Cancer Nlec

8/6/2019 Cancer Nlec

1/39

CANCER


2/39

DEATH

MALE- lung

- prostate

- colorectal


3/39

DEATH

FEMALE

- lung

- breast

- colorectal


4/39

DEFINITION

Disease process that begins when an

abnormal cellis transformed by the

genetic mutation of the cellular

DNA.


5/39

METASTASIS

- spread of cancer cells from the

primary tumor to distant sites


6/39

PATTERNS OF CELL GROWTH

HYPERPLASIA

- increase in the number of cells of a

tissue

METAPLASIA

- conversion of one type of nature cell

into another type of cell

DYSPLASIA- bizarre cell growth resultingin cells

that differin size, shape, or arrangement

from other cells of the same type of tissue.


7/39

PATTERNS OF CELL GROWTH

ANAPLASIA

- cells that lack normal cellular

characteristics and differin shape, and

organization with respect to their cells oforigin

NEOPLASIA

- uncontrolled cell growth that follows

no physiologic demand


8/39

MANAGEMENT

GOALS:

CURE

CONTROL

PALLIATION


9/39

DETECTION AND PREVENTION

PRIMARYPREVENTION:

- Life style changes.

- Stop smoking

-

Limit alcoholintake- Eat healthy diet

- Be physically active

- Avoid sun exposure- Chemoprevention


10/39

CHEMOPREVENTION

ASPIRIN

TAMOXIFEN

FINASTERIDE

COX-2 INHIBITORS

CALCIUM

BETA CAROTENE


11/39

SECONDARY PREVENTION

Cost effective routine screening test

Screening should be based on

individuals age, sex, family history

a. TESTICULAR CA: most common bet.

20 and 34

- recommends annual screening

beginning at 15 yo

b. PROSTATE CANCER


12/39


13/39

STAGING

T primary tumor

Tx

T0

Tis

T1, T2, T3, T4


14/39

STAGING

N presence or absence of regional lymph

node involvement

Nx

N0N1, N2, N3, N4


15/39

STAGING

M absence or presence or distant

metastasis

Mx

M0M1


16/39

SURGICAL MANAGEMENT

DIAGNOSIS:

1. BI OPSY: usually performed to obtain a

tissue sample for analysis of cells

suspected to be malignant.

a. EXCISIONAL

b. INCISIONAL

c. NEE DLE


17/39

PROCEDURE

1. PRIMARY: involves the removal of

a malignant tumor and a margin of

adjacent normal tissue

a. Local

b. Wide

c. Electrosurgery

d. Cryosurgery

e. Laser


18/39

PROCEDURE

2. SALVAGE SX: additional tx option

that uses an extensive surgical

approach to treat local recurrence of

cancer


19/39

PROCEDURE

3. PROPHYLACTIC SURGERYikely to develop

cancer

- Involves removing nonvital tissues or organs

that are likely to develop cancer


20/39

PROCEDURE

4. PALLIATIVE

- attempt to relieve complications


21/39

NURSING MANAGEMENT

Provide information about the procedure,

possible findings, post-op limitations,

changes in normal body functions.

Provide emotional support/

Provide patients comfort

Post-op teachings

Educate on plans for discharge, homecare, and follow up


22/39

RADIATION THERAPY


23/39

TYPES

1. BRAC HYTHERAPY

- Deliver high dose of radiation to a localized

area with direct tumor access.

a. INTERSTITIAL

b. INTRACAVITARY

2. TELETHERAPY: external beam irradiation

uses a device located at a distance from the

pt.


24/39

UNITS FOR MEASURING RADIATION

EXPOSURE

GRAY: unit to measure absorbed dose

ROENTGEN: standard unit of

exposure

RADIATIONDOSE EQUIVALENT

(rem): unit of measure that relates to

biologic effectiveness.


25/39

ACUTE ADVERSE EFFECTS

Fatigue and malaise

Skin: develop reaction as soon as

2wks

G I: N/V diarrhea

ORAL: changes in taste, dryness,

xerostomia

Bone marrow suppression


26/39

NURSING INTERVENTIONS

RISK FOR IMPAIRED SKININTEGRITY

- Dont apply lotion, ointment on the site

- Discourage vigorous rubbing, friction or

scratching

-Avoid tight fitting clothing

- Avoid exposure to sunlight

- Dont apply adhesive tape

- Avoid shaving

- Use luke warm water only and mild soap


27/39

RADIATION

Time: exposure to radiation is directly

proportional to the time spent within a

specific distance to the source

Distance: amount of radiation reaching

a given area decreases as resistance

increases

Shield: sheet of absorbing material

placed between the radiation source


28/39

CHEMOTHERAPY

Use of antineoplastic agents in an

attempt to destroy tumor cells by

interfering with cellular functions


29/39

PRINCIPLES

1. THE INTENT IS TO DESTROYAS MANY

TUMOR CELLS ASPOSSIBLE.

2. CANCER CELLSDEPEND ONTHE SAME

MECHANISMS FOR CELL DIVISION

THAT ARE FOUND INNORMAL CELLS.

3. CHEMOTHERAPYIS UTILIZED IN

DIFFERENT CLINICAL SETTING.

4. CHEMOTHERAPEUTIC AGENTS CANBE

EFFECTIVE ONONE OF THE FOURPHASES OF THE CELL CYCLE.


30/39

CELL CYCLE

G1: RNA and protein synthesis

S phase:DNA component doubles for

the chromosomes in preparation to cell

division

G2: short time period; Protein and

RNA synthesis occurs

M phase: extremely short pd; the cell

actually divides into two identical cells G0: resting not active in the cell

cycle


31/39

CHEMOTHERAPEUTIC AGENT

1. CELL CYCLE SPECIFIC

- Destroy cell that are actively reproducing by

means of the cell cycles

2. VI NCA/PLANT ALKALOIDS

3. CELL CYCLEDNONSPECIFIC- Actindependently of the cell cycle have

prolonged effect on cells, leading to cellular

damage or death.


32/39

ROUTES OF ADMINISTRATION

ORAL

IV

INTRATHECAL

IM

INTRA-ARTERIAL INTRACAVITARY

INTRAVESICAL

TOPICAL


33/39

SAFETY PRECAUTIONS

MINIMIZE EXPOSURE VIA

INHALATION

-wrap gauze or alcohol pads around the

neck of ampules

- Wrap gauze on injection sites when

removing syringes in IV ports


34/39

SAFETY PRECAUTIONS

MINIMIZE EXPOSURE VIA SKIN

CONTACT

- Wear gloves

- Handwashing

-

Wear gown- Eye and face shield


35/39

ADVERSE EFFECTS

Alopecia

Anorexia

Fatigue

N/V

Mucositis

Anemia

Neutropenia Thrombocytopenia


36/39

NURSING INTERVENTIONS

PREVENT INFECTION

PREVENTINGBLEEDING

MINIMIZINGFATIGUE

PROM

OTIN

GNUTRITI

ON


37/39

PAIN MANAGEMENT

TYPES:

1. Somatic

2. Neutropathic3. Visceral


38/39

PHARMACOLOGICMGT.

NON-OPIOID ANALGESICS:

- NSAID

-Acetaminophen

- Corticosteroids

-anti convulsants- Ant idepressants

OPIOID


39/39

NURSING MGT

ASSESSPAINREPEATEDLYAT EACH

VISIT.

USE A PAIN INTENSITYSCALE

ASSESS RELIEF FROM MEDICATIONAND

D

URATION

OF RELIEF. ADMINISTER DRUGS ORALLY

WHENEVER POSSIBLE

ADMINISTER ANALGESICS RTC

RATHER THANPRN.

Cancer Nlec

Documents

Transcript of Cancer Nlec