Oncology Nursing 2

Immunotherapy/Biotherapy

agents that stimulate the body's natural immune system to control and destroy malignant cells

Immunotherapy

The use of a person's immune system to fight Ca or to lessen the side effects caused by some cancer treatment

1. hematopoietic growth factor

2. biologic response modifiers

3. interferons

4. interleukins

5. monoclonal antibodies

6. vaccines

7. anti-angiogenesis agents

Classification of Biologic Agents HBIIMVA

Hematopoietic Growth Factor

substances that are specific type of cytokine that regulates hematopoiesis

Biologic Response Modifiers

substances that modify immune response: the main purpose is to enhance or suppress the immune response.

Interferons

an antiviral agent: a group of proteins that response to viruses

Interleukins

inflammatory chemical mediators, also necessary for hematopoiesis: enhanced immune system

monoclonal antibodies

MABS; type of protein that bind to a specific protein of the cancer cells

vaccines

can prevent or slow down the growth

anti-angiogenesis agent

prevent the growth of blood vessels in the tumor

Arsenic

carcinogens of the occupation mining and pesticide workers, which can develop lung, skin, liver

Asbestos

carcinogens of the occupation construction workers, which can develop lung and mesothelioma cancer

Benzene

carcinogens of the occupation petroleum, rubber, and chemical workers , which can develop leukemia

chromium

carcinogens of the occupation metal workers and electroplaters, which can develop lung cancer

Leather Dust

carcinogens of the occupation shoe manufacturing, which can develop Nasal and bladder cancer

Naphthylamine

carcinogens of the occupation chemical, dye, ruber workers, which can develop bladder cancer

Radon

carcinogens of the occupation underground mining, which can develop lung cancer

soots, tars, oils

carcinogens of the occupation coal, gas, petroleum workers, which can develop lung, liver, and skin cancer

Vinyl Chloride

carcinogens of the occupation rubber workers, polyvinyl chloride manufacturing, which can develop liver cancer

wood dust

carcinogens of the occupation furniture manufacturing, which can develop nasal cancer

Skin cancer

most common type of cancer

stratum basale

Basal Cell Carcinoma arises from what layer in the skin

stratum spinosum

Squamous Cell Carcinoma arises in what layer of the skin: non-healing ulcers

melanocytes

From which cells does malignant melanoma arise?

multiple dysplastic nevi

numerous moles that look different from normal ones (larger, irregular, more numerous, variable color)

basal cell carcinoma

What is the most common and least aggressive type of skin cancer?

small nodule with a pearly, translucent border

How do lesions of basal cell carcinoma typically begin or appear?

Crusting and occasional ulceration.

What additional features may be seen on basal cell carcinoma lesions?

face between the hairline and upper lip.

On which areas of the body do basal cell carcinoma lesions most commonly appear?

squamos cell carcinoma

What type of skin cancer is more aggressive and slow-growing?

lips, nose, and hands.

On which body areas is squamous cell carcinoma commonly found?

firm, irregular, erythemic, thickened scaly lesion

How does squamous cell carcinoma typically appear?

may sore and bleed

What symptoms may squamous cell carcinoma lesions show?

Malignant Melanoma

What is considered the most deadly type of skin cancer?

yes, to other organ

Can malignant melanoma metastasize? If yes, where?

the back and legs

What are the common sites where malignant melanoma appears?

1. Dysplastic nevi

2. Congenital Nevi

What are the precursors of malignant melanoma?

1. Asymmetry

2. Border irregularity

3. Color

4. Diameter

5. Evolution

What are the ABCDE characteristics of malignant melanoma?

Asymmetry

Two sides of pigmented mole do not match

Border Irregularity

Borders of mole are not smooth

Color

Different colors in pigmented area

Diameter

Spot is larger than 6 mm in diameter

Evolution

One or more of the ABCD characteristics is evolving

Incisional Biopsy

Diagnostic Test of Skin Cancer

Incisional Biopsy

removal of a piece of tissue to detect malignancy and level of invasion that determines treatment

Curettage

What procedure is used for managing small tumors?

complete excision

What is the recommended treatment for lesions with a depth of 1–4 mm?

osteogenic sarcoma

What is the most common form of bone cancer?

ends of long bones

Where does osteogenic sarcoma often start?

10 to 25 years old

What is the peak age of incidence for osteogenic sarcoma?

metaphysis of long bones

In which part of the bone is osteogenic sarcoma usually found?

Raditation exposure

What is a known risk factor for developing bone cancer?

1. MRI

2. CT scan

3. Bone biopsy

4. bone scan

What diagnostic tests are commonly used to detect bone cancer?

1. amputation

2. limb resection

What surgical treatments may be used for bone cancer?

1. chemotherapy

2. radiation therapy

What medical therapies are used in the management of bone cancer?

adenocarcinoma

What is the most common type of gastric cancer?

pernicious anemia

Gastric cancer is frequently seen in clients with what condition?

males

Which sex is more commonly affected by gastric cancer?

diet high in complex carbohydrates, grains and salts

What types of diet increase the risk for gastric cancer?

1. Biopsy

2. GI X ray

3. Gastroscopy

what diagnostic test are used in gastric cancer?

1. gastrectomy

2. chemotherapy

3. radiation therapy

Medical and Surgical management of gastric cancer

Bland Diet

What kind of diet must the patient with gastric cancer have?

Adenocarcinoma

Most common type of colon cancer

ascending and descending colon (Rectosigmoid area)

Where is colorectal cancer usually located?

1. bowel inflammatory disease

2. colon polyps

What family-related condition increases the risk for colorectal cancer?

>40

What age group is at higher risk for colorectal cancer?

1. fecal occult blood testing

2. barium enema

3. colonoscopy

4. biopsy

Diagnostic Test of colon cancer

Occult blood in stool

What is a common sign of right (ascending) colon cancer detectable in stool?

>50

At what age is yearly screening for occult blood in stool recommended?

Anemia

What blood-related condition may indicate right colon cancer?

above umbilicus

Where is abdominal pain typically felt in ascending colon cancer?

palpable mass

What physical finding may be present in ascending colon cancer?

1. occult blood in stool

2. anemia

3. anorexia and weight loss

4. Abdominal pain above the umbilicus

5. palpable mass

Assessment on Ascending Colon: Colorectal Cancer

rectal bleeding

What is a common symptom of distal colon or rectal cancer?

pencil or ribbon shaped stool

What changes in bowel habits can indicate distal colon or rectal cancer

Tenesmus

What sensation may patients with rectal cancer experience related to bowel movements?

Tenesmus

a sensation of incomplete bowel emptying.

1. rectal bleeding

2. constipation or diarrhea

3. pencil or ribbon shape stool

4. tenesmus

Assessment of Distal colon/rectal cancer

Stage A

Confined to bowel mucosa, 80-90% -5 year survival rate

Stage B

Invading muscle wass

Stage C

Lymph node involvement

Stage D

Metastases or locally unresectable, tumor, less than 5% 5 year survival rate.

blood transfusion

What supportive treatment may be given for anemia in colorectal cancer patients?

1. colectomy

2. colon resection

3. end-to-end anastomosis

What surgical procedures are commonly performed for colorectal cancer?

Fluorouracil

What chemotherapy drug is commonly used in the treatment of colorectal cancer?

radiation therapy

Besides surgery and chemotherapy, what other treatment modality may be used in colon cancer?

1. blood transfusion

2. surgery

3. chemotherapy

4. radiation theraphy

medical management of patient colon cancer

low-residue diet

What diet modification is recommended 3–5 days before colonic surgery and why?

clear liquid diet

What type of diet is recommended 24 hours before colonic surgery?

1. laxatives

2. cleansing enema

What mechanical cleansing methods are used before colonic surgery?

Neomycin sulfate tablet

What pharmacologic measure is taken to reduce colon bacteria before surgery?

Vitamin C and K

Which vitamins may need to be supplemented due to repeated enemas before surgery?

1. right abdomen

2. watery

Where is the stoma located in an ascending colostomy, and what is the consistency of the fecal drainage?

semi-formed stool

In a transverse (double-barreled) colostomy, what does the right (proximal) stoma drain?

mucus

In a transverse (double-barreled) colostomy, what does the left (distal) stoma drain?

Transverse Loop colostomy

2 openings in the transverse colon but with one stoma

Inflammatory Bowel Disease

Transverse Loop Colostomy is indicated in what disease

1. left abdomen

2. well-formed

Where is the stoma located in descending and sigmoid colostomies, and what is the consistency of the fecal drainage?