ONCOLOGIC NURSING

ONCOLOGY study of neoplasia new growth

Differentiated Encapulation Metastasis Prognosis Therapeutic

BENIGN (Tumor) well differentiated (+) (-) good modality surgery

MALIGNANCY (Cancer) poorly or undifferentiated (-) (+) poor 1. Chemotherapy plenty S/E 2. Radiation 3. Surgery most preferred treatment 4. Bone marrow transplant - Leukemia only

PREDISPOSING FACTORS: (carcinogenesis) G genetic factors I immunologic factors V viral factors a. Human papiloma virus causing warts b. Epstein barr virus E environmental Factors 90% a. Physical irradiation, UV rays, nuclear explosion, chronic irritation, direct trauma b. Chemical factors - Food additives (nitrates - Hydrocarbon vesicants, alkalies - Drugs (stillbestrol) - Uraehane - Hormones - Smoking

MALE
3.) Prostate cancer - common 40 & above (middle age & above) BPH 50 & above 1.) Lung cancer 2.) Liver cancer

FEMALE
1. Breast cancer 40 yrs old & up mammography 15 20 mins (SBE 7 days after mens) 2. Cervical cancer 90% multi sexual partners 5% early pregnancy 3. Ovarian cancer

CLASSES OF CANCER
TISSUE TYPING 1. Carcinoma arises from surface epithelium & glandular tissues Sarcoma- from connective tissue or bones 3. Multiple myeloma from bone marrow Pathological fracture of ribs & back pain 4. Lymphoma from lymph glands 5. Leukemia from blood

2.

WARNING / DANGER SIGNS OF CA C change in bowel /bladder habits A a sore that doesnt heal U unusual bleeding/ Discharge T thickening of lump breast or elsewhere I indigestion? Dysphagia O obvious change in wart/ mole N nagging cough/ hoarseness U unexplained anemia A - anemia S sudden wt loss L loss of wt

THERAPEUTIC MODALITY
1. Chemotherapy use various chemotherapeutic agents that kills cancer cells & kills normal rapidly producing cells GIT, bone marrow, and hair follicle. CLASSIFICATION: a.) Alkylating agents b.) Plant alkaloids vincristine c.) Anti metabolites nitrogen mustard d.) Hormones DES Steroids e.) Antineoplastic antibiotics S/E & MANAGEMENT GIT - -Nausea & vomiting Nsg Mgt: 1. Administer anti emetic 4 6h before start of chemo Plasil 2.Withhold food/ fluid before start of chemo 3.Provide bland diet post chemo 1.Non irritating / non spicy - Diarrhea 1. Administer anti diarrheal 4 6h before start of chemo 2. Monitor urine, I&O qh - Stomatitis/ mouth sores 1. Oral care offer ice chips/ popsickles 2. Inform pt hair loss temporary alopecia Hair will grow back after 4 6 months post chemo. -Bone marrow depression anemia 1.Enforce CBR 2.O2 inhalation 3.Reverse isolation 4.Monitor signs of bleeding Repro organ sterility 1. Do sperm banking before start of chemo

Renal system increase uric acid 1. Administer allopurinol/ xyloprin (gout) 2. Inhibits uric acid 3. Acute gout colchicines 4. Increase secretion of uric acid Neurological changes peristalsis paralytic ileus Most feared complication ff any abdominal surgery Vincristine plant alkaloid causes peripheral neuropathy 2. Radiation therapy involves use of ionizing radiation that kills cancer cells & inhibit their growth & kill N rapidly producing cells. TYPES OF ENERGY EMITTED 1. Alpha rays rarely used doesnt penetrate skin tissues 2. Beta rays internal radiation more penetration 3. Gamma ray external radiation penetrates deeper underlying tissues METHODS OF DELIVERY 1. External radiation- involves electro magnetic waves Ex. cobalt therapy 2. Internal radiation injection/ implantation of radioisotopes proximal to CA site for a specific period of time. 2 types: a.) Sealed implant radioisotope with a container & doesnt contaminate body fluid. b.) Unsealed implant radioisotope without a container & contaminates body fluid. Ex. Phosphorus 32

3 FACTORS AFFECTING EXPOSURE A.) Half life time period required for half of radioisotopes to decay. - At end of half life less exposure B.) Distance the farther the distance lesser exposure C. ) Time the shorter the time, the lesser exposure D.) Shielding rays can be shielded or blocked by using rubber gloves & gamma use thick lead on concrete. S/E & MANAGEMENT Skin errythema, redness, sloughing 1. Assist in battling pt 2. Force fluid 2,000 3,000 ml/day 3. Avoid lotion or talcum powder skin irritation 4. Apply cornstarch or olive oil GIT nausea / vomiting 1. Administer antiemetic 4 6h before start of chemo - Plasil 2 Withhold food/ fluid before start of chemo 3. Provide bland diet post chemo - Non irritating / non spicy - Dysglusia decrease taste sensitivity - When atrophy papilla (taste buds) 40 yo - Stomatitis Bone marrow depression 1. Enforce CBR 2. O2 inhalation 3. Reverse isolation 4. Monitor signs of bleeding