Comprehensive Cancer Management for Nursing Professionals

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**Title:** Comprehensive Cancer Management for Nursing Professionals: An In-Depth Guide

**Description:**

This presentation is designed to serve as a comprehensive resource for nursing professionals involved in cancer care, providing a thorough understanding of cancer management from multiple perspectives. In the increasingly complex field of oncology, nurses play a pivotal role in delivering patient-centered care, making it crucial to be well-versed in every aspect of cancer management.

### 1. **Introduction to Cancer: Understanding the Basics**
The presentation begins by laying a solid foundation with an introduction to cancer biology, discussing how normal cells transform into malignant ones. The pathophysiology of cancer is explored in detail, including the genetic and environmental factors that contribute to carcinogenesis. Understanding the types of cancer, their growth patterns, and how they spread through metastasis is essential for nurses to effectively manage and communicate with patients.

### 2. **The Role of Early Detection and Screening in Cancer Care**
Early detection is crucial in improving cancer prognosis, and nurses are at the forefront of screening efforts. This section covers the various screening guidelines and protocols for different types of cancer, such as breast, cervical, colorectal, and prostate cancers. The presentation highlights the importance of patient education in promoting regular screenings and early detection, which can lead to more successful treatment outcomes. Nurses are educated on how to guide patients through the screening process, addressing common concerns and barriers to participation.

### 3. **Cancer Treatment Modalities: A Comprehensive Overview**
Cancer treatment is multifaceted, involving surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy, and hormone therapy. This presentation delves into each of these modalities, explaining the principles behind them, their indications, and their effects on the body. Nurses are provided with detailed information on pre-treatment assessments, the administration of treatments, and the management of potential side effects. By understanding the intricacies of these treatments, nurses can better support patients and work alongside oncologists and other healthcare professionals to deliver optimal care.

### 4. **Symptom Management and Supportive Care**
Cancer and its treatments often lead to a range of symptoms that can significantly affect patients' quality of life. This section focuses on symptom management, emphasizing the nurse's role in alleviating pain, nausea, fatigue, and other treatment-related symptoms.

2. .
Dr/Samah GhonaemDr/Samah Ghonaem
Assistance prof of Medical -Surgical Nursing Faculty
of Nursing Benha University

3. OBJECTIVESOBJECTIVES
Identify the meaning of cancer
List types of cancer.
Enumerate risk factors of cancer.
List common clinical manifestation of cancer
Identify diagnostic tests
Classify treatment modalities
Apply nursing process for patient with cancer

4. Definition of cancerDefinition of cancer
Cancer is a collective term
describing a large group of diseases
characterized by uncontrolled
growth and spread of abnormal cells.

5. Types of tumor
Tumor can be classified as :
1- Benign tumor is a simple new growth is similar
in substance to the tissue in which it arises and is
named accordingly.
2- Malignant tumor is growth and spread of the
abnormal cells which continue to reproduce until
they form a mass of tissue known as cancer.

6. the difference between benign and malignant
tumor.
According Characteristic of benign and
malignant tumor.
1- Cell Characteristics 2- Mode of growth
3- Rate of growth 4- Metastasis
5- General effects 6- Tissue destruction
7- Ability to cause death

7. Types of cancer
Carcinoma: Malignant cells of epithelial tissue and skin.
Sarcomas: Malignant cells of connective tissue, muscle
and bone.
Leukemia: Malignant cells of blood or blood forming
organs.
Lymphomas: Malignant cells of lymph nodes.
There are different types of cancer, including: -
- Breast cancer - skin cancer -
lung cancer - colon cancer - prostate
cancer - lymphoma

8. Etiology& risk factors for cancer
A) Controllable risk factors for cancer
1-Tobacco use
2-Obesity, diet and exercise
3-Alcohol and drugs abuse
4-Ultraviolet (UV) radiation
5-Occupational exposure
6-Psychosocial factors
7-Reproductive and hormonal factors.

9. etiology& risk factors for cancer
B -Uncontrollable risk factors for
cancer:
1- Age.
2-Family history of cancer..
3-Genetic conditions;
4-Previous history of cancer;
5-Radiation therapy or chemotherapy;
6-Virus exposure

10. Clinical manifestation of cancer
The clinical manifestations of cancer are
numerous.
Each variant of the disease has its unique
manifestations that may be
-vague complaints of unexplained fatigue
 -weight loss - fever - pain - life
threatening medical emergencies

11. The following sings may be associated with
cancer and it called warning signs
1) Changes in bowel or bladder habits,
2) A sore that does not heal,
3) Unusual bleeding or discharge,
4) Thickening or lump in breast or any
other part of the body
5) Indigestion or difficulty swallowing
6) Cough or hoarseness

12. Detection and prevention of cancer
It includes primary and secondary prevention.
A) Primary Prevention : concerned with
reducing the risks of cancer in healthy people
through community education about cancer risk,
assisting patients to avoid known carcinogens, and
adopting dietary and varies lifestyle changes that
epidemiologic and laboratory studies show
influence the risk of cancer.

13. Ten steps to reduce the risk of cancer
1. Increase consumption of fresh fruits and vegetables
especially those of cabbage family.
2. Increase intake of vitamin A, C which act as protective
against many cancers.
3.Increase fiber intake and choose whole grains instead of
refined (processed) grains and sugars.
4. Maintain ideal body weight.
5. Limit consumption of red meat, especially processed
meats.

14. steps to reduce the risk of cancer
6. Reduce intake of dietary fat especially taken from
animal source.
7. Limit salt intake, salt-cured food, and smoked
foods.
8. Stop smoking.
9. Reduce alcohol intake.
10. Avoid exposure to direct sun light especially at
the duration from 10am to 3pm.

15. American cancer society (ACS) recommendations
for cancer checkup breast
- Routine monthly breast self-examination starting
at age 20
Clinical breast examination every 3 years from age
20-40 and yearly thereafter.
Screening mammography every 2 years from age
40 to 50 and yearly thereafter

16. B) Secondary Prevention
It involves screening and early detection for
cancer to achieve early diagnosis and prompt
intervention to stop the cancer process.
 Directed towards nursing and medical
management of cancer as disease effect and side
effect of therapy management
palliative care of advanced cancer signs and
symptoms.

17. Diagnoses of cancer
Medical diagnosis require obtaining a complete
patient history and physical examination in addition
to Radiological studies; X-rays, a CT scan, and MRI
Endoscopy; for example, colonoscopy to look inside
the colon).
Laboratory tests; such as blood and urine tests
Biopsy; a biopsy is the only sure way to know
whether the problem is cancer.

18. Treatment modalities and nursing care of
clients with cancer
Goals of treatment:
 1- Complete eradication of malignant disease
(cure).
 2-Prolonged survival and containment of cancer
cell growth (control).
 3-Relief of symptoms associated with the disease
(palliation).

19. Considerations in choosing therapy
Disease and results obtained from each
type of therapy.
Patient’s general conditions and co-
existing disease.

20. Multiple modalities are commonly used
in cancer treatment including:
1)Surgery
2)Radiation therapy
3)Chemotherapy
4)Hyperthermia
5)Acupuncture
6)Hormone therapy
7)Gene therapy
8)Bone marrow transplantation and steam cell

21. 1-surgery
Types of surgical application:
a ) Diagnostic surgery
,a variety of methods are used such as. Incisional biopsy:
removal of a small portion of tumor for examination by
endoscopic examinations.
- Excisional biopsy: removal of entire tumor.
d) Needle biopsy: aspiration of core tissue samples through
a needle.
- Endoscopy: removal of small portions of tumor with
forceps following visual examination.

22. b) Treatment of disease by surgery:
It involve the following:
(1)Local excision: is the simple excision of a tumor
and a small margin of normal tissue. Most
commonly used to treat skin cancer.
(2) Wide excision: is the removal of the primary
tumor, regional lymph nodes, lymphatic channels,
and neighboring structures (e.g.) radical mastectomy

23. 2- Radiation Therapy
Definition: Irradiation means application or exposure of
body tissues to radiation energy which may occur either
accidentally or for therapeutic purposes.
Uses of Radiation therapy
to cure the cancer,
When a tumor cannot be removed surgically or when local
nodal metastasis is present.
It can be used prophylactically
Palliative radiation therapy

24. Effect of radiation
A- Systemic effect Radiation causing nausea, vomiting, and
depression poor appetite, weight loss, and anemia
 B- Local effect Skin: Erythema – Edema-Chronic -Loss of
hair Bone and cartilage: Bone necrosis and pathological
fracture GIT: Ulceration and hemorrhage-Atrophy of
lymphoid tissue-Necrosis and perforation Kidney: Radiation
nephritis-Chronic renal failure-
 Testes and ovaries: Atrophy of germ cells leading to sterility
Bone marrow and blood: Anemia-Leucopenia-
Thrombocytopenia-Leukemia.

25. .. Nursing care related to side effects
that results from radiation therapy:
1- Impaired skin integrity related to radiation
therapy.
Nursing interventions: Assess skin integrity.
Instruct patient to minimize trauma
Clean skin with lukewarm water.
Avoid use of soap, powders
Avoid shaving and protect skin from cold, heat,
sun.- Avoid adhesive tape on irradiated skin

26. 2-Fatigue or activity intolerance related
to radiation therapy.
  Assess fatigue.
 Monitor blood counts for anemia.
 Help the pt to plan for assistance with
transportation, preparation of food.
 Help pt to taking a nap immediately after returning
home to have energy for the rest of the day.
Help the pt to maintain an adequate nutritional intake

27. 3-Altered nutrition less than body
requirements related to anorexia.
Nursing interventions:-
•Assess loss of appetite in pt. receiving radiation
therapy.
•Instruct the patient that small meals allow more
food to be consumed throughout the day.
•Instruct the patient to have high-calorie, high-
protein foods at all times

28. Altered oral mucous membrane related to
stomatitis secondary to radiation therapy of
head and neck.
•Mouth care. -Tooth brushing and if painful,
warm saline rinses and gentle swabbing with
moist gauze. -Inspecting oral cavity each day.
-- Instruct the patient to use soft diet to make
chewing and swallowing easier. - control
minor areas of bleeding in the mouth or
systemic antibiotics to control oral infections

29. Ineffective individual coping related to
alopecia.
Instruct the patient to use a scarf or turban
to protect scalp from the wind, cold, and
sun. A mild shampoo may be used, but
avoid excessive shampoo.
•Help the patient to cope with alopecia or
allowing verbalization of fears, grief, and
anger.

30. 6-Altered nutrition, less than body requirements
related to nausea and vomiting
•Assess for occurrence and pattern of nausea and vomiting.
•Prophylactic use of antiemetic before treatment each
day .
•Relaxation techniques and distraction such as listening to
soothing music and engaging in enjoyable activity.
•Provide diet that is low in fat, low in sugar. and easily
digested.
•Soups, broths and other fluids should be consumed to
maintain fluid intake and prevent dehydration

31. 3- Chemotherapy
Chemotherapeutic is an agent are effective
in destroying or preventing the multiplication
of cancer cell, normal tissue is also affected.
a cytotoxic drugs in the treatment of cancer,
chemotherapy is a systemic as opposed to
localized therapy such as surgery and
radiation therapy.

32. The goals of chemotherapy

To reduce tumor size preoperatively.
To destroy any remaining tumor cells
postoperatively.
To treat some forms of leukemia.
Cure, control, palliation (20% to 99%,
depending on dosage) of tumor cells is
destroyed.

33. Side effects of chemotherapy
Bone marrow suppression: - ↓Red blood cells
carry oxygen, Risk for anemia- - ↓white blood cells
that fight infection, Risk for fatigue, and infection --
↓platelets that help the blood to clot, Risk for
bleeding
mouth sores, nausea, vomiting, and diarrhea
Hair loss, also called "alopecia":
Chemotherapy affects the cells of the hair and nails

34. Nursing care related to side effects that results
From chemotherapy:
1- Disturbance in self-concept related to alopecia.
Nursing Intervention Inform patient that hair loss is
temporary and hair will regrow when the treatment is
stopped (it usually returns 2-6months).
-Provide resources for purchase/loan of wigs, scarves, and
caps).
Inform patient about health care measures for
scalp protection: use of gentle shampoos, and wear
protective covering when out doors.

35. Altered nutrition less than body requirements
related to anorexia.
-Nursing Intervention
-Assess loss of appetite in pt receiving chemo therapy.
-Instruct the patient that small meals allow more food to be
consumed throughout the day.
-Instruct the patient to have high-calorie, high-protein foods
at all times
 - Promote relaxed, quite, environment during mealtime
with increased social interaction as desired