Oncology

Cancer Types
- Benign Tumors: Tumors in the wrong place at the wrong time, generally harmless unless large enough to affect organ function.
  - Characteristics:
    - Well differentiated, resembling normal cells of origin.
    - Encapsulated, do not infiltrate surrounding tissues.
    - Slow growth, no metastasis, minimal generalized effects, not typically life-threatening unless vital functions are compromised.
- Malignant Tumors: Abnormal, harmful cells that do not serve a useful function.
  - Characteristics:
    - Undifferentiated, making it hard to identify the tissue of origin.
    - Overcomes contact inhibition, leading to uncontrolled growth.
    - Variable growth rates, tendency to metastasize, affecting other body parts.
    - Can cause systemic symptoms such as anemia, weakness, and inflammation.
    - Potentially fatal if untreated due to tissue damage and outgrowth of blood supply.

Primary Prevention: Avoid carcinogens and modify risk factors
- Avoid smoking, excessive sunlight.
- Maintain a healthy diet (low-fat, high-fiber).
- Safe sex practices and limited alcohol consumption.
- Prophylactic removal of at-risk tissues (e.g., moles, polyps).
- Chemoprevention: Use of drugs to disrupt cancer development.
  - Notable drugs include Aspirin, and Celebrex for colon cancer risk reduction.
  - Vaccinations (e.g., HPV vaccines) for cancer prevention.
Secondary Prevention: Early detection through screenings
- Regular mammograms, colonoscopies, prostate exams (DRE, PSA).
- Screening recommendations vary based on age, health status, family history.

Warning Signs (CAUTION):
- C: Change in bowel/bladder habits.
- A: A sore that doesn’t heal.
- U: Unusual bleeding or discharge.
- T: Thickening or lump in the breast or elsewhere.
- I: Indigestion or difficulty swallowing.
- O: Obvious changes in a wart or mole.
- N: Nagging cough or hoarseness.
- U: Unexplained anemia.
- S: Sudden weight loss.
Diagnosis Methods:
- Cytology, tissue biopsies, and bone marrow biopsies are critical for identifying cancer.
- Screening tests (e.g., PSA) are not definitive and may require biopsy for confirmation.
- Staging and grading assess the severity and differentiate treatment options.

Staging: Determines the extent of cancer spread.
- Stage 0: In situ, localized.
- Stage IV: Metastasized to distant organs.
- TNM Classification: Describes tumor size (T), lymph node involvement (N), and presence of metastasis (M).
Grading: Assesses the differentiation of tumor cells from normal cells.
- G1: Well differentiated (easier to treat).
- G4: Poorly differentiated (harder to treat).

Surgery:
- Types include curative, debulking, diagnostic, prophylactic, and palliative.
- Curative and debulking surgeries aim to remove or reduce tumor burden.
- Palliative surgery improves quality of life without curing cancer.
Radiation:
- Types: External beam radiation and brachytherapy.
- Can cause localized radiation toxicity, which impacts rapidly proliferating tissues.
- Common side effects include fatigue, skin reactions, and digestive issues.

Chemotherapy Agents: Various agents with significant side effects.
- Common drugs include 5-FU, doxorubicin, Taxol, and cisplatin.
- Side effects include:
  - CINV (Chemotherapy-Induced Nausea and Vomiting).
  - Bone marrow suppression leading to neutropenia, anemia, and thrombocytopenia.
  - Mucositis, alopecia, and potential neurotoxicity (e.g., with vincristine).
Management:
- Provide patient education on side effects (e.g., red urine with doxorubicin).
- Monitor for potential complications like extravasation.

Preoperative Care: Educate on surgical procedures and expectations.
Postoperative Care: Assess for complications, pain management, and provide education for home care and rehabilitation.
Radiation Management: Promote healing, monitor skin, maintain nutrition, and ensure safe interactions with caregivers.
Chemotherapy Management: Educate on nausea management, infection precautions, and manage side effects such as mucositis and fatigue.