Oncology

1
Chapter 34

• Oncology

2
Cancer

• Disease resulting from uncontrolled growth of
  abnormal cells
• Group of more than 200 different diseases that
  can attack any tissue or organ

3
Cancer Survival

• Survival rates influenced by
• Type of cancer
• Progression of disease at diagnosis
• Clients response to treatment

4
Cancer Pathophysiology

• Neoplasm
• Any abnormal growth of new tissue
• Benign
• Non-progressive

(continued)
5
Cancer Pathophysiology

• Malignant
• Becoming progressively worse
• Often resulting in death
• Carcinogen
• Chemical substance that promotes development of
  cancer

6
Classifications of Cancer

• Lymphomas
• Occurring in infection-fighting organs
• Leukemias
• Occurring in blood-forming organs

(continued)
7
Classifications of Cancer

• Sarcomas
• Occurring in connective tissue
• Carcinomas
• Occurring in epithelial tissue

8
Risk Factors

• Environmental
• Lifestyle
• Genetic
• Viral

9
Lifestyle Guidelines to Decrease Risk

• Do not smoke or use tobacco in any form
• Avoid overexposure to sun or indoor tanning
• Eat healthy diet
• Get plenty of exercise
• Have physical exam on regular basis
• Get plenty of sleep

(continued)
10
Lifestyle Guidelines to Decrease Risk

• Keep weight within normal limits
• Practice regular self-exam
• See physician if changes noted
• Know and follow health and safety rules in
  workplace

11
Detection

• When cancer develops, earlier the detection, more
  likely the control
• Cancer checkup recommendations
• Every three years for people ages 20 to 39
• Annually for people ages 40 or more

12
Diagnostic Testing

• Blood tests
• E.g., tumor markers
• Stool tests for occult blood
• Radiologic studies
• E.g., mammograms
• Invasive studies
• E.g., colonoscopy

13
Staging of Tumors

• TNM classification
• T anatomical size of tumor
• N extent of lymph node involvement
• M presence or absence of metastasis
• Influences treatment options

14
Grading of Tumors

• Well differentiated
• Tumor cells that retain many identifiable tissue
  characteristics of original cell
• Undifferentiated
• Tumor cells having little similarity to tissue of
  origin

(continued)
15
Grading of Tumors

• Based on degree of differentiation of malignant
  cells
• I to IV
• Higher the grade, higher the number
• Worse the prognosis

(continued)
16
Grading of Tumors

• Tumors containing poorly differentiated cells are
  more aggressive in growth and may display
  uncharacteristic behaviors
• Leads to poorer prognosis

17
Treatment Modalities

• Surgery
• Radiation
• External
• Internal
• Chemotherapy
• Biotherapy

(continued)
18
Treatment Modalities

• Photodynamic therapy
• Hormone therapy
• Targeted cancer therapy
• Bone marrow transplantation

19
Symptom Management

• Bone marrow dysfunction
• Nutritional alterations
• Pain
• Fatigue
• Alopecia
• Odors

(continued)
20
Symptom Management

• Dyspnea
• Bowel dysfunctions
• Pathological fractures
• Ascites
• Sexual alterations

21
Medical Emergencies

• Hypercalcemia
• Spinal cord compression
• Superior vena cava syndrome
• Cardiac tamponade

22
Psychosocial Alterations

• Each client responds differently to diagnosis
  depending on coping mechanisms and support
  systems
• Cancer also affects clients family

(continued)
23
Psychosocial Alterations

• Issues
• Loss of control
• Changes in body image
• Financial burdens

24
Nursing Interventions

• Be available to offer support and reassurance
• Encourage client to express fears and concerns
• Provide explanations and answer questions
• Give client and family privacy

(continued)
25
Nursing Interventions

• Touch
• Often most comforting intervention
• Keep client comfortable
• Provide pain management
• Offer counseling if necessary