Oncology

Terminology, Difference between benign and malignant, CAUTION are added

1. MEDICAL SURGICAL NURSING ONCOLOGY Prepared By: Dr. Peter Jasper Youtham Head of Department Medical Surgical Nursing

2. TERMINOLOGY A lopecia: Hair loss A naplasia : Cells that lack normal cellular characteristics and differ in shape and organization with respect to their cells of origin. Biological response modifier (BRM) therapy: Use of agents or treatment methods that can alter the immunologic relationship between the tumor and the host to provide a therapeutic benefit. B iopsy: A diagnostic procedure to remove a small sample of tissue to be examined microscopically to detect malignant cells.

3. Brachytherapy : Delivery of radiation therapy through internal implants. Cancer: A disease process whereby cells proliferate abnormally, ignoring growth regulating signals in the environment surrounding the cells. Carcinogenesis: Process of transforming normal cells into malignant cells. Chemotherapy: Use of drugs to kill tumor cells by interfering with cellular functions and reproduction. Control: Containment of the growth of cancer cells.

4. Cure : Prolonged survival and disappearance of all evidence of disease so that the patient has the same life expectancy as anyone else in his or her age group. Cytokines : Substances produced by cells of the immune system to enhance production and functioning of components of the immune system. Dysplasia : B izarre cell growth resulting in cells that differ in size, shape, or arrangement from other cells of the same type of tissue. Extravasation : Leakage of medication from the veins into the subcutaneous tissues. Grading : Identification of the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and structural characteristics of the tissue of origin.

5. Hyperplasia: Increase in the number of cells of a tissue; most often associated with periods of rapid body growth. Malignant: Having cells or processes that are characteristic of cancer. Metaplasia: Conversion of one type of mature cell into another type of cell. Metastasis: Spread of cancer cells from the primary tumor to distant sites. Myelosuppression: Suppression of the blood cell–producing function of the bone marrow. Oncology: Field or study of cancer.

6. Palliation: Relief of symptoms associated with cancer. Radiation therapy: Use of ionizing radiation to interrupt the growth of malignant cells. Stomatitis : Inflammation of the oral tissues, often associated with some chemotherapeutic agents. Staging: Process of determining the size and spread, or metastasis, of a tumor. Thrombocytopenia: Decrease in the number of circulating platelets; associated with the potential for bleeding.

7. Characteristics of Benign and Malignant Neoplasms BENIGN MALIGNANT Well-differentiated cells that resemble normal cells of the tissue from which the tumor originated Cells are undifferentiated and often bear little resemblance to the normal cells of the tissue from which they arose Tumor grows by expansion and does not infiltrate the surrounding tissues. Grows at the periphery and sends out processes that infiltrate and destroy the surrounding tissues. Rate of growth is usually slow Rate of growth is variable and depends on level of differentiation.

8. BENIGN MALIGNANT Does not spread by metastasis Gains access to the blood and lymphatic channels and metastasizes to other areas of the body Is usually a localized phenomenon that does not cause generalized effects. Often causes generalized effects, such as anemia, weakness, and weight loss Does not usually cause tissue damage unless its location interferes with blood flow. Often causes extensive tissue damage as the tumor outgrows its blood supply. may also produce substances that cause cell damage.

9. ETIOLOGY Certain categories of agents or factors implicated in carcinogenesis include: Viruses and bacteria - Epstein-Barr virus Herpes simplex virus type II Cytomegalovirus Physical agents - Excessive exposure to the ultraviolet rays of the sun. Exposure to ionizing radiation Chemical agents - Use of tobacco Pesticides and formaldehydes

10. Genetic or familial factors – Retinoblastomas Nephroblastomas Dietary factors - Fats, alcohol, salt-cured Smoked meats Foods containing nitrates & nitrites Hormonal agents - Oral contraceptives prolonged estrogen replacement therapy

11. Detection and Prevention of Cancer The American Cancer Society, the National Cancer Institute, clinicians, and researchers have placed greater emphasis on primary and secondary prevention of cancer. Primary Prevention is concerned with reducing the risks of cancer in healthy people. Secondary Prevention involves detection and screening to achieve early diagnosis and prompt intervention to halt the cancer process.

12. PRIMARY PREVENTION Assisting patients to avoid known carcinogens is one way to reduce the risk for cancer. Another way involves adopting dietary and various lifestyle changes that epidemiologic and laboratory studies show influence the risk for cancer. Nurses can use their teaching and counseling skills to encourage patients to participate in cancer prevention programs and to promote healthful lifestyles.

13. SECONDARY PREVENTION To provide individualized education and recommendations for continued surveillance and care in high-risk populations. Nurses need to be familiar with ongoing developments in the field of genetics and cancer. Public awareness about health-promoting behaviors can be increased in a variety of ways.

14. Risk Factors: Taking Steps to Reduce Cancer Risk 1. Increase consumption of fresh vegetables because studies indicate that roughage and vitamin-rich foods help to prevent certain kinds of cancer. 2. Increase fiber intake because high-fiber diets may reduce the risk for certain cancers ( eg , breast, prostate, and colon). 3. Increase intake of vitamin A , which reduces the risk for esophageal, laryngeal, and lung cancers. 4. Increase intake of foods rich in vitamin C , such as citrus fruits and broccoli, which are thought to protect against stomach and esophageal cancers.

15. 5. Practice weight control because obesity is linked to cancers of the uterus, gallbladder, breast, and colon. 6. Reduce intake of dietary fat because a high-fat diet increases the risk for breast, colon, and prostate cancers. 7. Practice moderation in consumption of salt-cured, smoked, and nitrate-cured foods, these have been linked to esophageal and gastric cancers. 8. Stop smoking cigarettes and cigars , which are carcinogens. 9. Reduce alcohol intake because drinking large amounts of alcohol increases the risk of liver cancer. 10. Avoid overexposure to the sun , wear protective clothing, and use a sunscreen to prevent skin damage from ultraviolet rays that increase the risk of skin cancer.

16. WARNING SIGNS OF CANCER CAUTION C Change in bowel or bladder habits A A sore that does not heal U Unusual bleeding or discharge T Thickening or lump in a breast or else where I Indigestion or difficulty in swallowing O Obvious change in a wart or mole N Nagging cough or hoarseness