Cancer and Tumors Pathophysiology

• Cancer involves changes or damage to cells.
• Cancer may be caused by inherited traits, errors in cell division, environmental factors, tobacco use, or ultraviolet light exposure.

Cancer Pathophysiology

• Changes or damage to cells.
• Caused by inherited traits, errors in cell division, environmental factors, tobacco use, or ultraviolet light.
• The effects of aging can be a cause of cancer.
• Cancers can be named by body part origin or cell type.
• Metastasis refers to the spread of cancer to other sites in the body.
• Cancers can produce primary and secondary tumors.
• Progression to malignancy can include hyperplasia, dysplasia, and carcinoma in situ.
• Hyperplasia is defined as an overgrowth of cells.
• Dysplasia is the presence of abnormal cells.
• Carcinoma in situ refers to a group of abnormal cells.
• Angiogenesis refers to the formation of new blood vessels and can contribute to cancer growth/spread.
• No apoptosis (cell death) takes place.

Types of Cancer

• Carcinoma is a type of cancer that forms in epithelial tissue.
• Sarcoma is a cancer that forms in bones and connective tissue such as fat and muscle.
• Leukemia is a cancer of blood-forming tissues, including bone marrow.
• Lymphoma is cancer of the lymphatic system, including lymph nodes, spleen, thymus gland and bone marrow.
• Hodgkin's lymphoma and non-Hodgkin's lymphoma are types of this cancer.
• Melanoma is a cancer of melanocytes (pigment producing cells).

Epidemiological and Etiological Risk Factors for Cancer

• Common risk factors include smoking, alcohol consumption, excess body weight, sedentary lifestyle, diet, and viruses.

Cancer Prevention

• Early detection and regular screening can help prevention.
• Genetic testing and health lifestyle choices can assist in preventing cancer.
• Consume protective foods like folate, vegetables, and fruits.
• Vaccines area a measure of prevention.

Warning Signs of Cancer

• Change in bowel or bladder habits
• A sore that does not heal
• Unusual bleeding or discharge
• Thickening or lump
• Indigestion or difficulty swallowing
• Obvious change in warts or moles
• Nagging cough or hoarseness

Clinical Presentation of Cancer

• General signs include unexplained weight loss, fatigue, palpable masses, swelling, pain, and skin changes.
• In situ cancers are abnormal cells only present in the cells they formed.
• Localized cancers are present in one organ but have not spread beyond it.
• Regional cancers have spread only to lymph nodes, tissues, and organs that are relatively close.
• Distant cancers have metastasized to distant body parts. Cancer has spread to distant sites or organs.
• Cancer staging includes TNM (tumor, mode, metastasis), Stages 0-IV, and additional terms.

Diagnosis

• Diagnosis can be determined by a biopsy (shave, punch, CT guided, or surgical).
• Radiological studies such as CT, MRI, bone scan, or angiography can diagnose.
• Nuclear imaging procedures with PET scans are diagnostic tools.
• Endoscopies are used for internal viewing.
• Tumor markers and specific organ function tests can be used as laboratory tests.
• Cytological studies involve looking at single cells or cell clusters under a microscope.

Side-effects of Cancer

• Physiological effects include pain, neutropenia, gastrointestinal issues, lymphedema, peripheral neuropathy and infertility.
• Cognitive effects include sleep disturbances, delirium, concentration problems, decreased organizational abilities, and impaired memory.

Other Side-effects

• Fatigue and anemia.
• Emotional strain, financial stressors, and changes to lifestyle.
• Pain medications.

Role of The Nurse

• Education and prevention of cancer includes educating cancer patients and the public to prevent cancer.
• Identification and treatment using venous access devices to manage symptoms and prevent infections.

Side Effects of Radiation

• Fatigue, nausea, vomiting, and anorexia
• Mucositis and mouth sores
• Xerostomia (very dry mouth)
• Possible skin reactions: erythema, irritation, swelling, blisters
• Potential bone marrow depression, contributing to infection and bleeding

Side Effects of Chemotherapy

• Bone marrow depression at nadir causes leukopenia, thrombocytopenia and anemia.
• Nausea, vomiting, diarrhea, and stomatitis.
• Alopecia hair-loss.
• Possible reproductive alterations and neurotoxicity.

Nursing Diagnoses

• Nursing concerns for patient include ineffective coping, acute/chronic pain, risk for infection, ineffective protection, imbalanced nutrition, grieving and disturbed body image.
• Nursing concerns for caregivers include caregiver role strain and deficit in knowledge.

Oncological Emergencies

• Superior vena cava (SVC) syndrome can occur.
• Manifestations of oncological emergencies also include shortness of breath, facial swelling, chest pain, difficulty swallowing, and spinal cord compression.
• Pain, burning, numbness, and loss of sensation in the extremeties as a result of compression
• Hypercalcemia can occur.
• Weakness, confusion, and fatigue result from hypercalcemia.
• Tumor lysis syndrome releases tumor cells leading to electrolyte shifts.

Breast Cancer Pathophysiology

• Breast anatomy knowledge required.
• Types include invasive versus noninvasive and ductal.
• Possible Estrogen and/or progesterone receptor positive cancers.

Breast Cancer: Risk Factors

• Risk factors include gene mutations, advanced age, family history, obesity, alcohol use, radiation exposure, breast disease, dense breast tissue, and estrogen exposure.

Breast Cancer Presentation

• Possible presentation includes mass or lump, swelling or discharge.
• Nipple retraction, skin changes, and swollen lymph nodes in the axilla area are possible.

Breast Cancer: Diagnosing

• Mammograms include screening and diagnostics.
• Clinical breast exams, MRIs, biopsies, hormone-sensitivity testing and growth factor testing comprise a diagnosis plan.

Breast Cancer: Treatments

• Surgery (lumpectomy, quadrantectomy, mastectomy)
• Radiation, chemotherapy, hormone therapy, and targeted therapy

Breast Cancer: Role of The Nurse

• Nurses have a role in direct care, coordination, and communication for breast cancer patients.
• Chemotherapy, radiation, and surgery all require a nurse in the care plan.

Lung Cancer: Pathophysiology

• Respiratory system anatomy knowledge is required.
• Types include small cell (less common) and non-small cell.
• Squamous cell carcinoma, adenocarcinoma, and bronchioalveolar carcinoma make up non-small cell.

Lung Cancer: Risk Factors

• Risk factors include HIV, family history, smoking and secondhand smoke.
• Radon gas, chemical exposure, asbestos, radiation, air pollution, diesel, exhaust, and metals are risk factors.
• Occupations like paving, roofing and rubber manufacturing are also risk factors.

Lung Cancer: Clinical Presentation

• Common manifestations include cough, hemoptysis, and shortness of breath.
• Other manifestations include fatigue, weight loss, and chest pain.
• Diagnosing Lung Cancer:
• Respiratory infections, new wheezing, and hoarse voice can be involved.

Lung Cancer: Diagnostic Tools

• Tools used for diagnosis include chest imaging, biopsy, sputum cytology, and bronchoscopy.

Lung Cancer: Treatment and Therapies

• Lung cancer may be treated with surgery (lobectomy, pneumonectomy, wedge resection).
• Chemotherapy, radiation, targeted therapy, and immunotherapy are used.

Lung Cancer: Role of the Nurse

• Nurses are needed for medication administration and surgical care (tubes, dressings, pain).
• Teaching and advocacy are important.
• Coordination with mental health professionals, nutritionists, and oncologists is needed.

Prostate Cancer: Pathophysiology

• Prostate anatomy: Located below the bladder and anterior to the rectum.
• Produces and holds fluid that becomes part of semen.
• Testosterone is required for the prostate to function.

Cell mutation: Most cancers arise mostly from glandular tissue. Cancer cells reproduce and develop into a tumor nodule and expands outside the prostate.

• Adenocarcinomas make up more than 95% of prostate cancers.

Prostate Cancer: Risk Factors

• Risk factors include being age 50 or older, family history, increase in body weight.
• Slow growing, very responsive to treatment, 98% chance of survival rate
• Black, Hispanic and Caribbean men are at high risk.

Prostate Cancer: Clinical Presentation

• Urinary frequency and urination problems, erectile dysfunction, and blood in urine or semen manifest.
• Digital rectal examination, PSA, ultrasound, MRI, and biopsy are all diagnostic tools.

Prostate Cancer: Treatment

• Active surveillance (monitoring)
• Surgery, radiation, chemotherapy, immunotherapy, hormone and targeted therapy

Prostate Cancer: Role of the Nurse

• Post surgical care for catheter care, urinary incontinence, and erectile dysfunction.
• Teaching and Coordination for mental health and social worker are necessary.

Colorectal Cancer: Pathophysiology

• Colorectal anatomy knowledge is necessary to understand the pathophysiology.
• Polyps are present and can lead to adenocarcinomas.
• Can lead to metastasis through bowel wall into lymph system.

Colorectal Cancer: Risk Factors

• Risk factors include excess body weight, low activity level, smoking, and diet.
• Low dietary intake of vegetables, fruits, whole grain fiber, and calcium increases the risk.
• Consumption of processed red meat and alcohol increases the risk.
• Certain medical conditions increase risk, including ulcerative colitis, Crohn's disease, type 2 diabetes, and certain genetic disorders.
• It is the third most diagnosed cancer.

Colorectal Cancer: Clinical Presentation

• Changes in bowel habits, blood in stool, rectal bleeding, anemia, abdominal discomfort, weight loss, and fatigue present.

Colorectal Cancer: Diagnostic Tools

• Testing for blood in stool is the first diagnostic tool.
• carcinoembryonic antigen (CEA) is a tumor marker commonly made by cancer cells.
• Colonoscopies and biopsies are used to diagnose.

Colorectal Cancer: Treatments

• Colonoscopies, biopsies, ablations, cryosurgery, resection, colostomy's- Chemo, Radiation, Targeted therapy
• Surgery, Chemotherapy, Radiation, Targeted therapy.
• Monoclonal antibodies, immunotherapy and radiofrequency ablation are treatments.

Colorectal Cancer: Role of the Nurse

• Surgical care such as bowel resections, dressing changes and ostomy care.
• Maintain dignity for the patient due to surgical changes and bodily function changes.

Pancreatic Cancer: Pathophysiology

• Pancreas anatomy and functions knowledge is necessary.
• Gland between the duodenum and the spleen.
• Insulin, glucagon, pancreatic enzymes
• Insulin, glucagone, pancreatic enzymes are used.
• Cancer of exocrine cells, origin for many pancreatic cancers will originate in the ducts

Pancreatic Cancer: Risk Factors

• Modifiable risks includes smoking.
• Medical conditions include type 2 diabetes and chronic pancreatitis. Family history, Genetic conditions, Lynch Syndrome, BRCA1/2 mutation

Pancreatic Cancer: Clinical Presentation

• Clinical presentation such as jaundice, skin itching, and dark urine.
• Anorexia, Weight loss, Nausea and vomiting occur and abdonal pain

Pancreatic Cancer: Role of The Nurse

• Surgical care: drains, catheter, NG tube, Whipple procedure
• Pain meds, pancreatic enzymes

Skin Cancer: Pathophysiology

• Skin anatomy knowledge is important.
• Cell damage an result in Mutations, leading to Types- Basal cell, Squamous cell or Melanoma.

Skin Cancer: Risk Factors

• Ultraviolet radiation, Family history, and Moles are the risk factors to skin cancer.
• Immunosuppression is a a factor in United States, skin cancer is the most commonly diagnosed cancer.

Skin Cancer: Treatments

• Chemical peels, Photodynamic therapy, Surgery, Radiation is important.
• Chemo/ Immunotherapy is a type of treatment.

Skin Cancer: Role of the Nurse

• Surgical care and medication adiminstration is important.
• Provide teaching, radiation and education skills- prevention and collaboration.

Brain and CNS Tumors: Pathophysiology

• CNS brain and spinal cord anatomy.
• Types- Astrocytoma, Glioblastomas and Meningiomas

Brain and CNS Tumors: Clinical Presentation

• Headaches, Seizures, Visual changes and balance issues are the presentation

Brain and CNS Tumors: Treatments

• Surveillance, Surgery and radiation.
• Medication administration surgical care and rehabilitataion is important

These notes offer a comprehensive study guide, capturing information on cancer pathophysiology, types, related risk factors, prevention methods, clinical presentations, diagnostic approaches, the impact on overall health, and the crucial role of nurses in managing and caring for cancer patients, with specific details on breast, lung, prostate, colorectal, pancreatic and skin cancers.