Cancer Overview + Diverticular Disease + Colorectal Cancer

Cancer definition

Cancer = uncontrolled cell growth; can occur anywhere in body

Normal cell traits

Specific function, controlled growth, tight adherence, apoptosis

Cancer cell traits

No function, rapid growth, loose adherence, metastasize

Carcinogenesis steps

Initiation > Promotion > Progression > Metastasis

Initiation

Carcinogens cause permanent DNA mutation

Promotion

Hormone/growth factor driven tumor growth (estrogen, insulin)

Progression

Tumor develops blood supply and grows (1 cm = 1 billion cells)

Metastasis

Cancer cells spread via lymph/blood and form secondary tumors

Common breast cancer metas

Liver, lung, bone, brain

Colorectal cancer common metas

Liver most common

Cancer primary prevention

Stop smoking, sunscreen, HPV vaccine, ↓ red meat, ↑ fiber/veggies

Cancer secondary prevention

Mammogram, colonoscopy, FOBT yearly, Pap + HPV

7 Cancer warning signs

CAUTION (change bowel, sore, bleeding, lump, indigestion, mole change, cough)

Cancer treatment goals

Cure, control, comfort

Chemotherapy key issue

Kills rapidly dividing cells; damages normal cells too

Chemo major toxicity

Bone marrow suppression (neutropenia, anemia, thrombocytopenia)

Neutropenia priority

Monitor fever, infection; avoid crowds

Radiation type

External (teletherapy) or internal (brachytherapy)

Teletherapy care

Do not remove markings; protect skin

Brachytherapy care

Patient radioactive; limit visitors, no pregnant caregivers

Immunotherapy

Action: boosts immune system to attack cancer cells

Cancer diet teaching

↓ animal fat, ↓ processed meats, ↑ fiber, ↑ fruits/vegetables

Diverticulosis

Multiple non-inflamed diverticula

Diverticulitis

Inflammation/infection of diverticula

Diverticulitis symptoms

LLQ pain, fever, nausea, vomiting, distention

Diverticulitis treatment

No fiber during flare, antibiotics, fluids

Diverticular prevention

High fiber when not flaring; no laxatives

Colorectal cancer risk factors

Age >50, low fiber/high fat diet, IBD, genetics

Common CRC symptom

Rectal bleeding + change in stool shape

CRC diagnosis tests

Colonoscopy + CEA + FOBT

Colostomy healthy stoma

Moist, pink/red, protrudes 1-3 cm, slight bleeding normal

Colostomy teaching

Empty at 1/3-1/2 full; gas buildup normal

Ascending colostomy stool

Liquid stool

Transverse colostomy stool

Pasty stool

Descending colostomy stool

More solid stool