Seminar in Nursing: Lung and Cervical Cancer PDF

SEMINAR IN NURSING​ ​ ​ ​ ​ ​ ​ BSN 4P Group 1 FROM ABERRATION TO ACTION: Illuminating the Path to Cancer Awareness Topic 1:​ LUNG CANCER B. ANATOMY & PHYSIOLOGY A. DEFINITION Tumors a...

SEMINAR IN NURSING​ ​ ​ ​ ​ ​ ​ BSN 4P Group 1 FROM ABERRATION TO ACTION: Illuminating the Path to Cancer Awareness Topic 1:​ LUNG CANCER B. ANATOMY & PHYSIOLOGY A. DEFINITION Tumors arising from the lung parenchymal or within bronchi is called bronchogenic carcinoma or lung cancer. Carcinogens, such as cigarette smoke, are mainly believed to be its main cause, as continued exposure to it can affect the lung epithelium and lead to dysplasia. The longer it goes on, the longer its surroundings get affected. This can affect the protein synthesis as a result of genetic mutations, and with the Anatomical Structure: changes of the cell, its cycle gets disrupted thus ​ Located in the thoracic cavity, protected by promoting carcinogenicity. the rib cage, and positioned on either side of the heart. Stages: ​ Divided into lobes: ​ Stage 0 (in situ) - Often asymptomatic and ○​ Right lung: 3 lobes (superior, middle, can only be detected through imaging or inferior). biopsy. ○​ Left lung: 2 lobes (superior, inferior) ​ Stage 1 Lung Cancer (Localized) to accommodate the heart. ○​ Stage IA: Tumor size is 3 cm or less ​ Each lung has 8–10 segments, separated ○​ Stage IB: Tumor size is between 3 by fissures: cm and 4 cm. ○​ Right lung: 2 fissures (horizontal, ​ Stage 2 Lung Cancer (Locally advanced) oblique). ○​ Stage IIA: Tumor size is more than 4 ○​ Left lung: 1 fissure (oblique). cm but has not spread significantly ○​ Stage IIB: Larger tumors or those Airways: that have spread to nearby lymph ​ Air enters through the nose or mouth → nodes. pharynx → larynx → trachea → two primary ​ Stage 3 Lung Cancer (Regional) bronchi. ○​ Stage IIIA: Cancer has spread to ​ Primary bronchi branches into secondary nearby lymph nodes but not beyond bronchi, bronchioles, and alveoli. the mediastinum; ○​ Stage IIIB: More extensive lymph Gas Exchange: node involvement or larger tumors ​ Occurs in alveoli, tiny sacs at the ends of affecting surrounding structures. bronchioles. ​ Stage 4 Lung Cancer ( Metastatic) ​ Lungs contain ~300 million alveoli, providing ○​ Stage IVA: Tumors have spread a surface area equivalent to a tennis court. outside the chest but not to distant ​ Oxygen diffuses from alveoli into capillaries; organs carbon dioxide diffuses out for exhalation. ○​ Stage IVB: Multiple metastases in one organ or spread to multiple Pleura and Respiratory Mechanics: organs. ​ Lungs are covered by a double-layered pleura: 1 SEMINAR IN NURSING BSN 4P Group 1 ○​ Visceral pleura: Closely envelops the lung tissue. ○​ Parietal pleura: Lines the chest wall. E. PATHOPHYSIOLOGY ○​ Pleural fluid between layers reduces friction during breathing. ​ Diaphragm and intercostal muscles aid in expanding and contracting the thoracic cavity for inhalation and exhalation. Lung Functions: ​ Supply oxygen to the bloodstream and remove carbon dioxide. ​ Perform gas exchange through alveolar and capillary membranes. ​ Pinkish-gray, spongy organs with three edges, surfaces, and an apex. Lobules and Segments: ​ Lobules: Groups of alveoli within each lobe. ​ Right lung: 10 segments; left lung: 8 segments. C. SIGNS & SYMPTOMS ​ Chronic Cough ​ Hemoptysis ​ Dyspnea ​ Unexplained Weight Loss ​ Chest Pain ​ Hoarseness ​ Fatigue ​ Recurrent Respiratory Infections D. ETIOLOGY a. Predisposing Factors ​ Gender ​ Genetics ​ Race b. Precipitating ​ Carcinogens ​ Tobacco use ​ Secondhand (Passive) Smoke ​ Occupational Exposures ​ Dietary Deficits ​ Air Pollution ​ Ionizing Radiation 2 SEMINAR IN NURSING BSN 4P Group 1 F. MEDICAL MANAGEMENT ​ Lobectomy Diagnostic exam ​ Pneumonectomy ​ Biopsy ​ Sleeve Resection ​ Chest x-ray ​ Open-Chest Surgery (Thoracotomy) ​ Sputum Cytology ​ VATS (Video-Assisted Thoracoscopic ​ Computed Tomography Scan Surgery) (CT SCAN) ​ RATS (Robot-Assisted Thoracic Surgery) ​ Magnetic Resonance Imaging (MRI) ​ Positron Emission Tomography (PET) Scan H. NURSING MANAGEMENT ​ Endoscopy with Esophageal Ultrasound 1.​ Ineffective Airway Clearance related to ​ Low dose Helical Computed Tomography tumor obstruction as evidenced by chronic productive cough and wheezing. Treatment 2.​ Impaired Gas Exchange related to tumor ​ Surgery growth as evidenced by a low oxygen ​ Chemotherapy saturation of 83%. ​ Radiation Therapy 3.​ Chronic Pain related to tumor invasion as ​ Targeted Therapy evidenced by a pain scale of 10/10 and guarding behavior Drugs 4.​ Risk for Infection as evidenced by ​ Carboplatin: DNA, RNA, and protein adherence to chemotherapy medication production are all disrupted by the 5.​ Anxiety related to unidentified causes interstrand DNA cross-linkages it creates. associated with lung cancer as evidenced Effective regardless of the cell cycle, by excessive worry, restlessness, carboplatin during the duration of a cell's tachycardia, and difficulty concentrating. existence. ​ Cisplatin: Causes both intrastrand and Topic 2: CERVICAL CANCER interstrand cross-links in the DNA of quickly proliferating cells, blocking the production of A. DEFINITION RNA, DNA, and proteins. Therapeutic Cervical cancer is a preventable yet effect: stops cancerous cells from growing significant health issue globally. It arises from the rapidly. uncontrolled growth of abnormal cells in the ​ Paclitaxel: Disrupts the normal function of cervix, often linked to persistent infection with microtubules in cells by promoting their high-risk strains of the human papillomavirus assembly and preventing disassembly. This (HPV). Below is an overview of its causes, results in inhibition of cancer cell replication, classifications, and prevention strategies. leading to cell death ​ Ondansetron: Prevents serotonin from Key Causes and Risk Factors triggering nausea and vomiting pathways, Human Papillomavirus (HPV): A sexually especially those caused by chemotherapy, transmitted infection, especially high-risk strains, is radiation therapy, and post-operative the primary cause. (Hoffman et al., 2020) conditions. Progression G. SURGICAL MANAGEMENT Untreated cellular changes caused by HPV can ​ Wedge Resection develop into cancer. ​ Segmental Resection 3 SEMINAR IN NURSING BSN 4P Group 1 ​ Prevalence: Cervical cancer ranks third Layers: among cancers in women globally, ​ Epithelium: particularly in areas with limited preventive ​ Squamous epithelium (outer portion). healthcare access. (Berek & Berek, 2020) ​ Columnar epithelium (inner portion). ​ Stroma: Dense connective tissue with Classification smooth muscle fibers. 1.​ Squamous Cell Carcinoma ​ Blood Supply: Uterine and vaginal arteries. a.​ Origin: Thin, flat cells lining the ​ Innervation: Hypogastric plexus. cervix. ​ Lymphatic Drainage: Pelvic lymph nodes b.​ Prevalence: Accounts for 70–90% of (external iliac, internal iliac, and sacral cases. nodes). 2.​ Adenocarcinoma Physiological Role: a.​ Origin: Glandular cells in the cervical ​ Produces mucus to facilitate or block sperm canal. entry (depending on the menstrual cycle b.​ Prevalence: Represents 10–25% of phase). cases. ​ Dilates during labor to allow childbirth. 3.​ Adenosquamous Carcinoma a.​ Characteristics: Features of both C. SIGNS & SYMPTOMS squamous and glandular cell types. ​ Abnormal vaginal bleeding b.​ Rarity: A less common form. ​ Pelvic Pain and Pain during intercourse (Hoffman et al., 2020) ​ Unusual Vaginal Discharge ​ Painful Urination or Blood in Urine B. ANATOMY & PHYSIOLOGY ​ Fecal Incontinence ​ Leg Swelling or Pain ​ Fatigue ​ Back Pain D. ETIOLOGY a. Predisposing ​ Age ​ Family Age ​ Race b. Precipitating Anatomical Structure: ​ Location: Lower, narrow part of the uterus; ​ Human Papillomavirus connects the uterine cavity to the vagina. ​ Smoking and Secondhand Smoker ​ Length: Approximately 2.5 to 3 cm in ​ Sexual Activity non-pregnant women. ​ Diethylstilbestrol exposure ​ External Os: Opening of the cervix into the ​ HIV or other infection vagina. ​ Low socioeconomic status ​ Endocervical Canal: Passage between the external os and the internal os. ​ Internal Os: Opening of the cervix into the uterine cavity. 4 SEMINAR IN NURSING BSN 4P Group 1 E. PATHOPHYSIOLOGY F. MEDICAL MANAGEMENT Diagnostic exam ​ Pap Test (Pap Smear) ​ HPV DNA Test ​ Colposcopy ​ Punch biopsy ​ Cone Biopsy ​ Endocervical curettage (ECC) Treatment ​ Radiation Therapy ​ Chemotherapy ​ Chemoradiotherapy ​ Targeted Therapy ​ Immunotherapy Drugs ​ Ondansetron: Prevents nausea and vomiting caused by chemotherapy or radiation. ​ Cisplatin: A platinum-based chemotherapy agent that kills cancer cells by damaging their DNA. ​ Carboplatin: A platinum-based chemotherapy drug used as an alternative to cisplatin with fewer side effects. ​ Paclitaxel: A chemotherapy agent that inhibits cancer cell division by stabilizing microtubules. ​ Avastin (Bevacizumab): An anti-angiogenic drug that blocks blood vessel growth in tumors, limiting their nutrients and oxygen supply. ​ Erythropoietin: Stimulates red blood cell production to treat anemia caused by chemotherapy or cancer. G. SURGICAL MANAGEMENT ​ Hysterectomy ​ Cryosurgery ​ Laser Ablation ​ Conization ​ Trachelectomy 5 SEMINAR IN NURSING BSN 4P Group 1 ​ Pelvic Exenteration ​ Females: Contains lobes and lobules that produce milk, connected to lactiferous ducts H. NURSING MANAGEMENT for milk transport. ​ Acute pain related to tumor obstruction as ​ Males: Lacks developed lobes and lobules, evidenced by guarding behavior. with no milk-producing function. ​ Anxiety related to the threat of death as ​ Adipose Tissue: Influences breast size and evidenced by expressed anguish. shape. ​ Deficient fluid volume related to excessive ​ Cooper’s Ligaments: Provide structural bleeding as evidenced by sudden weight support for breast tissue. loss ​ Vessels: Blood vessels supply nutrients, ​ Risk for constipation related to tumor and lymphatic vessels drain fluids, obstruction maintaining breast health. ​ Fatigue related to organ dysfunction as evidenced by expressed tiredness. Physiological Functions: ​ Hormonal Regulation in Females Topic 3: BREAST CANCER ​ Puberty and Pregnancy: Estrogen and progesterone promote breast growth and A. DEFINITION development. Breast cancer, a prevalent and potentially ​ Lactation ​ Prolactin: Stimulates milk production in life-altering disease, is characterized by the lobules. uncontrolled growth of malignant cells within the ​ Oxytocin: Triggers the let-down reflex, breast tissues. It is a type of cancer that originates releasing milk through ducts and the nipple. ​ Males: Minimal hormonal influence; breast primarily in the milk ducts or lobules of the breast. tissue remains undeveloped. Breast cancer can manifest in various forms, with the most common being invasive ductal carcinoma, C. SIGNS & SYMPTOMS ​ Stage 0: Ductal Carcinoma In Situ where cancer cells invade nearby tissues beyond ○​ Often asymptomatic the ducts. ○​ Lump or abnormal mammogram findings B. ANATOMY & PHYSIOLOGY ​ Stage 1 External Features: ○​ A lump in the breast ​ Nipple: Central protruding structure for milk ○​ Abnormal nipple discharge release. (including blood) ​ Areola: Pigmented area surrounding the ○​ Changes in breast shape or size nipple containing Montgomery glands, ○​ Skin texture changes (e.g., dimpling which secrete oils to protect and lubricate or color changes) the nipple during breastfeeding. ​ Stage 2 ​ Skin: Protective barrier with sweat glands, ○​ lump in the breast or underarm sebaceous glands, and hair follicles around ○​ Changes in breast shape or size the areola. ○​ Dimpling or puckering of the skin ○​ Inverted nipple Internal Features: ○​ Nipple discharge ​ Glandular Tissue: ​ Stage 3 6 SEMINAR IN NURSING BSN 4P Group 1 ○​ Breast pain, itchiness, or irritation E. PATHOPHYSIOLOGY ○​ An open sore or ulcer on the breast ○​ Symptoms from earlier stages (e.g., lumps, changes in appearance) ​ Stage 4 ○​ Bone pain, joint swelling ○​ Respiratory issues (e.g., chronic cough, shortness of breath) ○​ Jaundice if liver is involved ○​ Neurological symptoms if it spreads to the brain (e.g., headaches, memory loss) D. ETIOLOGY a. Predisposing Factors ​ Genetics ​ Sex ​ Age ​ Race ​ Menstrual History ​ Dense Breast Tissue b. Precipitating Factors ​ Sedentary Lifestyle ​ Radiation Exposure ​ Diabetes Mellitus ​ Obesity ​ Alcoholism ​ Contraceptives 7 SEMINAR IN NURSING BSN 4P Group 1 F. MEDICAL MANAGEMENT receiving the signals they need to grow and multiply. Diagnostic exam ​ Pap Test (Pap Smear) G. SURGICAL MANAGEMENT ​ HPV DNA Test ​ Lumpectomy (Breast-Conserving Surgery) ​ Colposcopy ​ Mastectomy (Simple or Total) ​ Punch biopsy ​ Modified Radical Mastectomy ​ Cone Biopsy ​ Sentinel Lymph Node Biopsy (SLNB) ​ Endocervical curettage (ECC) Treatment H. NURSING MANAGEMENT ​ Chemotherapy 1.​ Anxiety related to diagnosis of cancer as ​ Radiation Therapy evidenced by verbalization of deep concern ​ Immunotherapy and worries. ​ Targeted Therapy 2.​ Disturbed Body Image related to ​ Hormone Therapy Mastectomy and Hair loss from ​ Palliative Care chemotherapy as evidenced by patient verbalization of feelings of discomfort with Drugs self and expressing concerns about Common Drugs for Breast Cancer: appearance. ​ Anastrozole - This inhibits the enzyme 3.​ Risk for infection related to aromatase, which is responsible for immunosuppression from chemotherapy. converting androgens into estrogens in 4.​ Acute Pain related to tumor pressure as peripheral tissues. This action reduces evidenced by facial grimacing and guarding estrogen levels, slowing the growth of behavior. estrogen-dependent breast cancer cells. 5.​ Risk for impaired skin integrity related to ​ Cyclophosphamide - it interferes with the exposure to radiation therapy. replication of rapidly dividing cells by cross-linking DNA strands and inhibiting Topic 4: COLORECTAL CANCER protein synthesis, leading to cell death. It targets both cancerous and normal rapidly A. DEFINITION dividing cells. Colorectal Cancer (CRC) is a prevalent and ​ Everolimus - Everolimus selectively inhibits potentially fatal cancer affecting the colon or the mammalian target of rapamycin rectum, depending on the tumor's initial location. (mTOR), a protein kinase that regulates cell growth, proliferation, angiogenesis, and ​ Uncontrolled cell growth results in tumor metabolism. By blocking mTOR, everolimus formation, which can be: reduces tumor growth and progression in ○​ Benign: Non-cancerous, hormone receptor-positive and non-invasive, and not HER2-negative breast cancers and other life-threatening. types of tumors. ○​ Malignant: Cancerous, invasive, ​ Tamoxifen - Tamoxifen binds to estrogen and capable of spreading through receptors on breast cancer cells, blocking the bloodstream or lymphatic estrogen's effect. This action inhibits the system. growth of estrogen receptor-positive (ER+) breast cancer cells by preventing them from 8 SEMINAR IN NURSING BSN 4P Group 1 Origin and Risk Factors: B. ANATOMY AND PHYSIOLOGY ​ Often originates from polyps (non-cancerous growths) in the colon or Colon rectum. ​ Common in older individuals but can also result from genetic predisposition in younger people. Types of Polyps: ​ Adenomatous Polyps (Tubular Adenoma): ○​ Most common type, small, tube/round-shaped. ○​ Slow development, taking years to potentially become cancerous. Linings of ​ Hyperplastic Polyps: the Colon ○​ Small with a low risk of becoming cancerous. ​ Sessile Serrated Polyps: ○​ Found in the upper colon, smaller, with a higher potential for malignancy. ○​ Difficult to detect. ​ Inflammatory Polyps: Motility in the Large Intestine: Haustral ○​ Form during chronic inflammation Contractions (e.g., Inflammatory Bowel Disease). ○​ Often not true polyps but reactions to inflammation. ​ Villous Adenomas (Tubulovillous Adenomas): ○​ High malignancy risk, requiring immediate surgical removal. Adenoma-Carcinoma Sequence: ​ Gradual transformation of adenomas into cancer spans several years. ​ Involves gene mutations disrupting growth control mechanisms. ​ Cancerous cells infiltrate the bowel wall and may metastasize to other regions via blood or lymphatic systems. 9 SEMINAR IN NURSING BSN 4P Group 1 Rectum and Anus E. PATHOPHYSIOLOGY C. SIGNS & SYMPTOMS ​ Change in Bowel Habits (Constipation or Diarrhea) ​ Blood in the Stool (Melena or Hematochezia) ​ Abdominal Discomfort (Cramp and Pain) ​ Fatigue ​ Anemia ​ Nausea and Vomiting ​ Persistent Bloating ​ Unexpected Weight Loss ​ Lumbar Pain (Lower Back Pain) D. ETIOLOGY a. Predisposing factors ​ Age ​ Ethnicity ​ Family History b. Precipitating Factors ​ Sedentary Lifestyle ​ Inflammatory Bowel Disease ​ Tobacco use ​ Diet (Processed, Grilled Meat) 10 SEMINAR IN NURSING BSN 4P Group 1 preventing its breakdown through inhibition of thymidine phosphorylase. This then F. MEDICAL MANAGEMENT stunts the growth of the tumor cell growth. Diagnostic exam ​ Colonoscopy G. SURGICAL MANAGEMENT ​ Fecal Occult Blood Test (FOBT) ​ Right Hemicolectomy ​ Sigmoidoscopy ​ Local excision ​ Carcinoembryonic Antigen (CEA) Test ​ Endoscopic mucosal resection ​ Polypectomy Treatment ​ Colectomy (Partial or Total) ​ Surgery ​ Chemotherapy H. NURSING MANAGEMENT ​ Radiation Therapy 1.​ Acute Pain related to tumor invasion as ​ Targeted Therapy evidenced by reports of pain and guarding ​ Immunotherapy behavior 2.​ Imbalanced Nutrition: Less than body Drugs requirements related to impaired gastrointestinal function as evidenced by ​ 5-Fluorouracil: It inhibits the synthesis of weight loss and fatigue thymidylic acid and is specific to the S 3.​ Risk for Infection as evidenced by phase of the cell cycle during cell division. Neutropenia With this, it inhibits the DNA & RNA 4.​ Fatigue related to cancer treatments synthesis evidenced by reports of exhaustion, ​ Capecitabine: It is metabolized into reduced physical activity, and difficulty 5-fluorouracil (5-FU), which inhibits completing daily tasks. enzymes required for the production of 5.​ Risk for Bleeding as evidenced by low essential cellular components. Thus, platelet counts associated with interfering the action of DNA synthesis, chemotherapy treatment. RNA prcoessiong, and protein synthesis. ​ Irinotecan: It reversibly binds to topoisomerase I, an enzyme that alleviates torsional strain in DNA by creating temporary single-strand breaks. This binding inhibits the re-ligation of these breaks, leading to double-strand DNA damage and cell death. ​ Oxaliplatin: disrupts DNA replication and transcription by cross-linking DNA strands, and is not specific to any phase of the cell cycle. Thus, it results in cellular death. ​ Trifluridine: Trifluridine, the active cytotoxic component, disrupts DNA synthesis and inhibits cancer cell proliferation. Tipiracil enhances trifluridine's effectiveness by 11