cancer

by cells that multiple rapidly, are uncontrolled and invade normal tissue

contact inhibition

non cancerous abnormal growth that is non recurrent

cancerous abnormal growths that grow exponentially until cells break off leading to metastasis.

1cm or 1/2 inch

slow growing localized mass that typically are encapsulated. They are movable and have well defined edges. They rarely reoccur and arent life threatening

rapidly growing mass that invades surrounding tissue or travels to distant organs. The mass is rarely encapsulated and has irregular borders and is immovable. Cells cant be readily identified as to the tissue or origin and they commonly reoccur. Are fatal if not treated

Yes. like lung cancers cause SOB and coughing. The cancer prevents normal functioning

spread of a tumor from the primary site to a different part of the body

means tumor is contained in one area/ localized.

• cancer invades the blood or lymph vessels
• moved by mechanical means (cells accidentally transplanted during surgery)
• cancer lodges and grows in a new location by directly extending into surrounding tissue

the mutation of cellular genes leads to abnormal cell growth and the lack of inhibition of the division of cells caused by contact with other cells

• carcinogen exposure
• initiation: normal cells are altered or damaged
• promotion: repeat exposure to carcinogens cause cell mutation
• progression: further genetic mutation occurs

• Oncoviruses
• radiation
• chemicals
• irritants
• genetics
• diet
• hormones
• immune factors

high fat; low fiber

lung cancer

• most common type of cancer that affects the skin and organs with linings. its composed of rapidly dividing cells.
• (ex: lungs, colon)

blood, bone, cartilage, and adipose tissue

bone marrow

lymph nodes and spleen

• cells that produce skin pigment
• (melanin= melanoma)

• lung
• prostate
• colon

• lung
• breast
• colon

• Early detection
• screening
• genetic testing
• healthy lifestyle
• vaccines
• protectant foods

pickled and smoked foods

• biopsy
• radiological studies
• labs (tumor markers psa and cea; increased calcium)
• Nuclear imagine
• ultrasounds
• endoscopy
• cytological study

tumor markers for prostate cancer

tumor marker for colon cancer

• cells are confined to tissue of origin with no sign of mets.
• Tumor In Situ

limited spread of cancer to local area; generally to lymph nodes

Large tumor; probably has invaded surrounding tissues

cancer has metastasized

• tumor (size) : 1-4 range. 1= small 4= extra large
• nodes (involvement) : 0-3 0=none 3=large amount
• metastasis : 0-1 0=none 1=some

• curative- tumor can be removed
• pallative- done only to help pain and control symptoms
• prophlyactic- removes areas before cancer growth (ex:breasts, moles)
• Reconstructive

• radiation is admitted inside the pt allowing for higher dose to affected area while reducing destruction of surrounding area.
• have to use safety precautions while pt is being treated.
• All secretions are radioactive.

Radiation beams destroy cancer cells with minimal damage to normal healthy cells.

radiation given po or iv

radiation is deposited as "seeds" that radiologist insert and remove from cavities. it delivers specific amounts of radiation over hours or days

• time: plan ahead. Nurses may spend less than 1 hour exposed to radiation over an 8 hour shift. provide activities for pt bc they isolated.
• distance: stand as far away as possible
• shielding: wear lead apron if in close contact or prolonged exposure

• visitors are limited to 10 minutes exposed to pt
• pt on strict bed rest to prevent dislodgment of seeds
• proper signage on door
• do not bath pt below waste if vaginal radiation; keep legs closed
• low residue diet to slow bm
• force fluids
• foley cath to keep bladder from absorbing radiation
• hob 30-45 degrees MAX
• TED hose for bed rest
• *long handled forcepts and lead container in case of seed dislodging* no touchy
• check position of applicator by assess threads attached externally
• call radiologist if seed falls out

removal

• fatigue
• nausea, vomiting, anorexia 
• mucositis (inflammation of MM)
• xerostomia (dry mouth)
• skin reactions (red blistering)
• bone marrow depression

not considered radioactive

5 minutes

• skin markings should not be removed
• use water based lotions bc radiation is drying to skin
• bath with mild soap
• avoid lying on affected side or area and other irritants.

• affects cells that rapidly divide and reproduce (gi, oral, hair, bone marrow)
• All malignant cells must be destroyed for cancer to be cured

po, iv,im, topical

combination

every 3 week to allow for blood counts to regrow.

attacks cells in a specific phase of reproduction

• Red Urine** pt teaching
• loss of hair
• n/v
• cardiac damage
• is a vesicant drug** destroys tissue if it infiltrates

hair loss, neuropathy, muscle aches

Difficulty hearing, rigging of ears

Sob/ cough/ pulmonary fibrosis

increased Bp

• (Epogen,Epoetin Alpha, Procrit)
• stimulated RBC production
• erythrocytes=rbc

• (Neumega)
• stimulates platelet production

• Leukine (sargramostim)
• stimulates WBC

• (Neupogen,neulasta)
• stimulates wbc production

Bone marrow depression** occurs 7-10 days after chemo

Leukopenia (low wbc)- avoid fresh fruit bc bacteria in pectin

thrombocytopenia (low platelets) *monitor pts with <20 bc spontaneous bleeding; pts with <50 for falls/injury 

anemia

• small frequent meals
• fluids between meals
• *bland diet*
• avoid greasy, spicy or stinky foods

• inflammation of mouth
• medicate for pain
• avoid hot or cold liquids, citrus, alcohol or smoking, spicy food, and mouth wash (all that is gonna cause pain)
• preform mouth care
• use mouth wash of baking soda, salt, and water or benadryl and water**

• starts 10-21 days after first chemo
• always inform pt of this side effect
• hair loss is temporary
• could fall out slowly or in large clumps
• ice caps could help by freezing follicles

• Always significant risk with bone marrow depression
• report temps of 101 or more
• prophylactic antibiotics and drugs to raise WBC
• possible hospitalization

• decreased sex drive
• painful intercourse (vaginal and intestinal lining is being killed off)
• erectile dysfunction 
• infertility

• "chemo fog"
• memory lapses
• trouble concentrating
• unable to remember details or multi-task

• limit contact with others if severe neutropenia
• avoid injury or trauma with thrombocytopenia

• higher the dose the worse the symptoms
• treatment is based on adequate lab values- withheld if blood counts are too low
• ANC = wbc x segs. if neutrophil count is less than 2000 hold treatment

• strict guidelines for mixing agents
• must wear gloves and gowns
• wash hands before and after mixing
•  double and triple check for accuracy
• prevent spills
• if spills occur use special clean up kit for biohazards only*****

• B: bleeding- low plt
• I: infection- low wbc
• t: tiredness- anemia
• e: emesis -nutrition and electrolyte imbalances
• s: skin changes- radiation reaction or break down

• no OTCs without approval
• never increase, decrease, or omit dose of chemo without approval
• assess mouth daily
• drink fluids 8-10 cups
• keep all apointments
• alcohol in moderation
• no invasive procedures without prior approval
• have blood checked as order, on time!!

• less than 6 mo prognosis
• inpt
• outpt
• keep pt comfy
• all curative treatments stop
• promotes comfort and quality of life
• pt may go through the stages of grieving or death (denial, anger, bargaining, depression, acceptance)

• Most common in pts with lung cancer
• tumor grows and blocks the vessel
• s/s: high pitched voice, edema of head and neck, maybe seizures
• hospitalization needed with radiation and drugs to shrink tumor

• occurs in pts with bone mets to spine
• s/s: lower back pain and loss of use of legs
• mri used to rule out compression
• radiation to relieve compression

• most common in pt with bone mets
• s/s: calcium over 11 (5.3-8.) is normal, confused and disoriented
• treatment is Aredia and Zometa- decrease calcium in blood . calcitonin injection given at home.
• check calcium levels daily
• too high calcium can cause a coma