Usi, George Anthony P.

BSN 4B College of Nursing Bulacan State University

CARE CLIENTS WITH CANCER

What is CANCER?
Cancer is a class of diseases characterized by out-of-control cell growth Harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumors It develops when cells in a part of a body begin to grow out of control

 Normal body cells divide and die in an orderly fashion Known medically as a malignant neoplasm Is a broad group of various disease
In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body.

 Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form
Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide This leads to a mass of abnormal cells that grows out of control.

Common Prefixes used in CANCER:

Adeno- = gland Chondro- = cartilage Erythro- = red blood cell Hemangio- = blood vessels Hepato- = liver Lipo- = fat Lympho- = white blood cell

 Melano- = pigment cell

Myelo- = bone marrow

Myo- = muscle
Osteo- = bone Uro- = bladder Retino- = eye Neuro- = brain

Epidemiology of CANCER
Most occur in people ages 65 and above Higher in men than women Higher in industrialized sectors and nations More than 1.4 million of American diagnosed each year with cancer 2nd leading cause of death

 Number of cancer deaths have decreased slightly more than 560, 000 per year The leading cause of cancer death is: -Lung Cancer -Breast

-Colorectal cancer
-Prostate

Causes and Risk Factors for Cancer:

Hereditary/Family History -Certain types of cancer run in the family Carcinogens -Capable in causing cancer -This may be a chemical, environmental agent, radiation and viruses -Effects of carcinogens depend on the amount or dosage

 Chemicals or environmental agents: -Polycystic hydrocarbons -Aflatoxin

Benzopyrene -Produced when meat, fish are charcoal broiled or smoked -When food is fried -Fat/Cooking oil that has been reusing reapeteadly

 Nitrosamines
-These are powerful carcinogens

-Used in preservatives food

-Formation of nitrosamines maybe

inhibited by the presence of antioxidants

in the stomach

-Limit the eating of preserved foods

-Increase the vegetable and fiber intake

 Radiation -Causes cancer including ultravilet -X-rays -Radoiactive chemicals -Other form of radiation
Viruses -Can enter the host cell and cause cancer -Human papilloma virus that causes cervical cancer

-Hepatitis B virus that causes liver cancer -Epstein-Barr virus that causes lymphoma and nasopharyngeal cancer

Other Risk Factors: Age Gender Race Personal and family medical history Lifestyle

Particular CANCER and their risk Factors:

1. LUNG CANCER: Tobacco use Chewing the tobacco Radiation

Second hand smoke

2. ORAL CANCER:

Tobacco use
Excessive alcohol use

Chronic irritation
Vitamin A deficiency

3. LARYNGEAL CANCER:
Tobacco use

Poor nutrition
Alcohol

Weakening immune system

Exposure to wood and dust, paint fumes

Gender
Age (More than 60 years old)

4. BLADDER CANCER: Tobacco use Exposure to dyes and solvents Chronic bladder inflammation
5. RENAL CANCER: Tobacco use Obesity Diet, not well cooked meat Exposure to asbestos, organic solvents Age (50-70 years old)

6. CERVICAL CANCER: Tobacco use HPV infection Chlamydia infection Diet Family history of cervical cancer
7. ESOPHANGEAL CANCER: Tobacco use Gender Alcohol use Diet

8. BREAST CANCER:
Early menarche/ late menaupouse

Age
High fat diet

Obesity
Physical inactivity

Alcohol consumption
Family history of breast cancer

9. PROSTATE CANCER: All men is at risk Age Race Diet Family history
10. LIVER CANCER: Viral hepatitis Cirrhosis of the liver Long term exposure to aflatoxin

11. SKIN CANCER: Strong sunlight UV rays

12. COLONIC CANCER: Personal family history of polyps High fat diet Low fiber diet History of ulcerative colitis Age

13. UTERINE/ ENDOMETRIAL CANCER: Estrogen replacement therapy Early menarche/ late menopause

PATHOPHYSIOLOGY

The Normal Cell Growth/Cell Cycle

Normal cell division is required for the generation of new cells during development and for the replacement of old cells as they die.

 The term cell growth is used in the contexts

of cell development and cell division

(reproduction).
It refers to growth of cell populations, where

one cell (the "mother cell") grows and divides

to produce two "daughter cells

 Most cells remain in interphase, the period

between cell divisions

At least 90 percent of the cell cycle.

Cell populations go through a particular type

of exponential growth called doubling

Each generation of cells should be twice as

numerous as the previous generation.

Malignancy
A malignant neoplasm is composed of cells that look less like the normal cell of origin It has a higher rate of proliferation It can potentially invade and metastasize

 Is the tendency of a medical condition, especially tumors to become progressively worse and to potentially result in death.

Those derived from mesenchymal

(connective tissue) cells are called sarcomas.

 Malignant brain neoplasms and neoplasms of

the immune system are special categories

with complex nomenclature

Malignant neoplasms derived from epithelial

cells are called carcinomas

Characteristics of Malignant Cells

More rapid increase in size

Less differentiation (or lack of differentiation,

called anaplasia)

Tendency to invade surrounding tissues

Ability to metastasize to distant tissues

Cytologic features of malignant neoplasms

include:

Increased nuclear size (with increased

nuclear/cytoplasmic ratio--N/C ratio).

Variation in nuclear or cell size

(pleomorphism).

Lack of differentiation (anaplasia).

 Increased nuclear DNA content with subsequent dark staining on H and E slides (hyperchromatism). Prominent nucleoli or irregular chomatin

distribution within nuclei.

Mitoses (especially irregular or bizarre

mitoses).

Tumor Invasion/ METASTASIS

Is the spread of a cancer from one organ or
part to another non-adjacent organ or part

The new occurrences of disease thus generated

are referred to as metastases

 Cancer occurs after a single cell in a tissue is progressively genetically damaged to produce cells with uncontrolled proliferation

This uncontrolled proliferation, mitosis produces a primary tumor

These Phenotype allows:

Intravasation

Extravasation

Tumorigenesis

 Some cancer cells acquire the ability to

penetrate the walls of lymphatic and/or blood

vessels
Other sites and tissues in the body is the

target
lymphatic or hematogeneous spread

Illustration of Hematogenous Spread

 After the tumor cells come to rest at another

site, they re-penetrate the vessel or walls and

continue to multiply, eventually forming

another clinically detectable tumor

New tumor is known as a metastatic

(or secondary) tumor

 And its cells are similar to those in the

original tumor.

Initially, nearby lymph nodes are struck

early

The lungs, liver, brain and bones are the

most common metastasis locations from

solid tumors.

Characteristics of Malignant Neoplasms:

Cell Characteristics:

Undifferentiated Little resemblance

Mode of Growth

Growth at Periphery Infiltrate and destroys the tissue

Rate of Growth
Variable The more anaplastic the tumor the more faster its growth.

Metastasis
Gain access to blood, lymphatic vessels Metastasize to other site of the body

General Effects
Causes Generalized effects -Anemia -Weakness -Weight Loss Tissue Effects Extensive tissue damage Cell damage

SIGNS AND SYMPTOMS: Lymph nodes Lymphadenopathy

Lungs Cough Hemoptysis Dyspnea

 Liver Hepatomegaly Nausea Jaundice Bones Bone Paine Fracture

 Brain ALOC Seizure Dizziness Headache

Vertigo

4 Routes of Metastasis
1. Transcoelomic
Peritoneal

Pleural
Pericardial Subarachnoid spaces

2. Lymphatic spread
lymph nodes 3. Hematogenous spread Originating in the kidney (renal cell carcinoma 4. Transplantation or implantation To lymph nodes

Routes of Metastasis

Behind Every Doctor there is a Great NURSE Thank you and GODBLESS us!!!
PREPARED BY: USI, GEORGE ANTHONY P.