Presentation on theme: "Cancer Definition & Significance A group of more than 200 diseases characterized by unregulated growth of cells. Cancer is the 2 nd leading cause of death."— Presentation transcript:
Cancer Definition & Significance A group of more than 200 diseases characterized by unregulated growth of cells. Cancer is the 2 nd leading cause of death in the U.S. (CAD is # 1). An estimated 30% of Americans now living will experience cancer at some point in their lives.
Cancer Con’t…. Two major dysfunctions present in the process of CA are: > Defective cellular proliferation (growth) > Defective cellular differentiation The natural history of CA is an orderly process occurring in 3 phases over time: > Initiation- genetic change occurs-altering growth & function > Promotion- the altered cell continues to undergo additional malignant changes. > Progression- involves the continued growth of the cell containing the malignant phenotype.
Cancer Classification Anatomic site (tissue of origin & behavior of tumor > Carcinomas- grown from epithelial cells;usually solid tumors (skin,stomach, colon,breast) > Sarcomas- arise from muscle, bone, fat, or connective tissue-may be solid. > Lymphomas & leukemias- arise from lymphoid tissue(infection-fighting organs)& grow from bld.forming organ. Histologic analysis (Grade 1- IV) Extent of disease (Clinical staging 0-IV) > Stage 0: CA in situ > Stage 1: Localized tumor growth > Stage 11: Limited local spread > Stage 111: Extensive local & regional spread > Stage IV: Metastasis
Comparison of Benign & Malignant Tumors Malignant Benign Cell typeAbnormal from those of original tissues Close to those of original tissues GrowthRapid;infiltrates surrounding tissues in all directions Slow & noninfiltrating EncapsulatedInfrequentFrequent MetastasisThrough blood,lymph,or new tumor sites Remains localized
Cancer Risk Factors Endogenous Age- incidence increases with age. Genetic heritage- exhibit a inheritance pattern. Hormonal factors – influence the process of carcinogenesis. Immunologic factors – malignant cells are antigenically different and should be recognized & destroyed by an intact immune system.
Cancer Risk Factors External: Drugs and Chemicals- are proven carcinogen Radiation- both ionizing & ultraviolet can cause CA. Tobacco- single most lethal known carcinogen Nutrition- high in fat & calories. Viruses- several viruses have shown to cause CA. Sexual practices- multiple partners are associated with cancer in females. Psychological factors – life stressors can cause CA
Cancer Diagnosis-General Cytology studies- (e.g. PAP smear) CXR Serum studies (e.g. CBC, liver function test, oncofetal antigens) Proctoscopic exam Radiographic studies (e.g. mammogram) CT/MRI Biopsy
Cancer Early warning signs Change in bowel or bladder habits Any sore that does not heal Bleeding or unusual discharge Lump or thickening in breast or elsewhere Indigestion or difficulty swallowing Obvious change in wart or mole Nagging cough or hoarseness
Cancer Treatment Goal(s): Cure, Control, Palliation Treatment: > Chemotherapy > Radiation > Biologic Response Modifiers > Surgery
Cancer Chemotherapy- General Effect of chemo is at the cellular level 1. Interrupting cell life-modifies or interferes with DNA synthesis. 2. Eradicate cells, both normal & malignant, that are in the process of cell reproduction. PO & IV administration most common Adverse effect classified as: > Acute:N/V, allergic reactions, disrhythmias > Delayed: mucositis, alopecia, bone marrow suppression. > Chronic: damage to organs (e.g. heart, liver, kidneys & lungs)
Cancer Radiation- General The major target of the radiation effect is DNA Administration accomplished by: > External radiation-gamma rays, linear accelerator > Internal radiation- isotopes, radium needles Side effects include: > Fatigue > Anorexia > Bone marrow suppression > Skin reactions > Pulmonary effects > GI effects > Reproductive effects
Radiation Therapy Implementation Maintain bedrest when radiation source in place Administer ROM exercises Observe for untoward effects:dehydration Observe & report skin eruption, discharge, abnormal bleeding. Observe frequently for dislodging of radiation source (linen & dressing) Notify MD if N/V, diarhea, frequent urination or bowel movements or temp. above 100 F.
Cancer Biologic Response Modifiers- General Agents that modify the relationship between the host & the tumor Classified as: > Interferons > Interleukins > Monoclonal Antibodies > Tumor necrosis Factor > Colony- Stimulating Factors Common side effect: flu-like symptoms
Cancer Surgery Classified as: > Cure & control: removal of localized CA tissue: Primary site and site of metastasis. > Supportive care: insertion of therapeutic devices > Palliation of symptoms: surgery to promote quality of life. > Rehabilitative management: reconstructive surgery.
Psychological Care for the Cancer Patient Develop a collaborative relationship with the patient. Always be honest with the client. Assist to cope with pain Provide general comfort measures Do not undermedicate for cancer pain Support family as they move through the grieving process Introduce the hospice concept-provides care for the terminally ill pt. & family.
Oncologic Emergencies Sepsis- life-threatening & common death in pts, with CA. DIC-triggered by many illnesses, including CA.Caused by sepsis from cancer cells. Strict adherence to aseptic technique. SIADH- excessive amts. Of water are reabsorbed by the kidney & put into systemic circulation. Caused hypoNA. & some degree of fluid retention. Mild S/S-weakness, muscle cramps, anorexia, fatigue.
Oncologic Emergencies Superior Vena Cava Syndrome- is compressed or obstructed by tumor growth.S/S- edema of the face, periorbital edema, tightness of the shirt or blouse collar(Stoke’s sign). High-dose radiation the most common tx. Tumor Lysis Syndrome- large quantities of tumor cells are destroyed rapidly. TLS is a positive sign that CA tx. is effective. S/S- hyperuricemia. Hydration-3L to 5L of fluid.
Oncologic Emergencies Spinal Cord Compression- when a tumor directly enters the spinal cord or when the vertebral column collapses from tumor entry. S/S- back pain, tingling; loss of urethral, vaginal, & rectal sensation, muscle weakness. Tx-palliative-high dose radiation-reduce the size of the tumor. Hypercalcemia- CA in bones causes the bone to release calcium into the bloodstream. S/S- fatigue, anorexia, N/V, constipation, & polyuria.