Professional Documents
Culture Documents
By:
Ruby Ruth T. Roces, R.N., M.D.
Oncology defined
It is a branch of medicine that
deals with the study, detection,
treatment and management of
cancer
glossary
Neoplasia-uncontrolled cell growth that
follows no physiologic demand
Anaplasia-cells that lack normal cellular
/function
Hypertrophy-increase in the size
“Root words”
A- none
Ana- lack
Hyper- excessive
Meta- change
Dys- bad, deranged
Classification of Neoplasia
1. Benign
2. Malignant
3. Borderline/ in situ
WAYS TO DIFFERENTIATE A BENIGN
FROM A MALIGNANT TUMOR
Characteristics Benign Malignant
Osteoma- bone
Myoma- muscle
Nomenclature of Neoplasia
Tumor is named according to:
2. Pattern and Structure, either GROSS or
MICROSCOPIC
Fluid-filled CYST
Glandular ADENO
Finger-like PAPILLO
Stalk POLYP
Nomenclature of Neoplasia
Tumor is named according to:
3. Embryonic origin
Ectoderm ( usually gives rise to epithelium)
tissues)
BENIGN TUMORS
Suffix- “OMA” is used
Adipose tissue- LipOMA
Bone- osteOMA
Muscle- myOMA
Blood vessels- angiOMA
Fibrous tissue- fibrOMA
MALIGNANT TUMOR
Named according to embryonic cell origin
1. Ectodermal, Endodermal, Glandular,
Epithelial
Use the suffix- “CARCINOMA”
Pancreatic AdenoCarcinoma
FibroSarcoma
Myosarcoma
AngioSarcoma
“Exceptionistas”
S- DNA Synthesis
division
M- Mitotic phase (I-P-M-A-T)
CANCER NURSING
Theories to the Pathogenesis of Cancer
Cellular transformation and derangement
theory
Immune response failure theory
CANCER NURSING
Etiology of cancer
1. PHYSICAL AGENTS
Radiation (thyroid CA)
Papilloma Virus
RNA Viruses- HIV, HTCLV
Bacterium- H. pylori
CANCER NURSING
Etiology of cancer
6. Hormonal agents
DES
OCP especially estrogen
CANCER NURSING
Etiology of cancer
7. Immune Disease
AIDS
CANCER NURSING
CARCINOGENSIS
Malignant transformation
IPP
Initiation
Promotion
Progression
CANCER NURSING
CARCINOGENSIS
INITIATION
Carcinogens alter the DNA of the cell
Cell will either die or repair
CANCER NURSING
CARCINOGENSIS
PROMOTION
Repeated exposure to carcinogens
Abnormal gene will express
Latent period
CANCER NURSING
CARCINOGENSIS
PROGRESSION
Irreversible period
Cells undergo NEOPLASTIC transformation
then malignancy
CANCER NURSING
Spread of Cancer
1. LYMPHATIC
Most common
2. HEMATOGENOUS
Blood-borne, commonly to Liver and Lungs
3. DIRECT INVASION/EXTENSION
Seeding of tumors
CANCER NURSING
Body Defenses Against TUMOR
1. T cell System/ Cellular Immunity
Cytotoxic T cells kill tumor cells
2. B cell System/ Humoral immunity
B cells can produce antibody
3. Phagocytic cells
Macrophages can engulf cancer cell debris
CANCER NURSING
Cancer Diagnosis
1. BIOPSY
The most definitive
2. CT, MRI- for visualization and staging
3. Tumor Markers
CANCER NURSING
Cancer Grading
The degree of DIFFERENTIATION
Grade 1- Low grade
N- Node
M- Metastasis
2. Stage 1 to Stage 4
CANCER NURSING
GENERAL Promotive and Preventive Nursing
Management
1. Lifestyle Modification
2. Nutritional management
3. Screening
4. Early detection
SCREENING
1. Male and female- Occult Blood, CXR, and
DRE
2. Female- SBE, CBE, Mammography and
Pap’s Smear
3. Male- DRE for prostate, Testicular self-
exam
Nursing Assessment
Utilize the ACS 7 Warning Signals
CAUTION
U- Unusual bleeding
I- Indigestion
2. Chemotherapy
3. Radiation therapy
4. Immunotherapy
excision
prophylactic
implants
Identify max time that can be spent safely
inpxs room
Use of shielding equipments
diarrhea
Myelosuppression
Nephrotoxicity-danorobucin, doxorubucin
stoma care
3. Administer antibiotics 1 day prior
Colon cancer
NURSING INTERVENTION
Pre-Operative care
4. Enema or colonic irrigation the evening and
NURSING INTERVENTION
Post-Operative care
3. Assess wound dressing for bleeding
NURSING INTERVENTION
Post-Operative care
6. Instruct to splint the incision and
5. Nulliparity
8. Hormonal replacement
9. Alcohol
2. Breast feeding
3. Pregnancy before 30 yo
Breast Cancer
ASSESSMENT FINDINGS
1. MASS- the most common location is the
irregular borders
3. Skin dimpling
4. Nipple retraction
5. Peau d’ orange
Breast Cancer
LABORATORY FINDINGS
1. Biopsy procedures
2. Mammography
Breast Cancer
Breast cancer Staging
TNM staging
I - < 2cm
II - 2 to 5 cm, (+) LN
III - > 5 cm, (+) LN
IV- metastasis
Breast Cancer
MEDICAL MANAGEMENT
1. Chemotherapy
2. Tamoxifen therapy
3. Radiation therapy
Breast Cancer
SURGICAL MANAGEMENT
1. Radical mastectomy
2. Modified radical mastectomy
3. Lumpectomy
4. Quadrantectomy
Breast Cancer
NURSING INTERVENTION : PRE-OP
1. Explain breast cancer and treatment options
abilities
3. Promote decision making abilities
exercise
Breast Cancer
NURSING INTERVENTION : Post-OP
1. Position patient:
Supine
edema
Breast Cancer
NURSING INTERVENTION : Post-OP
2. Relieve pain and discomfort
Moderate elevation of extremity
drainage
Maintain patency of drain (JP)
less than 30 ml in 24 H
Lotions, Creams are applied ONLY when
TID
NO BP or IV procedure on operative site
Breast Cancer
10-20% of patients
pack
Breast Cancer
NURSING INTERVENTION : Post-OP
MANAGE COMPLICATIONS
Infection
Monitor temperature, redness, swelling and
foul-odor
IV antibiotics
Annual mammography
Lung cancer
6th-7th decade
Number 1 in the morbidity and mortality
survey among all cancers
Equal incidence for both men and women
85% caused by inhalation of carcinogenic
materials most commonly cigarette smoking
Squamous cell carcinoma- more centrally
located, commonly in the segmental and
subsegmental bronchi.
AdenoCarcinoma- presents more peripherally
as peripheral mass or nodules; most prevalent
lung Ca for both M and F
Large cell carcinoma-fast growing tumor that
arise peripherally
Bronchioalveolar cell CA- arises fr the
terminal bronchus and alveoli; usually slow
growing
Small cell Ca- arises primarily as a proximal
lesion but may arise in any part of the
tracheobronchial tree
Lung Cancer
Etiology
Tobacco use
Hemoptysis
Wheeze, stridor
Dyspnea
Pneumonitis
Pain
I T1-2,N0,M0 60-80
II T1-2,N1,M0 25-50
IV Any M0 <5
Lung Cancer
T1-< 3 cm
T2->3 cm
T3- direct extension into chest wall
T4- invades mediastinum
N0
N1-peribronchial
N2-ipsilateral mediastinal
N3-contralateral mediastinal
Lung Cancer
TREATMENT
Surgery
Radiotherapy
Chemotherapy
Prostate Cancer
Etiology
Age-related
Blacks>white
95 % are adenocarcinomas
Prostate Cancer
Manifestations:
Rel. to urinary flow obstuction
sonography (TRUS)
Prostate Cancer
Treatment
Surgery- radical retropubic prostatectomy
Radiation therapy
Immunophenotyping
Cytogenetic analysis
aggressive forms
In aggressive types, combination chemotherapy are