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Cancer
abnormal growth of cells which tend to proliferate in an uncontrolled way and in some cases metastasize
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Oncology
- field of medicine devoted to cancer
- medical
- surgical
- radiation
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Tumor
lump, mass, swelling
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Neoplasm
- new formation
- abnormal mass of tissue in which growth exceeds and is uncoordinated with that of the normal tissue
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Development of Cancer
- chemical
- environmental
- genetic
- immunologic
- viral
- spontaneous in origin
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Carcinogen
cancer causing
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Heritable trait of cancerous cells
- Autonomy: independence from normal cellular controls
- Anaplasia: lose differentiation of function & shape
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Benign Neoplasm
- well differentiated
- encapsulated
- expansive mode of growth
- characteristics similar to parent cell
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Malignant neoplasm
- able to metastasize
- infiltrative & expansive
- frequent recurrence
- moderate to marked vascularity
- makes own growth factor
- angiogenic: develops own blood supply
- telomeres immortal
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Metastasis
- -to spread
- Direct: self seeding
- Lymphatic: distant seeding
- Bloodstream: distant seeding
- Transplantation: transfer of cells from one site to another
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Carcinogen factors
- environmental factors 80-90% including chemicals, diet, industrial pollution, medical treatments
- Immunological defeccts
- radiation: uv, nuclear, x-ray
- Oncogenic: HPV
- Contributing factors: age, sex, race, genetic predisposition, envrionmental exposure levels, behavioral habits, occupation
- STRESS-PSYCHOLOGICAL
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Prevention & Detection
- educate pt on risks, explore their risk factors
- self-exams
- seek medical care
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7 warning signs
- Change in bowel/bladder
- Any sore that doesn't heal
- Unusual bleeding/discharge
- Thickening in breast/elsewhere
- Indegestion
- Obvious change in skin, wart, mole
- Nagging cough or hoarseness
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Histologic Analysis
- Grade1-4
- 1: cells differ slightly from normal cells & are well differentiated
- 2: cells more abnormal & mod differ
- 3: Cells very abnormal & poorly differ
- 4: Cells immature/primitive & undiffer; cell of origin difficult to determine
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Clinical Staging
- Stage 0-4
- 0: in situ
- 1: tumor limited to tissue of origin
- 2: limited local spread
- 3: extensive local & regional spread
- 4: metastasis
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Collaborative Care
- curative: therapy may involve surgery or extended systemic therapy
- control: initial course & maintenance therapy
- Palliation: relief or control of symptoms & maintenance of quality of life
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Surgery for cancer
- preventative- prophylactic: removal of tissue
- diagnostic: for definitive diagnosis
- curative: primary trtmt mode for localized tumor
- reconstructive: restore function or improve quality of life
- palliative: improve quality of life
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Nursing implications, internal radiation
- maintain bed rest when source in place
- communicate from distance
- stand opposite radiation source
- max exposure 30min/shift
- do not touch implant
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common chemotherapy SE
- anemia
- infection d/t low WBC
- N/V
- pain
- alopecia
- depression/emotional stress
- stomatitis: sores in mouth
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Nursing Diagnosis
- risk for infection
- acute/chronic pain
- imbalanced nutrition: less than body requirements
- fatigue
- impaired oral mucus membranes
- impaired skin integrity
- grieving
- psychological support
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Myelosuppression
- decreased RBC, WBC, platelets
- neutropenia
- thrombocytopenia
- anemia
- Nadir
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