Adult Health cancer

Cancer Definition

• Cancer is characterized by abnormal, uncontrolled cell division that invades and crowds out healthy tissue.
• It is a non-discriminatory disease, meaning it can affect any tissue type.
• It is the second leading cause of death in the U.S.
• Higher incidence among African Americans.

Risk Factors/Carcinogens

• Smoking (including tobacco and e-cigarettes)
• Diet high in fat, low in fiber, and inadequate nutrients
• Obesity and inactivity
• Ultraviolet radiation
• Environmental and chemical carcinogens
• Frequent heavy alcohol consumption
• Genetics

Comparison of Neoplasms (Malignant vs. Benign)

• Malignant:*

• Usually rapid growth

• Metastasizes (spreads to other areas)

• Outside capsule

• Irregular, more immovable

• Little resemblance to parent tissue

• Invades tissue

• May recur

• Fatal without treatment

• Benign:*

• Slow growth

• Localized

• Encapsulated

• Smooth, well-defined edges, movable

• Resembles parent tissue

• Crowds tissue

• Rarely reoccurs after removal

• Rarely fatal

Spread of Cancer (Metastasis)

• Diffusion to other body cavities
• Circulation via blood or lymphatic system

Forms of Cancer

• Carcinoma: Most common type; arises from epithelial tissue (e.g., skin, lining of organs)
• Sarcoma: Solid form; arises from connective tissue (e.g., bone, muscle, cartilage)
• Blood-forming: Leukemias, lymphomas (Hodgkin's and non-Hodgkin's), multiple myeloma

Primary Prevention

• Dietary changes
• Lifestyle modifications

Secondary Prevention

• Screening tests:
  • SBE (Self breast exam)
  • Clinical breast exam
  • Mammograms
  • Digital rectal exams
  • Pap Smear
  • Stop smoking
  • Prostate exam and/or PSA
  • Self skin examination

Classification of Malignancies (Grading and Staging)

• Grading:*

• GX: Normal tissue

• G1: Well-differentiated

• G2: Moderately differentiated

• G3: Poorly differentiated

• G4: Undifferentiated/poor resemblance to parent tissue

• Staging:*

• Stage 0: Cancer in situ (confined to original site)

• Stage 1-4: Increasing extent from localized to regional spread to metastasis

Warning Signs of Cancer

• Change in bowel or bladder habits
• Sore that does not heal
• Unusual bleeding or discharge
• Thickening or lump
• Indigestion or difficulty swallowing
• Obvious change in wart or mole
• Nagging cough or hoarseness
• White patches on tongue or inside mouth

Know Your ABCDE's (Skin Cancer)

• Asymmetry: One half doesn't match the other
• Border: Irregular borders
• Color: Variety of colors (brown, tan, black)
• Diameter: Larger than a pencil eraser (1/4 inch)
• Evolution: Change in size, shape, color, elevation

Diagnostic/Screening Tests

• Pap smear
• Biopsy
• Bronchoscopy
• EGD/colonoscopy/flexible sigmoidoscopy
• Mammograms
• GI series (UGI, BE)
• CT scans
• PET scans
• MRI
• Ultrasounds
• Radioisotope studies
• Lab tests (e.g., CEA, CA-125, PSA, CA-19-9, occult blood test)

Treatment - Surgery

• Often primary, curative, palliative, or diagnostic
• Newer techniques include laser and cryosurgery

Treatment - Radiation

• Damages DNA and disrupts cell division in cancerous cells, and occasionally normal cells nearby.
• Can be used alone or as an adjunct therapy.
  • External Beam: Patient is not radioactive, sites marked with ink, shielded areas. Side effects include radiation sickness, stomatitis, alopecia, cystitis, bone marrow depression, and pneumonitis.
  • Sealed Internal Radiation: Implants are placed near cancer site. Types include vaginal/uterus, head and neck. Nursing interventions focus on shielding, avoiding certain activities, and monitoring.
  • Unsealed Internal Radiation: Patient is a source of radioactivity. Nursing interventions require using specific utensils, limiting visitors, and appropriate precautions and hygiene.

Treatment - Chemotherapy

• Acts systemically, affecting both cancerous and healthy cells, especially those in the GI system.
• Aims for cure, control, or palliative care. Common side effects include leukopenia, stomatitis, thrombocytopenia, alopecia, and assessing for infection.

Treatment - Targeted Therapy / Biotherapy

• Uses immunotherapy, human growth factors, and biological response modifiers, like interferons, interleukins, and tumor necrosis factor.
• Aims for antitumor effects via activating a variety of responses.
• Colony stimulating factors (e.g., G-CSF) promote growth of blood cells (granulocytes, RBCs).

Treatment - Bone Marrow Transplant

• Replaces diseased or damaged bone marrow with healthy marrow. Types include autologous (patient's own marrow), allogenic (compatible donor tissue), syngeneic (identical twins), and related/unrelated donors.
• Pre-transplant treatment typically involves chemo and/or radiation. Precautions for germ-free environment and recovery time are necessary.

Emotional Support

• Understanding the patient's perspective.
• Addressing anxiety, depression, and potential feelings of punishment associated with the illness.
• Encouraging patient progress and understanding the grieving process.
• Providing support groups and encouraging participation in self-help groups.

Rehab

• Encouraging patients to return to normal activities
• Supporting independence as much as possible

Other Key Considerations (from various slides)

• Cancer classifications: Carcinoma, sarcoma, blood-forming
• Warning signs: Comprehensive list across various body systems
• Cancer stages: Described as Stage 0, 1, 2, 3, and 4
• Treatment focus: Comfort, altered body image, nutrition, chemotherapy, evaluate response, respite for caretakers
• Review of ATI AMS cancer chapters.
• Tumor lysis syndrome: Emergency associated with rapid cancer cell death, including electrolyte imbalances (hyperkalemia, hyperuricemia). Nursing interventions involve hydration and medications (e.g., allopurinol)
• Anemia with chemotherapy: Potential for low hemoglobin levels (anemia) as a complication requiring rest, nutrition, and in some cases blood transfusions
• Neutropenia: Low white blood cell count, increasing risk of infection; treatment involves medications like colony stimulating factors. Nursing interventions focus on preventing infection and promoting hygiene.

Test your knowledge on the functions and treatments related to cancer management. This quiz covers topics like tumor necrosis factor, bone marrow transplants, emotional responses, and nursing interventions during cancer treatment. Enhance your understanding of crucial aspects in oncology care.