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Oncology
Is the study of cancer.
Oncologists
Specialize in caring for patients with cancer.
Oncology Nurse
Have special skills in assisting the clients and family with the psychosocial
issues with cancer and terminal illness.
CANCER
Is the disease of the body cell’s the microscopic units that proteins and
energy producing compounds the body needs to remain alive and healthy each
type of cell has a unique function and each grows in a particular place and at a
particular rate.
For various reasons (some known, others not) certain cells become
cancerous, that is they suddenly abandon their normal growth pattern and begin to
reproduce uncontrollably.
RISK FACTORS
1) Heredity
Family cancer syndrome
2) Age – 70% over age 65
FIVE CYCLES OF GENETIC MUTATION seem necessary to cause
permanent damage to the afflicted agents.
Long term exposure to high doses of promotional agents.
Immune response alters with aging.
Hormonal changes.
Free radicals (moleculed resulting from body’s metabolic and oxidative
damage and mutation). Tend to accumulate in the cells overtime,
causing damage and mutation.
Severe/cumulative losses – ex-spouse, loved ones, stress – changes in
immune system.
3) Gender
Thyroid cancer – women
Bladder cancer – men
4) Poverty
Inadequate access to health care; preventive screening, counseling
Diet, stress
5) Stress
Continuous production of hormones- epinephrine results in systemic
fatigue and impaired immunologic surveillance.
6) Diet
Preservative, coffee
Increase fat, decrease fiber
Excessively fried, boiled meat, fish
Reaction using fat to fry food
7) Occupation
Outdoor workers – solar radiation
X-ray tech – ionizing radiation
Asbestos
Wood, leather dust – woodworkers
Chemotherapy drugs
8) Infection
Viruses – prevention
9) Tobacco Use
Oropharyngeal, esophageal, laryngeal, gastric pancreatic and bladder
cancer.
Second hand tobacco source
10)Alcohol Use
Modifying the metabolism of carcinogens in the liver and esophagus,
thus increase the effectiveness of carcinogens in some tissues.
11)Recreational Drug Use
Drug users – decrease nutrition
- Chromosomal damage
12)Obesity
Excessive amount of hormones
13)Sun Exposure
DIFFERENTIATION
Is a normal process occurring over many cell cycles that allows cell to
specialize in certain tasks.
1) Hyperplasia
2) Metaplasia
3) Dysplasia
Represents a loss of DNA control over differentiation occurring in
response to adverse reactions.
4) Anaplasia
Regression of a cell to an immature or undifferentiated cell type.
TYPES OF NEOPLASMS
NEOPLASM
Is a mass of new tissue that grows independently of its surrounding
structures and has no physiologic purposes.
They are said to be autonomous.
They grow at a rate uncoordinated with the needs of the body.
They function independently.
They store some of the properties of the parent cells but with altered
size and shape.
They do not benefit the host and in some cases are actively harmful.
They are classified as BENIGN OR MALIGNANT.
1) BENIGN NEOPLASM
Localized in growth.
Form a solid mass, have well defined boarders encapsulated.
Respond to body’s Homeostatic control.
Often stop growing when they reach the boundaries of another tissue.
2) MALIGNANT NEOPLASM
Grow aggressively and don’t respond to body’s homeostatic control.
Irregular in shape.
They cut through surrounding tissues causing bleeding, inflammation
and necrosis.
Travel through blood stream.
Can occur after surgical intervention.
INVASION
METASTASIS
STEPS:
1) Accumulated stress
2) Depression
3) Increase Age
4) Pregnancy
5) Chronic Disease
6) Chemotherapy
9) Physical Stress
• Increase general adaptation syndrome.
• Increase Immunologic activity.
• Increase in inflammatory response activity.
• Nutritional fluid and electrolytes alterations.
10)Psychological stress
• Grief
• Guilt
• Anger
• Hopelessness
• Fear
• Isolation
COLLABORATIVE CARE
Begins with a variety of specializes laboratory diagnostic test once cancer is
diagnosis the initial focus is on medical treatment, the goals of treatment
are:
a) Eliminate the tumor or malignant cells
b) Prevent metastasis.
c) Reduce the cellular growth or the tumor burden.
d) Promote functional abilities, providing pain relief.
CLASSIFICATION OF CANCER
Classified by tissues and cells involved blood cells in which it’s originated
most cancerous drive from epithelial tissues are called carcinomas.
a) Adenocarcinomas – glands
b) Sarcoma – connective tissues or muscles
c) Gliomas – brain and spinal tissues
d) Melanomas – pigmented cells
e) Myolomas – plasma cells
f) Lymphomas – lymphatic
g) Leukemia – white blood cells
h) Erythroleukemia – red blood cells
Classification
To help characterized diagnosis and treatment protocoli an endocrine system
has been developed.
a) Naming the tumor
b) Describing its aggressiveness ( Grading)
c) Spread with in or beyond the tissue of origin ( Staging)
Grading
Evaluates the amount of differentiation level of functional maturity of the cell
and estimates the rate or growth based on the mitotic rate.
• GRADE 1
Cells are the most differentiated – least malignant with better
prognosis.
• GRADE 2
Reserved from the least differentiated and most aggressively
malignant cells.
STAGING
Use to classify solid tumors and refers to the relative size of the tumor and the
extent of the disease
PHYSICAL ASSESSMENT
1) Nutritional Status; basing on height, weight
2) Evaluate laboratory results
3) Note Signs and Symptoms
4) Assess level of hydration status
Input and Output
Skin turgor and moisture
Vital Sign
Tongue
Eyeballs
Sounds of murmurs
Laboratory values
Manifestation of Cancer
1) Hair loss
2) Depression
3) Fever
4) Bleeding gums
5) Anorexia
6) Nausea and vomiting
7) Diarrhea
8) Hypotension
9) Odor of decay
10) Etc.
NURSING GOAL
POSSIBLE DIAGNOSIS
1) ANXIETY
• Assess level of anxiety
• Establish therapeutic relationship
• Encourage to express feelings (develop rapport)
• Improve specific information
• Provide Safe environment
• Crisis Intervention (expect for the worse)
3) ANTICIPATORY GRIEVING
• Use therapeutic communication skills with provide an open
environment for the client or significant others to discuss their feelings
realistically.
• Answer question about illness and prognosis honesty but always
encourage hope.
• Encourage the dying client to make funeral, burial plans ahead of time,
be sure that the will is in order.
• Encourage client to continue taking past in activity he enjoys including
maintaining employment as long as possible.