Week 2 - Cancer

What is Cancer ?

The uncontrolled growth of abnormal cells

• Can invade nearby tissue and metastasize (spread)

Benign

Non-cancerous, localized

Malignant

Spread to distant organs

General Cancer Risk Factors

Smoking/tobacco use

Alcohol use

Poor diet (high fat, low fiber)

Obesity

Radiation exposure (UV, X-Rays)

Environmental toxins (asbestos, chemicals)

Family history/genetics

Chronic Inflammation

Viruses (HPV, Hepatitis B)

Cancer Staging

TNM

What does the T in TNM stand for?

Tumor - Size/extent of tumor

What does the N in TNM stand for?

Nodes (lymph nodes) - lymph node involvement

What does the M in TNM stand for?

Metastasis - spread to distant organs

Stages of Cancer

Stage 0

Stage I

Stage II & III

Stage IV

What is Stage 0?

In situations (localized)

What is Stage I?

small and localized

What is Stage II & III?

Larger, spread to nearby tissues/nodes

What is Stage IV?

Distant metastasis (spread)

Common Cancer Treatments

1. Surgery

2. Chemotherapy

3. Radiation Therapy

4. Immunotherapy/ Targeted Therapy

5. Hormone Therapy

Surgery

Removal of tumor (curative or palliative)

Chemotherapy

Kills rapidly dividing cells

Affects healthy cells too (hair, GI, bone marrow)

Radiation Therapy

Uses high-energy rays to destroy cancer cells

Immunotherapy/ targeted therapy

Helps immune system fight cancer

Targets specific cancer cells

Hormone therapy

Used in hormone-sensitive cancers (breast & prostate)

Risk Factors for Breast Cancer

Female gender

Age greater than 50

Family history (BRCA1 & BRCA2)

Early menstruation/late menopause

No pregnancies or late first pregnancy

Hormone replacement therapy

Obesity

Clinical Manifestations for Breast Cancer

Painless lump in breast

Change in breast shape or size

Skin dimpling (peak d’ orange)

Nipple discharge or inversion

Redness or swelling

Treatment for Breast Cancer

Surgery (lumpectomy or mastectomy)

Radiation

Chemotherapy

Hormone therapy (Tamoxifen)

Nursing Interventions for Breast Cancer

Post-op care:

• monitor incision and drainage

• Prevention infection

Arm Precautions

• No BP, IV’s or blood draws

Prevent lymphedema

• Elevate arm

• Avoid injury

Teach self-breast exam

Risk Factors for Lung Cancer

Smoking (Most important)

Secondhand smoke

Asbestos exposure

Air pollution

Family history

Clinical Manifestations of Lung Cancer

Persistent cough

Hemoptysis (coughing blood)

Shortness of breath

Chest pain

Weight loss

Recurrent pneumonia

Horseness

Treatment for Lung Cancer

Surgery (early stages)

Radiation

Chemotherapy

Targeted therapy

Nursing Interventions for Lung Cancer

Monitor respiratory status (o2 stat, breath sounds)

Position high Fowler’s

Encourage coughing & deep breathing

Administer oxygen as ordered

Manage dyspnea/anxiety

Slowest growing Cancer

Prostate Cancer

Risk Factors for Prostate Cancer

Age greater than 50

Male gender

Family history

African American

High-fat diet

Clinical Manifestations of Prostate Cancer

Often asymptomatic early

Difficulty urinating

Weak urine stream

Urinary retention

Blood in urine or semen

Back/hip pain (late stage metastasis)

Treatment for Prostate Cancer

Surgery (prostatectomy)

Radiation

Hormone therapy (androgen deprivation)

Nursing interventions for Prostate Cancer

Monitor urinary output

Post-op Catheter care

Watch for urinary retention

Manage incontinence

• Teach kegel exercises

Monitors for infection

Risk Factors for Colorectal cancer

older than 50

Low-fiber, high-fat diet

Red/Processed meats

Family History

Inflammatory bowel disease (Crohn’s, ulcerative colitis)

Obesity

Clinical Manifestations

Change in bowel habits (diarrhea/constipation)

Blood in stool (bright red/dark)

Abdominal pain

Fatigue (for anemia)

Weight loss

Treatment for Colorectal Cancer

Surgery (tumor removal, possible colostomy)

Chemotherapy

Radiation (rectal cancer)

Nursing Interventions

Colostomy Care

• Assess stoma (should be pink/red)

• Skincare around stoma

Monitor bowel function

Watch for obstruction

Diet education (low residue initially)

Pancreatic Cancer

Not usually found in early stages

Risk factors for Pancreatic Cancer

Smoking

Chronic pancreatitis

Diabetes

Obesity

Family hifstoy

Clinical Manifestations of Pancreatic Cancer

Jaundice (yellow skin/eyes)

Dark unit, pale stools

Abdominal back pain

Weight loss

Loss of appetite

Nausea

Treatments for Pancreatic Cancer

Surgery (whipple procedure)

Chemotherapy

Radiation

Nursing interventions for Pancreatic Cancer

Manage pain (often severe)

Monitor blood pressure (pancreas, affects insulin)

Nutritional support

• Small, frequent meals

• Monitor for jaundice & live meals