOSTIC (BREAST CANCER):
-Start : 20 years old
-Frequency : Monthly
-Schedule : 1 week after menstruation (Start counting on the 1st day)
-Irregular/Menopause: Same day each month
-Position : Standing in shower in front of mirror
Lying in bed in front of mirror
Breast Self Exam
DIAGNOSTIC (BREAST CANCER):
Gold standard / Confirmatory
2 types:
1. Percutaneos – Fine Needle Aspiration
2. Surgical
Biopsy
SIGNS OF BREAST CANCER (AVON)
Assymetrical
Venous prominence
Orange – peel skin
Nipple dimpling with discharges (pus)
MANAGEMENT OF BREAST CANCER
- Radiation & Chemotherapy
- DOC: > Tamoxifen
- Hormone antagonist
- To decrease estrogen level
> Diethyl Stibestrol (DES)
- Synthetic estrogen - Surgery:
> Lumpectomy – Excision of breast mass
> Simple / Total Mastectomy – Removal of entire breast
- Complication: Lymph Edema
- POC: Semi-fowlers with 1-2 pillows under affected arm
- Avoid BP & IV puncture on affected side
- Avoid lifting, gardening using affected arm
- Encourage ROM: - Hair combing
- Hand wall climbing
- Rope rotation
> Radical Mastectomy – Removal of breast, lymph node, and pectoralis minor
> Modified Radical Mastectomy- “Halstead Procedure”
- Ibilin ang PECTORALIS MINOR for breast implant
Helen, a leukemia patient, has entered the phase known as “the nadir.” As a nurse, you ste aware of the following facts regarding this time period:
A. Patient helen is most vulnerable to blood clots and may have platelet count of 500,000 or higher
B. During this time Helen is most vulnerable to bleeding and may have a platelet count of 50,000 or fewer
C. Patient Helen is at risk for increase hemoglobin and hematocrit
D. Because of the low WBC count, Helen will beed to be placed in reverse isolation
Answer: B Nadir is extemely low ang BC, wbc, ug platelet So asa ana na choice ang naghisgot abot nadir, so letter B.
You are a senior nurse at Manuel J. Doctors Provincial Center delegating patients for the upcoming shift, how would you care for a patient who has had a sealed radiation source placed?
A. Nurse Charlotte is responsible for providing continuity of care to all patients having sealed radiation therapy.
B. Nurse Sasha, who was the same nurse yesterday, will continue to provide excellent treatment.
C. Nurse Bayley who had her duty on the neurologic ward yesterday
D. Nurse Becky who is 5 weeks pregnant on her 3rd child
Answer: C. B and C are both correct. But ang pinaka correct is si C its because wala pa siyay exposure to radiation compared to B
Nurses in preventative health care are tasked with improving the health of patients through evidence-based recommendations while encouraging individuals to receive preventative services such as screenings, counseling and precautionary medications. Mr. April Graham, a 34-year-old Chinese instructor, is learning about testicular cancer through you. What is Mr. Graham’s correct remark about a testicular exam?
A. “I do a self-testicular exam every six months.”
B. “Due to monthly hormonal changes, the testicle may have small bumps or enlargement.”
C. “After a shower is the ideal time to undertake a self-examination.”
D. “The testicle should be tight but hard.”
Answer: C
Option A: wrong. every month mag self-testicular
Option B: naa bay bumps ang testicles? WALA
Option D: si D? hard ba ang testicle? DILI HUHU iba yung hard
You are assigned to Juan Dela Cruz, a 36-year-old who underwent Bone marrow transplant. What important assessment should you anticipate?
A. Hematocrit of 44%
B. INR of 5.0
C. Blood Pressure of 110/85mmHg
D. Intracranial pressure of10mmHg
Answer: B. INR of 5.0
Option A, C, D: Hematocrit is normal, so wala tay dapat ikabahala as well as the bp and icp Option B: correct. pinaka abnormal diha na kailangan nato e’report is the INR because normal value of INR is 1.0 only
You teach Ms. George with chronic cancer pain about optimal pain control. Which of the following recommendations is most effective for pain control?
A. Get used to some pain and use a little less medication than needed to keep from being addicted.
B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.
C. Take analgesics only when pain returns.
D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day to block the pain.
Answer: B. kay chronic na nga pain, so expected na naay round the clock pain reliever.
Ramon is receiving vincristine. Client teaching by the nurse should include instructions on:
A. Use of loperamide.
B. Fluid restriction.
C. Low-fiber, bland diet.
D. Bowel regimen.
Answer: A. its because and loperamide is a medication to control our bowel movement. Kaya nga nagka lack of bowel control dahil sa paralysis, so para ma control ang bowel, tagaan nato ug loperamide.
Jessy who is receiving chemotherapy is not eating well but otherwise feels healthy. Which meal suggestion would be best for this Kris John?
A. Cereal with milk and strawberries.
C. Toast, gelatin dessert, and cookies.
B. Broiled chicken, green beans, and cottage cheese.
D. Steak and French fries.
Answer: B. Kay high fiber tapos wala sad siyay fresh fruits and vegetables.
Mang Kanor is receiving monthly doses of chemotherapy for treatment of colon cancer. You should report which of the following laboratory results to the oncologist before the next dose of chemotherapy is administered? Select all that apply.
A. Hemoglobin of 14.5 g/dL
B. BUN of 12 mg/dL
C. Temperature of 38.4°C
D. Platelet count of 40,000
E. White blood cell count of 2,300
F. PaCO2 of 88mmHg
Answer: DEC (Note: Class yes taas ang PACO2 but wala shay connect sa question)
Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumors and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries. Which of the following client is at highest risk for colorectal cancer?
a. Client Eve a 26-year -old who has been a smoker for almost a decade
b. Client Maryse a 24-year-old who has a history with Crohn’s disease
c. Client Bella a 20-year-old who was diagnosed with pancreatitis
d. Client Alicia a 27-year-old who loves fresh fruits and is a vegan
Answer: B. Chrons disease kay at risk sha magka colorectal cancer.
A Greg Marvin 21-year-old male undergoes bone marrow aspiration to establish a diagnosis of possible cancer. Which statement made by Greg demonstrates proper understanding of discharge teaching?
a. “I will take morphine for pain.”
b. “I do not need to inspect the puncture site to let it heal.”
c. “I will not be able to play basketball for the next 2 days.”
d. “I can apply a warm compress only to the puncture site.”
Answer: C. Risk sha for lipong since RBCs carries oxygen bya sir tapos RBCS kay gkan sa bone marrow
Other term for lung cancer
Bronchogenic Carcinoma
Risk factors of lung cancer
- smoking (Pack years = #packs/day x years of smoking)
- Underlying Respiratory disease (COPD/PTB)
- Radon Gas
- Genetics
- Environmental/Occupational- Asbestos and Radiation Exposure

how to calculate pack years
Pack years = #packs/day x years of smoking
Signs and symptoms of lung cancer
-Initial: Asymptomatic
-Early: Non productive cough (later becomes productive)
-Recurring fever
-Dyspnea
-Late: Blood-tinged cough and hoarseness of voice
Diagnostic tests for Lung Cancer
-Chest X-ray
-CT Scan
-MRI
-Sputum Culture
-Bronchoscopy
Management for Lung Cancer
-Radiation
-Chemotherapy
-Surgery:
1. Lobectomy
2. Bilobectomy
3. Pneumonectomy
Purpose of Post op position in patient with Lung Cancer
To promote lung expansion
Post Op position in lung cancer (LUPA)
Lobectomy
Unaffected
Pneumonectomy
Affected
Nursing Interventions for Lung Cancer
-Monitor breathing pattern and breath sounds
-administer analgesics as prescribed for pain management
-Semi-fowler’s position
-Dyspnea: Administer O2
Common site of Colon Cancer
Sigmoid Colon
Stool in Ascending and Transverse Colon
Watery Stool
Predisposing factors of Colon Cancer
-Increase Fat Intake
-Low fiber intake
-Aflatoxins consumption
-Benzopyrine consumption
-History of GI polyps and Ulcerative Colitis 
Manifestations of Colon Cancer
Depends on what site
Ascending Colon Manifestations
(-) Obstruction kay liquid paman ang stool
Cauliflower mass
Occult Blood
Descending Colon Manifestation
(+) Obstruction kay solid naman ang stool
Feeling of incomplete emptying
Abdominal pain LLQ
Ribbon-like stool
Gross bleeding stool
Diagnostics in Colon Cancer
-Colonoscopy
-Increase CEA (protein) tumor marker
management of Colon Cancer
- Chemotherapy - 5FU (Fluorouracil)
- Radiation to decrease tumor size
- Antibiotic - Neomycin Sulfate
- Surgery - Hartmann Procedure with colostomy creation (tanggal ang sigmoid)
Signs of Colostomy Acceptance
-Looks the colostomy
-Ask about the colostomy
-Touch the colostomy
cause: unknown
also an estrogen-dominance cancer
Cervical Cancer
Risk factors of Cervical Cancer
- Multiple Sexual Partner
- Oral Contraceptive
- Multiparity
- Smoking
- Early age coitus/pregnancy (16 y/o)
Prevention of Cervical Cancer
Pap smear - done yearly, starting 21 y/o
Early Signs and Symptoms of Cervical Cancer (PAINLESS)
- Post coidal bleeding
- Metrorrhagia - bleeding between menses
- Menorrhagia - Prolong menstruation
- Malodorous discharges
late signs and symptoms of Cervical Cancer (Naa nay PAIN)
- Bleeding (dark, foul odor)
- Anemia
- Weight Loss
- Pain (Pelvic, Low back, Flank) - signs of metastasis
Tumor markers of Cervical Cancer
BRCA 1 & BRCA 2
Management of Cervical Cancer
- Radiation and Chemotherapy
- Surgery:
-Conization: Removal of cone-shaped mass
-Cryotherapy: Freezing and destroying cervical tissue
-TAHBSO
Androgen-dependent cancer
Prostate cancer
Risk factors of Prostate Cancer
-Smoking
-Increase history of sexual activity
-African-American
-Fat/obese
-Family History
-History of STD
Diagnostics of Prostate Cancer
Digital Rectal Exam
Increase Prostatic Specific Antigen (PSA)
Increase Serum Phosphate
Contraindicated to patient with cardiac problems (vagal stimulation) low hr, bp, rr
Digital Rectal Examination
Normal and Abnormal Prostate when doing Digital Rectal Exam
Normal: Soft and Tender, rubbery (bouncy), (+) sulci-scrotum grooves like (kanang sa siko na texture)
Abnormal: Hard and boggy
Gold Standard for prostate cancer test
N: 0.4 ng/ml
Increase Prostate Specific Antigen (PSA)
indicates metastasis to pelvic bone
Increase serum phosphate
Signs and symptoms of Prostate Cancer
- Early: Asymptomatic
- Urinary Obstruction
- Hematuria
- Painful urination
- Back pain
Drug of Choice for Prostate Cancer
Lupron
Diethyl stilbestrol
Surgery for Prostate Cancer
- Prostatectomy
- Transurethral Resection of the Prostate (TURP)
Post op continuous bladder irrigation
Cytoclysis
Fast drip
TURP
Flushes the bladder with sterile liquid or NSS
Purpose: Remove and prevent blood clots accumulated from TURP procedure
Continuous Bladder Irrigation
Continuous Bladder Irrigation:
Color of Outflow
Reddish-pink during 1st 24 hours WITHOUT CLOT
Continuous Bladder Irrigation:
If with clots
Increase irrigation flow
Continuous Bladder Irrigation:
If with clear color
Decrease Irrigation Flow
Increase of immature WBC
Common cause: Hypoplasia of bone marrow
Leukemia
2 types of WBC
- Bands - Baby/Immature WBC
- Segmenters (Segs) - Mature WBC
2 Type of Leukemia
- Acute Myeloid Leukemia (MATANDA)
- Acute Lymphoid Leukemia (LIIT)
Pathophysiology
Decrease Bone Marrow Activity
-decrease RBC: Anemia
-Increase immature cells: Risk for infection
-Decrease Platelet: Risk for bleeding
Diagnostics in LEUKEMIA
Bone Marrow Aspiration
Bone Marrow Aspiration SITE
PeDIA - TiBIA
Adult - Ileac Crest
