Group 1: JHASHA

What is a Brain Cancer???

The growth of abnormal cells in the tissues of the brain. A brain tumor is a localized intracranial lesion that occupies space within the skull.

Two Main Types of Brain Cancer

Primary brain cancer

Metastatic brain cancer (Secondary brain tumors)

Primary brain cancer

Astrocytoma
Ependymoma

Medulloblastoma

Brain Stem Gliomas

Ependymoma

Medulloblastoma

Oligodendrogliomas

Glioblastoma multiforme

Metastatic brain cancer

most common types of cancer that spread to the brain

Melanoma Breast Cancer Renal Cell Carcinoma Lung Cancer Colorectal Cancer

Etiology
Race

Age

Exposure to radiation

Chemical exposure

Family history of brain tumors

PREDISPOSING FACTORS: History of cancer disease Growth & development Hormone changes Age Sex

Pathophysiology
Genetic mutation of cellular DNA

PRECIPITATING FACTORS: Idiopathic Exposure to ionizing radiation Head trauma Dietary exposure to nitrates Tumors

Abnormal cell transformation

Cloning of cells

Proto-oncogenes (KRAS2) acts as on switch for cellular growth on chromosome 12 and TP53 turn off unseeded cellular proliferation

Abnormal proliferation of cells, ignoring growth regulating signals in the surrounding cells

Cells acquire invasive characteristics

Changes in surrounding tissues

Infiltration of cells to tissues gaining access to lymph and blood vessels

Carrying of cells to the area of the body

Production of destructive enzymes (proteinases), lysosomal hydrolyses

Destruction of surrounding tissues

Facilitation of invasion of malignant cells

Growth of tumors at different areas of brain

Mechanical pressure of rapidly growing tumor

Signs and symptoms: Headache Visual dysfunction Hypothalamic disorders Sleep disorders Appetite disorders Temperature disorders Emotional disorders Increased ICP

Compression and infiltration of tissue Invasion of tumor to the cavernous sinuses or sphenoid bone

Pressure on adjacent structures

Signs and symptoms: loss of hearing, tinnitus, vertigo, staggering gait, painful sensations of face

Increased ICP

Decreased cerebral blood flow

Signs and symptoms: increased systolic blood pressure widened pulse pressure cardiac slowing

Cushings response (rise in arterial pressure

Deterioration of brains autoregulation

Signs and symptoms: Bradycardia Hypertension Bradypnea

Cushings triad

Herniation of brainstem and occlusion of cerebral blood flow

Cessation of blood flow

Cerebral ischemia

Infarction

Coma

Brain death

DEATH

Diagnostic Tests
CT Scan MRI PET Scan

Computer assisted stereotactic biopsy

Cerebral angiography EEG Cytological studies of CSF

Medical Management

Chemotherapy

Radiation Therapy

Intravenous (IV) autologous bone marrow transplantation

Corticosteroids

Gene-transfer Therapy

Photodynamic Therapy

Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation

Surgical Management
Transsphenoidal microsurgical removal

Craniotomy

Radiosurgery

Nursing Management
Evaluate preoperatively the gag reflex and ability to swallow. In patients with diminished gag response, care includes teaching the patient to direct food and fluids toward the unaffected side, having the patient sit upright to eat, offering a semisoft diet, and having suction readily available. Check patients neurologic function. Monitor patients vital signs. Maintain a neurologic flow chart. Space nursing interventions to prevent rapid increase in ICP.

Nursing Management
Reorient client when necessary to person, time and place. Patient with changes in cognition caused by the lesion require frequent reorientation and use of orienting devices (personal possessions, photographs, lists, clock). Supervision and assistance with self-care and ongoing monitoring and intervention for prevention of injury. Patients with seizures are carefully monitored and protected from injury. Motor function is checked at intervals because specific motor deficits may occur, depending on the tumors location.

Nursing Management
Assess sensory disturbances. Evaluate speech. Maintain cerebral tissue perfusion through careful monitoring of intraventricular drainage. Improve gas exchange by assessing signs of respiratory infection. Regulate temperature and use measures to reduce body temperature such as removing blankets, applying ice bags to axilla and groin areas and etc.

Nursing Management
Manage sensory deprivation by placing patient in an head up position and applying cold compress over the eyes to reduce edema. Encourage patient to verbalize feelings and frustrations about any change in appearance. Monitor increased in ICP and bleeding. Manage fluid and electrolyte disturbances.

Nursing Management
Preoperative Nursing Care: Instruct patient and family about the necessity and importance of diagnostic tests to determine the exact location of the tumor. Monitor and record vital signs and neurological status accurately q2-4h, or as ordered. Report changes to professional nurse immediately. Institute measures to prevent inadvertent increases in intracranial pressure.

Nursing Management
Institute seizure precautions at patient's bedside. (Tongue blade airway). Supportive nursing care is given depending upon the patient's symptoms and ability to perform activities of daily living. Administer all doses of steroids and antiepileptic agents on time.

Nursing Management
Post-Operative Nursing:

Meticulous nursing management and care aimed at prevention of postoperative complications are imperative for the patient's survival. Accurately monitor and record all vital signs and neurological signs. Administer artificial tears (eye drops) as ordered, to prevent corneal ulceration in the comatose patient. Maintain skin integrity.

Nursing Management
Bone flap may not have been replaced over surgical site; turning patient to the affected side, if the flap has been removed, can cause irreversible damage in the first 72 hours. Maintain head of bed at 30elevation. Perform passive range of motion exercises to all extremities every 2-4 hours. Maintain body temperature.

Nursing Management
Institute seizure precautions at patient's bedside. (Tongue blade, airway.) Maintain accurate record of intake and output. Prevent pulmonary complications associated with bedrest. Continuously talk to the patient while providing care, reorienting him to person, place, and time.

PREVENTION
LIFESTYLE CHOICES Diet Avoid Smoking Avoid drinking alcohol Proper exercise Sweating is powerful way to cleanse your body from accumulated toxins Avoid exposure to chemicals Avoid or minimize exposure to radiation

PREVENTION
STRESS MANAGEMENT AND YOUR IMMUNE SYSTEM

Laughter Therapy Change your mood Boost up your immune system by taking vitamins and eating nutritious foods Avoid junk foods!

PREVENTION
EARLY DETECTION: 7 CANCER WARNING SIGNS

Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breast, testicles, or elsewhere Indigestion or difficulty swallowing Obvious change in the size, color, shape, or thickness of a wart, mole, or mouth sore Nagging cough or hoarseness

References
www.Curezone.com www.Powershow.com www.Cancer.org http://dynamicnursingeducation.com http://www.free-ed.net http://www.cancer.gov/cancertopics/types/brain http://www.umm.edu/altmed/articles/brain-cancer000024.htm http://www.healthcommunities.com/brain-cancer/types.shtml http://www.neurosurgery.pitt.edu/neuro_oncology/brain/type s.html Medical-Surgical Nursing 10th edition and 11th edition by Brunner and Suddarth Pathophysiology: Concepts of Altered Health States. 7th ed. By Carol Mattson Porth Lippincotts Review Series: Pathophysiology. 2nd edition.

Thank You!!!