Oncology defined
Branch
of medicine
that deals with the
study, detection,
treatment and
management of cancer
and neoplasia
Root words
Neo-
new
Plasia- growth
Plasm- substance
Trophy- size
+Oma- tumor
Statis- location
Root words
A-
none
Ana- lack
Hyper- excessive
Meta- change
Dys- bad, deranged
Characteristics of Neoplasia
Uncontrolled
1.
Benign
2. Malignant
Characteristics of Neoplasia
BENIGN
Well-differentiated
Slow
growth
Encapsulated
Non-invasive
Does NOT metastasize
Characteristics of Neoplasia
MALIGNANT
Undifferentiated
Erratic
Nomenclature of
Neoplasia
Tumor is named according to:
1. Parenchyma, Organ or Cell
Hepatoma- liver
Osteoma- bone
Myoma- muscle
Nomenclature of
Neoplasia
Tumor is named according to:
2. Pattern and Structure, either GROSS or
MICROSCOPIC
Fluid-filled CYST
Glandular ADENO
Finger-like PAPILLO
Stalk POLYP
Nomenclature of
Neoplasia
Tumor is named according to:
3. Embryonic origin
Ectoderm ( usually gives rise to
epithelium)
Endoderm (usually gives rise to glands)
Mesoderm (usually gives rise to
Connective tissues)
BENIGN TUMORS
Suffix-
OMA is used
Adipose tissue- LipOMA
Bone- osteOMA
Muscle- myOMA
Blood vessels- angiOMA
Fibrous tissue- fibrOMA
MALIGNANT TUMOR
Named
origin
1. Ectodermal, Endodermal, Glandular,
Epithelial
Use the suffix- CARCINOMA
Pancreatic AdenoCarcinoma
Squamos cell Carcinoma
MALIGNANT TUMOR
Named
origin
2. Mesodermal, connective tissue origin
Use the suffix SARCOMA
FibroSarcoma
Myosarcoma
AngioSarcoma
PASAWAY
1. OMA but Malignant
TERATOMA
Choristoma
Hamatoma
CANCER NURSING
Review of Normal Cell Cycle
3 types of cells
1. PERMANENT cells- out of the cell cycle
Liver, kidney
CANCER NURSING
Cell Cycle
G0------------------G1SG2M
G0- Dormant or resting
G1- normal cell activities
S- DNA Synthesis
G2- pre-mitotic, synthesis of proteins
for cellular division
M- Mitotic phase (I-P-M-A-T)
CANCER NURSING
Proposed
CANCER NURSING
Etiology of cancer
1. PHYSICAL AGENTS
Radiation
Exposure to irritants
Exposure to sunlight
Altitude, humidity
CANCER NURSING
Etiology of cancer
2. CHEMICAL AGENTS
Smoking
Dietary ingredients
Drugs
CANCER NURSING
Etiology of cancer
3. Genetics and Family History
Colon Cancer
CANCER NURSING
Etiology of cancer
4. Dietary Habits
Low-Fiber
High-fat
Processed foods
alcohol
CANCER NURSING
Etiology of cancer
5. Viruses and Bacteria
DNA viruses- HepaB, Herpes, EBV, CMV,
Papilloma Virus
RNA Viruses- HIV, HTCLV
Bacterium- H. pylori
CANCER NURSING
Etiology of cancer
6. Hormonal agents
DES
OCP especially estrogen
CANCER NURSING
Etiology of cancer
7. Immune Disease
AIDS
CANCER NURSING
CARCINOGENSIS
Malignant transformation
IPP
Initiation
Promotion
Progression
CANCER NURSING
CARCINOGENSIS
INITIATION
Carcinogens alter the DNA of the cell
Cell will either die or repair
CANCER NURSING
CARCINOGENSIS
PROMOTION
Repeated exposure to carcinogens
Abnormal gene will express
Latent period
CANCER NURSING
CARCINOGENSIS
PROGRESSION
Irreversible period
Cells undergo NEOPLASTIC
transformation then malignancy
CANCER NURSING
Spread of Cancer
1. LYMPHATIC
Most
2.
3.
common
HEMATOGENOUS
Blood-borne, commonly to Liver and
Lungs
DIRECT SPREAD
Seeding of tumors
CANCER NURSING
Body Defenses Against TUMOR
1. T cell System/ Cellular Immunity
2.
3.
Phagocytic cells
Macrophages can engulf cancer cell
debris
CANCER NURSING
Cancer Diagnosis
1. BIOPSY
2.
CT, MRI
3. Tumor Markers
CANCER NURSING
Cancer Grading
The degree of DIFFERENTIATION
Grade 1- Low grade
Grade 4- high grade
CANCER NURSING
Cancer Staging
1. Uses the T-N-M staging system
T- tumor
N- Node
M- Metastasis
2. Stage 1 to Stage 4
CANCER NURSING
GENERAL MEDICAL MANAGEMENT
1. Surgery- cure, control, palliate
2. Chemotherapy
3. Radiation therapy
4. Immunotherapy
5. Bone Marrow Transplant
CANCER NURSING
GENERAL Promotive and Preventive
Nursing Management
1. Lifestyle Modification
2. Nutritional management
3. Screening
4. Early detection
SCREENING
1.
Nursing Assessment
Utilize the ACS 7 Warning Signals
CAUTION
C- Change in bowel/bladder habits
A- A sore that does not heal
U- Unusual bleeding
T- Thickening or lump in the breast
I- Indigestion
O- Obvious change in warts
N- Nagging cough and hoarseness
Nursing Assessment
Weight
loss
Frequent infection
Skin problems
Pain
Hair Loss
Fatigue
Disturbance in body image/ depression
Nursing Intervention
MAINTAIN
TISSUE INTEGRITY
Handle skin gently
Do NOT rub affected area
Lotion may be applied
Wash skin only with SOAP and Water
Nursing Intervention
MANAGEMENT
OF STOMATITIS
Use soft-bristled toothbrush
Oral rinses with saline gargles/ tap
water
Avoid ALCOHOL-based rinses
Nursing Intervention
MANAGEMENT
OF ALOPECIA
Alopecia begins within 2 weeks of
therapy
Regrowth within 8 weeks of termination
Encourage to acquire wig before hair
loss occurs
Encourage use of attractive scarves and
hats
Provide information that hair loss is
temporary BUT anticipate change in
texture and color
Nursing Intervention
PROMOTE NUTRITION
Serve food in ways to make it appealing
Consider patients preferences
Provide small frequent meals
Avoids giving fluids while eating
Oral hygiene PRIOR to mealtime
Vitamin supplements
Nursing Intervention
RELIEVE PAIN
Mild pain- NSAIDS
Moderate pain- Weak opiods
Severe pain- Morphine
Administer analgesics round the clock with
additional dose for breakthrough pain
Nursing Intervention
DECREASE FATIGUE
Plan daily activities to allow alternating rest
periods
Light exercise is encouraged
Small frequent meals
Nursing Intervention
IMPROVE BODY IMAGE
Therapeutic communication is essential
Encourage independence in self-care and
decision making
Offer cosmetic material like make-up and wigs
Nursing Intervention
ASSIST IN THE GRIEVING PROCESS
Some cancers are curable
Grieving can be due to loss of health, income,
sexuality, and body image
Answer and clarify information about cancer
and treatment options
Identify resource people
Refer to support groups
Nursing Intervention
MANAGE
COMPLICATION: INFECTION
Fever is the most important sign (38.3)
Administer prescribed antibiotics X
2weeks
Maintain aseptic technique
Avoid exposure to crowds
Avoid giving fresh fruits and veggie
Handwashing
Avoid frequent invasive procedures
Nursing Intervention
MANAGE COMPLICATION: Septic shock
Monitor VS, BP, temp
Administer IV antibiotics
Administer supplemental O2
Nursing Intervention
MANAGE COMPLICATION: Bleeding
Thrombocytopenia (<100,000) is the most
common cause
<20, 000 spontaneous bleeding
Use soft toothbrush
Use electric razor
Avoid frequent IM, IV, rectal and
catheterization
Soft foods and stool softeners
A quick
overview
RADIATIO
N
THERAPY
RADIATION THERAPY:
MEANING
is theMEDICALuse ofhigh
ionizing radiation.
Also known as
It
Radiotherapy
Radiation
Often
RT
RTx
XRT
oncology
abbreviated as
RADIATION THERAPY:
PURPOSE
Curative
Control
or killmalignantcells
Adjuvanttherapy
Prevent
tumor recurrence
after surgery to remove a
primary malignant tumor
Palliative
Prolong
survival
RADIATION THERAPY:
TYPES
1. External Beam Radiation Therapy
Intensity-modulated radiation
therapy(IMRT)
Aka
HIR
CHART
Stereotactic
Radiation
Therapy
PCI (Prophylactic Cranial
Irradiation)
RADIATION THERAPY:
TYPES
2. INTERNAL RADIATION THERAPY
AKA BRACHYTHERAPY
RADIATION THERAPY:
TYPES
3. SYSTEMIC RADIATION
THERAPY
-In systemic radiation
therapy, a patient swallows
or receives an injection of a
radioactive substance
Radioactive
iodine
RADIATION
THERAPY:
PRESCRITION
Common:
Fatigue
Nausea with or without vomiting
Mouth, throat, stomach sores
Swelling
Fibrosis
Damage to the bowels, causing diarrhea and
bleeding
Memory loss
Infertility
Rarely, asecond cancercaused by radiation
exposure