Cancer

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39.

Body's response to chemo of cellular destruction of normal tissue: Cancer is high in what gender and ethnicity? Cancer survivorship:

fatigue, anorexia, taste alterations

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Collaborative care goals:

Cure (Surgery alone or periods of systemic therapy), control (Initial course and maintenance therapy) and palliation-goalrelief or control of symptoms & maintain quality of life. Disfigurement, emaciation Dependency Disruption of relationships Pain Financial depletion Abandonment Death Primary cause of death in cancer patients Some sites of infection Lungs Genitourinary tract system Mouth, rectum Peritoneal cavity, blood health history, identification of risk factors, the physical examination, and specific diagnostic studies.

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Men and African Americans

Common fears:

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Survival rates have steadily increased over last 30 years Goal is to maintain an optimal quality of life Be aware of late and long-term effects of cancer Secondary cancer Cognitive changes Cardiovascular/sexual dysfunction Psychosocial effects fluid accumulation in the pericardial sac, constriction of the pericardium by tumor, or pericarditis secondary to radiation therapy to the chest. Manifestations include a heavy feeling over the chest, shortness of breath, tachycardia, cough, dysphagia, hiccups, hoarseness, nausea, vomiting, excessive perspiration, decreased level of consciousness, pulsus paradoxus, distant or muted heart sounds, and extreme anxiety. Invasion of artery wall By tumor Erosion following surgery or radiation Bleeding can manifest as Minor oozing Spurting of blood in case of a blowout In the case of a blowout, pressure should be applied. IV fluids and blood administered to stabilize for surgery skin, inhalation during drug prep, transport, and administration. Risk also handling body fluids of chemo exposure within 48 hours. an occupational hazard to health care professionals who do not follow safe handling guidelines.m the use of chemicals as a systemic therapy for cancer.

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Common Infection:

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Cardiac Tamponade

A diagnostic plan for the person in whom cancer is suspected includes: Diagnostic studies to be performed will depend on: Different types of biopsy?

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he suspected primary or metastatic site(s) of the cancer.

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Carotid Artery rupture:

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. Percutaneous biopsy is commonly performed for tissue that can be safely reached through the skin. Endoscopic biopsy may be used for lung or other intraluminal lesions (esophageal, colon, bladder). Fine-needle aspiration (FNA) may be accomplished with a small-gauge aspiration needle that provides cells from the mass for cytologic examination. Large-core biopsy cutting needles will deliver an actual piece of tissue (core) that can be analyzed with the advantage of preserving the histologic architecture of the tissue specimen. Excisional biopsy involves the surgical removal of the entire lesion, lymph node, nodule, or mass; therefore it is therapeutic as well as diagnostic. If an excisional biopsy is not feasible, an incisional biopsy (partial excision) may be performed with a scalpel or dermal punch.

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Chemo drugs may be absorbed through: Chemo drugs may pose: Chemotherapy:

Different types of needles used in biopsy are:

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Example of lifestyle habits that reduce risk of cancer:

Avoid or reduce exposure to known or suspected carcinogens Cigarette smoke, excessive sun exposure Eat a balanced diet Exercise regularly Obtain adequate rest Regular health examination Change perceptions of stressors Learn to cope with stress Enjoy consistent periods of relaxation and leisure multiple myeloma & chronic lymphocytic leukemia. basal cell carcinoma & acute promyelocytic leukemia & head and neck cancers. Know 7 warning signs of cancer Practice self-examination Seek medical care if cancer is suspected bladder reservoir at the time of cystectomy, breast reconstruction after a mastectomy, and insertion of appliances to facilitate functionality

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Factors that determine the response of cancer cells to chemo: Factors that determine tx modality known as multimodality or combined modality therapy: The goal of chemo: The goals of cure, control, and palliation are achieved through the use of four treatment modalities for cancer: Goals of the prescribed radiation plan are met by:

mitotic rate of tissue from which the tumor arises, size of tumor, age of tumor, location of the tumor & presence of resistant tumor cells Cell type Location and size of tumor Extent of disease Physiologic and psychologic status Expressed needs and desires to eliminate or reduce the number of malignant cells surgery, radiation therapy, chemotherapy, and biologic and targeted therapy

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Examples of Control collaborative Care Examples of Cure collaborative Care Examples of habits that reduce the risk of prevention & detection of cancer: Examples of rehabilitative surgical procedures include: Examples of supportive surgical procedures:

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determining the orientation and size of radiation beams, location of fieldshaping blocks, and outlining the field on the patient's skin. Permits maximum treatment of tumor with minimal damage to normal tissue. occurs in the presence of cancer that involves metastatic disease of the bone or multiple myeloma. Manifestations apathy, depression, fatigue, muscle weakness, ECG changes, polyuria and nocturia, anorexia, nausea, & vomiting. Needle or aspiration, incisional or excisional. decreased

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Hypercalecemia

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nsertion of feeding tube to maintain nutrition during head and neck cancer treatment 2. Creation of a colostomy to allow healing of a rectal abscess 3. Suprapubic cystostomy for the patient with advanced prostatic cancer 4. Placement of venous access devices to deliver chemotherapy agents, pain medication, parenteral nutrition, blood products, and other supplements 5. Removal of metastatic liver lesions in a person with colorectal cancer (Lewis
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In a biopsy tissue may be obtained by: Incidence of lung, colorectal, and oral cancer have: Infection occurs due to:

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Examples of surgical procedures performed for palliation of symptoms: Examples of tx in which palliation is the primary goal include:

Debulking of tumor or radiation therapy to relieve pain or pressure Colostomy for relief of bowel obstruction Laminectomy for relief of spinal cord compression using radiation therapy or chemotherapy to reduce tumor size & relieve subsequent symptoms such as pain of bone metastasis.

Ulceration Necrosis Compression of vital organs by the tumor Neutropenia caused by disease or treatment

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Internal radiation:

Implantation or insertion of radioactive materials into or close to tumor Minimal exposure to healthy tissue Commonly used in combination with external radiation Patient is emitting radioactivity. Limit amount of time near patients being treated. Organize care. Use shielding. Wear film badge to monitor exposure. Bone, lungs, brain, liver, adrenals. Patient report should always be believed and accepted as primary source for pain assessment data Drug therapy should be used to control pain Fear of addiction is unwarranted Nonpharmacologic interventions including relaxation therapy and imagery can be effectively used "treatment port" Syndrome of inappropriate antidiuretic hormone (ADH) secretion Hypercalcemia Tumor lysis syndrome Septic shock Disseminated intravascular coagulation (DIC) effective but often at the expense of greater toxicity. Burkitt's lymphoma

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Non-hodgkin's lymphoma and skin cancer has: Nurses can help cancer survivors:

Increased Educate health care workers about needs of cancer survivors Teach survivors to look for late effects Promote healthy behaviors Good nutrition Regular exercise Appropriate health screening Encourage survivors to seek any help they need be involved in prep and admin of antineoplastic agents. lifestyle habits Coping Assist in planning Transportation, nutrition, emotional support Teach symptom management to maintain quality of life Offer community resources Tell patient what to expect to decrease anxiety Encourage discussion of fears Reassure patient that situation is only temporary Inform patient of provided supportive care Support patient and family by Being available especially during difficult times Exhibiting a caring attitude Listening actively to fears and concerns Providing relief from distressing symptoms Provide information about cancer Maintain relationship based on trust and confidence Be honest Use touch to exhibit caring

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Main sites of bloodborne metastasis: Management of Cancer Pain

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Only specifically trained personnel in chemo handing should Prevention & detection of cancer is reduced by : Psycho-social

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Marks are placed on the skin to delineate the: Metabolic emergencies caused by production of ectopic hormones

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Psychosocial support:

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Multimodality therapy has the benefits of being more: Name the associated cancer with EpsteinBarr virus? Name the associated cancer with Hepatitis B virus? Name the associated cancer with Human immunodeficiency virus (HIV)? Name the associated cancer with Human papillomavirus?

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Hepatocellular carcinoma

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Kaposi's sarcoma

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Squamous cell carcinoma ex: cervical, head and neck cancers.

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Psyho-social support:

Coping with cancer Coping with stress in the past Availability of significant others Ability to express feelings/concerns Age at time of diagnosis Extent of disease Disruption of body image Presence of symptoms Past experiences with cancer Attitude associated with cancer Emphasis placed on maintaining optimal quality of life Positive attitude of patient, family, and health care providers can have a positive impact on the patient's quality of life May also influence prognosis

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The target tumor defined using a variety of possible imaging techniques, physical examination and surgical reports: Third Space Syndrome

x-rays, CT, MRI, PET scans

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Shifting of fluid from vascular space to interstitial space Signs of hypovolemia including hypotension, tachycardia, low central venous pressure, and urine output Treatment: Replacement of fluids, electrolytes, and plasma protein altered body image & functional ability Four hallmark signs: Hyperuricemia Hyperphosphatemia Hyperkalemia Hypocalcemia Usually occurs within 24 to 48 hours after chemotherapy May persist for 5 to 7 days Triggered by chemotherapy's rapid destruction of large numbers of tumor cells Serum phosphate causes calcium to go resulting in hypocalcemia. Can cause biochemical changes resulting in renal failure Can be fatal Primary goal : Preventing renal failure and severe electrolyte imbalance Primary treatment Increase urine production with hydration therapy Decreased uric acid concentrations casts, bite blocks, thermoplastic face masks.

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Pt who has adenomatous familial polyposis may benefit from: Pt who has BRCA1 or BRCA2 may benefit from: Radiation can be delivered: Radiation therapy stimulation: Radiation therapy:

a total colostomy to prevent colorectal cancer

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To maintain quality of life, pt must be able to accept & cope with: Tumor lysis syndrome:

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prophylatic mastectomy

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externally (teletherapy) or internally (brachytherapy). ...

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Tumor lysis syndrome:

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Local treatment modality One of the oldest nonsurgical methods of cancer treatment Up to 60% of all cancer patients will receive radiation therapy Normal tissues are usually able to recover. Cancer cells are more likely to be permanently damaged. Tumor in epidural space of spinal cord; signs include Intense, localized, persistent back pain Motor weakness Sensory paresthesia and loss Change in bladder or bowel function is part of radiation tx planning used to accurately localize the tumor and ensure setup position reproducibility.
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Spinal cord compression:

Tumor lysis syndrome:

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Stimulation:

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Superior Vena Cava Syndrome:

Obstruction by tumor or thrombosis Manifestation/Signs include: Facial and periorbital edema Distention of veins of head, neck, and chest, Seizures, Headache

Uses immobilization devices to help patient maintain a stable position. Examples of devices are:

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What are the 7 warning signs that a client should be taught? Hint CAUTION:

C hange in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge from any body orifice T hickening or a lump in the breast or elsewhere I ndigestion or difficulty in swallowing Obvious change in a wart or mole N agging cough or hoarseness

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What general public education is appropriate? Which cancer is rising faster than any other malignancy in the U.S?

You can have a definite impact in persuading people that a change in lifestyle patterns can have a positive influence on their health. To achieve the desired effect, you must recognize the challenge and proactively develop strategies to effectively teach cancer prevention and early detection principles. Melanoma

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