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ONCOLOGY NURSING

Cancer is a NEOPL STI , M LI N NT,CUR LE, and an IDIOPATHICDisease.NEOPLASMS HAVE TWO DIFFERENT TYPES: IT IS EITHER BENIGNOR MALIGNANT.

TWO TYPES OF METASTASIS:TUMOR (New Growth) OR HEMATOGENOUS(e.g. Leukemia)

CARCINOGENESIS IS THE DEVELOPMENT OF A CANCER.

*note: CA means Cellular Aberration

Factors in the Development of cancer;

Decreased apoptosisIncreased proliferation

Abnormal proliferation

Phases:

Initiation: includes external factors such as carcinogens

Promotion: includes internal factors such as oncogene associated with genetics

Progression: cells complete transformation which leads to invasion and metastasis

*Endometriosis is a the only benign tumor that is metastasizing

Risk factors:

Bacteria and viruses:

H. PyloriGastric CA

Epstein Barr virusNasopharyngeal CAHPV - Cervical CA

Chemicals

AlcoholsLiver Cancer

SmokingAll CA * Alcohol + Smoking = 2x Effect

NitrosaminesFound in Cosmetics, Latex, Pesticides, Rubber Products

BenzopyrenesGrilled Foods

Hydrocarbonssmoke belched

AflatoxinAmag Nuts and rice

TalcOvarian CA

Chronic Irritation

Multiple Sexual Partners

Toxic Diethi fat, low fiber> Colon CA

*Cruciferous foods (cauliflower, broccoli, cabbage) can prevent prostate CA

*Carotenoids (carrots and tomatoes- which is high in lycopene) are anti CA agents

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Early Detection and Prompt Treatment:

Breast CA: BSE, Mammography

Cervical CA: Pap Smear over age 18in between menses annually

Colorectal CA: DRE,Guiac Test, Colonoscopy

Prostate CA: DRE, PSA (Prostate Specific Antigen)

DIAGNOSTIC TESTS:

1. Biopsymost definitive test for cancerAspirational Biosywith use of fine needle

Excisional BiopsyRemoval of the Entire tumor- for small sized tumor only

Incisional Biopsy - only a portion of tumor is being removedfor big sized tumors.

2. Cancer MarkersChemical Being produced by cancerBreast CACA-153/ BRCA 1&2

Colon CACEACarcinoembryonic Antigen

Prostate CA - Increased PSA

Liver CAIncreased AFP

3. Host Response MarkertNF (Tumor Necrotic Factor)Suppresses Satiety Center of the Brain Appetite Center (Hypothalamus)

Sever Anorexia

Muscle wasting / Muscle weight lossCACHEXIA

Weight Loss

CHEMOTHERAPY: kills rapid dividing cells*

*Hair cells- alopecia

Lasts for 2-3 weeks (Cut hair before chemo)

Child/boy/manuse cap

Preventionice helmet intermittent application of 30 minutes.

*Mucus membranestomatitis/mucositis

Use of soft toothbrush, bland soft dietViscous lidocaine

*Gonads- Infertility

*Bone marrow depression

Anemia

Neutropenia PANCYTOPENIA

Thrombocytopenia

ROUTES OF CHEMOTHERAPY:

ORAL- MOST CONVENIENT

IVMOST DANGEROUS AND DEADLIEST

INTRAMUSCULAR RARELY GIVEN

INTRATHECAL OMMAYA RESERVOIR

INTRAPERITONEAL- COLON CANCER

INTRAVESICALTHRU FOLEY CATHETER

DANGEROUS CHARACTERISTICS:

TERATOGENIC

CARCINOGENIC

VESICANT

PHOTOSENSITIVE- USE ALLUMINUM FOIL

HAZARDS:

INHALATION

SKIN ABSORPTION/TOPICAL

INGESTION MOST COMMON

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FLUSHING OF INTERMITTENT IV DEVICES

SALINE LOCK:SALINE FLUSH ADMINISTER DRUGSALINE FLUSH

HEPARIN LOCK:SALINE FLUSH ADMINISTER DRUGSALINE FLUSHHEPARIN FLUSH

RADIATION TREATMENTDamages DNA of the Cell to Decrease Replication

TELETHERAPY/EXTERNAL RADIATION THERAPYpainless procedure that last from 15 -30 mins

NEVER LET THE PATIENT REMOVE THE SKIN MARKING Instruct the patient that the treatment is painless No residual radiation after treatment Redness, swelling , peel off Use plain water, NOsoap, lotion, moisturizer

TELETHERAPY DONE ON THE PELVIS

DIARRHEA CYSTITIS ERECTILE DYSFUNCTION VAGINAL STENOSIS STERILITY

TREFOIL SIGN - RADIOACTIVE