Oncology Essentials

Cancer vs Tumour

• Cancer: group of diseases with uncontrolled, abnormal cell division and spread.
• Tumour (neoplasm): abnormal tissue growth; can be benign or malignant.

Adult Warning Signs (CAUTION)

• Change in bowel/bladder habits
• A sore that does not heal
• Unusual bleeding/discharge
• Thickening/lump in breast or elsewhere
• Indigestion or swallowing difficulty
• Obvious change in mole/wart
• Nagging cough/hoarseness

Childhood Warning Signs (SILUAN)

• Eye: white pupil, new squint/blindness, bulging eye
• Lump: abdomen, pelvis, head, neck, limbs, testes, glands
• Unexplained: long fever, weight loss, pallor, fatigue, bruising/bleeding
• Aching: bones, joints, back, easy fractures
• Neurological: gait/speech change, milestone regression, persistent headache, enlarging head

Benign vs Malignant Neoplasms

• Cell diff.: well-differentiated vs poorly differentiated
• Growth: localized vs infiltrative/metastatic
• Speed: slow vs rapid
• Capsule: present vs absent
• Recurrence/tissue damage/death: rare vs common
• Prognosis: good vs depends on early detection & treatment

Surgical Management

• Diagnostic (biopsy)
• Prophylactic (preventive removal)
• Therapeutic (curative/supportive/palliative)
• Rehabilitative (reconstructive)
• Combination (mixed aims)

Radiation Therapy

• Goal: cure, control, palliation
• External beam: X-rays, gamma rays
• Internal
  • Sealed source: radioiodine, pellets/seeds
  • Unsealed source: brachytherapy fluids/seeds placed temporarily
• Key side effects: fatigue, marrow suppression, anorexia, skin/mucosal burns, site-related GI or organ effects

Chemotherapy

• Systemic treatment targeting micro-metastasis
• Phases
  • Induction: high-dose multi-drug start
  • Consolidation: repeat to prolong remission
  • Intensification: higher doses to raise cure chance
  • Maintenance: low dose, long-term to delay relapse
• Contra-indications: infection, recent surgery, renal/hepatic impairment, recent radiotherapy, pregnancy, marrow suppression
• Common side effects: marrow depression, GI toxicity, alopecia, cardiac/lung/reproductive toxicity, chromosomal changes, peripheral neuropathy, fatigue

Psychosocial Aspects

• Kubler-Ross stages: denial → anger → bargaining → depression → acceptance
• Patient support: symptom control, comfort, emotional care

Nursing Role

• Unrestricted visiting, family encouragement
• Comfort & emotional support; no false hope
• Respect privacy, culture, religion; clear communication

Family Support

• Bereavement counselling, empathy, venting encouragement
• Support visiting, rest rotations, cultural rituals (adapted during pandemics)