Chapter 40 Cancer, Immune System, and Skin Disorders Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Cancer  Cells reproduce for tissue growth and repair.  Cell division and growth are sometimes out of control. A mass or clump of cells develops. This new growth of abnormal cells is called a tumor. A mass or clump of cells develops. This new growth of abnormal cells is called a tumor.  Tumors are benign or malignant. Slide 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Cancer (cont’d)  Benign tumors  Do not spread to other body parts  Can grow to a large size, but rarely threaten life  Usually do not grow back when removed  Malignant tumors (cancer)  Invade and destroy nearby tissue  Can spread to other body parts  May be life-threatening  Sometimes grow back after removal Slide 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

 Metastasis is the spread of cancer to other body parts.  Cancer cells break off the tumor and travel to other body parts.  New tumors grow in other body parts.  Cancer can occur almost anywhere.  Cancer is the second leading cause of death in the United States. Slide 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 The National Cancer Institute describes these risk factors:  Growing older Most cancers occur in persons over 65 years of age. Most cancers occur in persons over 65 years of age.  Tobacco  Sunlight  Ionizing radiation  Certain chemicals and other substances  Some viruses and bacteria  Certain hormones  Family history of cancer  Alcohol  Poor diet, lack of physical activity, and being overweight Slide 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 Treatment depends on:  The tumor type  Tumor site and size  If the tumor has spread  The treatment goal may be to:  Cure the cancer.  Control the disease.  Reduce symptoms for as long as possible.  Some cancers respond to one type of treatment.  Others require two or more types. Slide 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 Surgery removes tumors.  It is done to cure or control cancer.  It relieves pain,  Radiation therapy (radiotherapy)  Destroys certain tumors  Shrinks a tumor before surgery  Destroys cancer cells that remain after surgery  Controls tumor growth to prevent or relieve pain Slide 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 Chemotherapy involves drugs that kill cells. It is used to:  Shrink a tumor before surgery  Kill cells that break off the tumor  Relieve symptoms caused by the cancer  Side effects depend on the drug used.  Hair loss (alopecia)  Gastro-intestinal irritation  Decreased blood cell production Slide 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 Hormone therapy prevents cancer cells from getting or using hormones needed for their growth.  Drugs are given to prevent the production of certain hormones.  Organs or glands that produce a certain hormone are removed.  Biological therapy (immunotherapy) helps the immune system fight the cancer.  It also protects the body from the side effects of cancer treatments. Slide 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 Other therapies  Stem cell transplants A stem cell is a cell from which new cell types develop. A stem cell is a cell from which new cell types develop.  The new cells have certain functions (blood cells, brain cells, bone cells). Some persons need high doses of chemotherapy or radiation therapy. Some persons need high doses of chemotherapy or radiation therapy.  Such therapies kill cancer cells and blood cells in the bone marrow.  Fewer blood cells are produced. A person is given blood-forming stem cells. A person is given blood-forming stem cells. New blood cells develop from the stem cells. New blood cells develop from the stem cells.  Complementary and alternative medicine (CAM) Used along with standard cancer treatments Used along with standard cancer treatments Used instead of standard cancer treatments Used instead of standard cancer treatments Slide 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

 Persons with cancer have many needs, including:  Pain relief or control  Rest and exercise  Fluids and nutrition  Preventing skin breakdown  Preventing bowel problems  Dealing with treatment side effects  Psychological and social needs  Spiritual needs  Sexual needs Slide 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Cancer (cont’d)

Immune System Disorders  The immune system  Protects the body from microbes, cancer cells, and other harmful substances  Defends against threats inside and outside the body  Immune system disorders occur from problems with the immune response.  The response may be inappropriate, too strong, or lacking. Slide 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Immune System Disorders (cont’d)  Autoimmune disorders can occur.  The immune system attacks the body’s own normal cells, tissues, or organs.  One of the following may occur. One or more types of body tissues are destroyed. One or more types of body tissues are destroyed. An organ grows abnormally. An organ grows abnormally. There is a change in how an organ functions. There is a change in how an organ functions.  Common autoimmune disorders include Graves’ disease (the most common form of hyperthyroidism) Graves’ disease (the most common form of hyperthyroidism) Lupus (an inflammatory disease that affects the blood cells, joints, skin, kidneys, lungs, heart, or brain) Lupus (an inflammatory disease that affects the blood cells, joints, skin, kidneys, lungs, heart, or brain) Multiple sclerosis Multiple sclerosis Rheumatoid arthritis Rheumatoid arthritis Type 1 diabetes Type 1 diabetes Slide 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

 Signs and symptoms depend on the type of disease. Fatigue, dizziness, not feeling well, and fever are common. Fatigue, dizziness, not feeling well, and fever are common.  Most autoimmune disorders are chronic.  Treatment depends on the: Type of disorder Type of disorder Tissues and organs affected Tissues and organs affected  Treatment is aimed at: Reducing symptoms Reducing symptoms Controlling the autoimmune response Controlling the autoimmune response Maintaining the body’s ability to fight disease Maintaining the body’s ability to fight disease Slide 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Immune System Disorders (cont’d)

 Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV).  HIV attacks the immune system.  HIV is spread through body fluids (blood, semen, vaginal secretions, and breast milk).  HIV is transmitted mainly by: Unprotected anal, vaginal, or oral sex with an infected person Unprotected anal, vaginal, or oral sex with an infected person  “Unprotected” means without a new latex or polyurethane condom. Needle and syringe sharing among IV drug users Needle and syringe sharing among IV drug users HIV-infected mothers HIV-infected mothers Slide 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Immune System Disorders (cont’d)

 HIV cannot: Live outside the body Live outside the body Be spread by casual, everyday contact Be spread by casual, everyday contact Be transmitted by food prepared by the infected person Be transmitted by food prepared by the infected person  Some HIV-infected persons have symptoms within a few months. Others are symptom-free for more than 10 years. (They carry the virus and can spread it to others.) Others are symptom-free for more than 10 years. (They carry the virus and can spread it to others.)  The person with AIDS can develop other health problems. The immune system is damaged. The immune system is damaged. Slide 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Immune System Disorders (cont’d)

 The person with AIDS is at risk for: Pneumonia Pneumonia Tuberculosis Tuberculosis Kaposi’s sarcoma (a cancer) Kaposi’s sarcoma (a cancer) Nervous system damage Nervous system damage  Many new drugs Help slow the spread of HIV in the body Help slow the spread of HIV in the body Reduce complications Reduce complications Prolong life Prolong life  You may care for persons with AIDS or those who are HIV carriers. Protect yourself and others. Protect yourself and others. Follow Standard Precautions and the Bloodborne Pathogen Standard. Follow Standard Precautions and the Bloodborne Pathogen Standard. Slide 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Immune System Disorders (cont’d)

Skin Disorders  Shingles (herpes zoster)  Shingles is caused by the same virus that causes chickenpox.  The virus lies dormant (inactive) in nerve tissue.  The virus can become active years later.  Persons at risk include those who: Are over 50 years of age Are over 50 years of age Have had chickenpox Have had chickenpox Have weakened immune systems Have weakened immune systems  The doctor orders anti-viral drugs and drugs for pain relief.  A vaccine is now available to prevent shingles. Slide 18 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.