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Nursing Care of the Child With Cancer
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NeoplasiaCell growth in cancerous tissue proliferates in
disorderly and chaotic waysNeoplasm- literally “new growth,” but usually
refers to abnormal new growth
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ASSESSING CHILDREN WITH CANCERS
History Physical and laboratory examination
Biopsy Bone marrow aspiration
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OVERVIEW OF CANCER TREATMENT MEASURES USED WITH CHILDREN
Radiation therapy Immediate side effects Long term side effects
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OVERVIEW OF CANCER TREATMENT MEASURES USED WITH CHILDREN
Chemotherapy Chemotherapy protocols…no ASA, no live
viruses, no folic acid Side effects & toxic reactions
Hair loss and N&V are common Also malnutrition, stomatitis, constipation, and diarrhea
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OVERVIEW OF CANCER TREATMENT MEASURES USED WITH CHILDREN
Bone Marrow transplantation Can be autologous or allogenic
Hematopoitic Stem Cell transplant Autologous, peripheral Stored umbilical cord blood Embryonic?
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THE LEUKEMIAS
Leukemia-uncontrolled proliferation of WBCs and the most common childhood cancer
Acute Lymphocytic Leukemia 75% of leukemias fall into this category Overproliferation of lymphocytes S/S
Pallor, low-grade fever, lethargy Goal
Total cure, 95% of children will have a first remission but if they experience a relapse, the prognosis is less favorable
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THE LEUKEMIAS
Acute Myelogenous Leukemia Accounts for 20% of leukemias Overproliferation of granulocytes S/S are the same as with ALL but may also have
had recent URIs Goal
Remission is harder to achieve than in ALL and tends to be shorter
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THE LYMPHOMAS
Malignancies of the lymph or reticuloendothelial system
Hodgkin’s Disease Reed-Sternberg cells S/S
One painless, enlarged, rubbery-feeling lymph node, usually cervical
Therapeutic Management Chemo and radiation 90% 5-year survival rate and relapses respond well the
further therapy
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THE LYMPHOMAS
Non-Hodgkin’s Lymphoma Proliferation of lymphocytes Spread through the bloodstream rather than by
lymph flow S/S
Enlargement of lymph nodes of neck and chest Therapeutic Management
Chemo and autologous bone marrow transfusion 80-90% of those with minimal symptoms will achieve
remission
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Non-Hodgkin’s Lymphoma Burkitt’s lymphoma
Rare form of Non-Hodgkins Associated with the Epstein-Barr virus that causes
mononucleosis S/S
• Enlarged lymph node in the neck or abdomen Therapeutic Management
• Surgery, then chemo
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NEOPLASMS OF THE BRAIN
Types of Brain Tumors Astrocytomas Medulloblastomas Brain stem tumors
S/S Symptoms of increased ICP
Headache, vomiting, vision changes, enlarging head circumference
Therapeutic management Surgery, then chemo and radiation
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BONE TUMORSOsteogenic Sarcoma-malignant tumor of the
long bone S/S
Pain and swelling, esp. around the knee Therapeutic Management
Surgery, usually amputation, then chemo60-65% of those rigorously treated can be cured
Ewing’s Sarcoma-occurs most often in the bone marrow of long bones S/S is pain Therapeutic Management is surgery, radiation,
and chemo
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OTHER CHILDHOOD NEOPLASMS
Neuroblastoma Tumors that arise from the cells of the
sympathetic nervous system The most common abdominal tumor in childhood S/S
Palpable abdominal mass Therapeutic Management
Depends on staging Surgery, chemo, bone marrow transplant Overall survival rate is 70-90%
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OTHER CHILDHOOD NEOPLASMS
Rhabdomyosarcoma Tumor of striated muscle S/S depend on site Therapeutic Management
Surgery, then chemo Prognosis depends on size and location of tumor
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OTHER CHILDHOOD NEOPLASMS
Wilm’s tumor- malignant tumor that rises from the metanephric mesoderm cells of the upper pole of the kidney Accounts for 20% of solid tumors in childhood Associated with aniridia, cryptorchidism, hypospadias S/S
Firm, nontender, abdominal mass Therapeutic Management
Abdominal palpation seems to increase metastasis Surgery, radiation, chemo
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OTHER CHILDHOOD NEOPLASMS
Retinoblastoma-malignant tumor of the retina of the eye Accounts for only 1-3% of childhood
malignancies Associated with an alteration of chromosome 13
and also an inherited autosomal dominant pattern S/S
Absence of red reflex in the pupil then later, strabismus Therapeutic Management
Cryosurgery for small tumors, enucleation for large ones