Week 3 Cancer Care Flashcards
Cancer - definition & clinical manifestations
Cancer - uncontrolled division of abnormal cells in the body. It affects almost any organ or tissue, and can spread/invade other areas
Clinical manifestations:
Depends on the type of cancer e.g., skin cancer (abnormal moles/spots on skin), breast/testicular cancer (lumps)
Nausea and vomiting
Diarrhoea or constipation
Confusion and cognitive disturbance
Cancer - pathophysiology
cancer begins when one or more genes develop a mutation → these mutations lead to the production of abnormal proteins → abnormal proteins can cause cells to multiply uncontrollably and become cancerous
Cancer - reducing risk & diagnosing
Identifying cancer early / Reducing cancer risk:
Quit smoking
Eat for health
Maintain a healthy weight
Be Sun Smart
Limit alcohol intake
Move your body
Get checked - men and women (e.g., supportive care screening tool)
Diagnosing cancer:
Patient history and physical examination
Initial tests (bloods, urine, medical imaging)
Tissue/cell biopsy (e.g., colonoscopy)
Microscopic examination to determine specific type of cancer and any cell markers to guide treatment
Cancer staging (TNM)
T - Tumour: size of the tumour and any spread to surrounding tissues. Unable to assess the primary tumour (Tx), no evidence of primary lesions (T0), and deep penetrating tumour (T4)
N - Nodal Involvement: determines spread of cancer to the lymph nodes. Unable to assess lymph node involvement (Nx), no lymph node involvement (N0), metastasis in 1-3 nodes (N1), and metastasis to 4+ nodes (N2)
M - Metastasis: determines spread of tumour beyond regional lymph nodes. Unable to assess distant metastasis (Mx), no distant metastasis (M0), distant metastasis (M1)
Cancer staging (numbered system)
Stage 0 in situ - abnormal cells present but have not spread, size of cancer is small
Stage 1 localised - cancer is small and has not spread to surrounding tissues, or only a little. Not spread to lymph nodes
Stage 2 size - cancer is larger in size but without spreading to surrounding tissues
Stage 3 regional - cancer is large in size, has spread to nearby tissues, lymph nodes, and organs
Stage 4 distant - cancer has spread to other areas of the body away from primary tumour. Also known as the metastatic cancer or advanced cancer stage
Cancer - quality of life concerns
Altered mobility and fatigue - difficulty completing day-to-day activities
Poor body/self image
Family/carers of people affected by cancer
Education/support for the person and family affected by cancer
Cancer treatments - surgery
Prophylactic surgery for people with high risk malignancy (family history)
Surgery to obtain biopsies
Surgery to cure/control cancer as a treatment 0 remove tumours (lumpectomy, prostatectomy)
Surgery for palliative care - if cancer is obstructing organs, causing pain
Cancer treatments - Radiotherapy
Damages a cell’s DNA causing a single or double break in the double helix - preventing a cell from dividing and therefore dies
Sometimes organs and tissues outside of the targeted area are affected
Cancer treatments - Chemotherapy
Damages the genes responsible for cell division (as cancer cells rapidly divide)
Cannot differentiate between cancer cells and healthy cells - loss of cells in mouth, bone marrow, hair, skin, bowel, stomach
IV, oral, intrathecal, subcutaneous, intramuscular
Cancer treatment - Immunotherapy
Boosts body’s immune system (B and T lymphocytes) to kill cancer cells
Orally, intravenous, topically, intravesically (in bladder)
Cancer therapy - Hormone therapy
Breast, prostrate, testicular, endometrial, and thyroid cancers are hormone stimulated
Tablet or injection
Oestrogen receptor antagonists, oestrogens, aromatase inhibitors, anti-androgens, progestogens, luteinizing hormone releasing hormone
Cancer treatment - Targeted therapy
Block growth of new blood vessels, starve cells of nutrients/oxygen, and slow growth of cancer
Via tablets, infusion, or injection (daily for months to years)
Cancer care - nursing role considerations
Radiation induced skin reactions
Neutropenic fever (febrile + low level of WBC)
Sepsis
Cytotoxic precautions
