Presentation on Oncology medical Surgical Nursing

Medical Surgical Nursing
Oncology
2nd year
Nursing

1. PRESENTATION ON ONCOLOGY

2. Topics To Be Covered: Definition Epidemiology Etiology Classification Pathophysiology Staging Clinical Manifestations

3. DEFINITION Cancer is a large group of diseases that can srart in almost any organ or tissue of the body when abnormal cells grow uncontrallably ,go beyond their usual boundaries to invade adjoining parts of the body or spread to other organs..

4. EPIDEMIOLOGY Cancer incidence and death rates also vary by geography. In states where the prevalence of tobacco use in high, the incidence of lung cancer tends to be greater than in states where smoking is not as common According to Indian council of medical research (ICMR) India is likely to have 17.3 lakhs new cases of cancer and over 8.8 lakh deaths due to cancer by 2020 with cancers of breast, lungs, cervix topping the list. According to WHO cancer report ,the number of cases in India is increasing every year. National cancer registry reported that the cancer of lungs, oral cavity, lip, throat, and neck in men and cancer of breast, cervix, and ovary account for 50% of all cancer deaths in India.

5. CONT… The northeast region in india reported the highest number of cases in both male and females.

6. PATHOPHYSIOLOGY Genetic mutation of cellular DNA( inherited or acquired) Abnormal cell behavior Forms a clone and proliferate abnormally Evading normal intracellular and extracellular growth regarding process and defense mechanism of body. abnormalities in cell signaling transduction process. Invades surrounding tissues Gains access to lymph and blood vessels metastasis

7. ETIOLOGY Following are the known contributing causes of cancer. VIRUSES AND BACTERIA It is estimated that about 11% of all cancer worldwide are linked to viral infections. Examples of these viruses that are known to cause cancer include Human papilloma virus, (cervical, head and neck cancer),Epstein barr virus( Burkitt lymphoma and nasopharyngeal cancer.)

8. Cont … Helicobacter pylori is one bacterium identified as a significant cause of gastric Cancer. Physical Agents. Physical factors associated with carcinogenesis include exposure to sunlight, radiation, chronic irridation or inflammation,tobbaco carcinogens, industrial chemical, asbestos. Excessive exposure to ultraviolet rays of the sun, especially in fair skined people increases the risk of sk8n cancers. Exposure to ionising radiations can occur with repeated diagnostic x ray procedures or with radiation threapy used to treat disease.Improved x ray euipment minimizes the risk of extensive radiation exposure. Radiation threapy used in cancer treatment and exposure to radioactive materials at nuclear weapon manufacturing sites or nuclear power plant in the past have been associated with a higher incidence of leukemia, multiple myeloma,and cancers of the lung, bone, breast ,thyroid and other tissues.

9. CHEMICAL AGENTS Most hazardous chemicals produce their toxic effects by altering DNA structure. Tobacco smoke ,thought to be the single most lethal chemical carcinogen, account for about one thrid of cancer deaths .Smoking is strongly asdociated with cancer of the lung, head and neck , esophagus,stomach , pancreas, cervix, kidneys, abd bladder with acute myeloblastic anemia. Passive smoke has been linked to lung cancer , non smoker who live with smoker have about a 20 to 30% greater risk of developing kung cancer.passive smoker may be linked with childhood leukemia,and cancers of larynx, phrynx,brain , bladder ,rectum, stomach and breast. Smokeless tobacco products,such as chewing tobaccoand snuff used most often by young adults aged 18 to 24 years are associated with an increased risk of oral, Pancreatic and esophageal cancer.

10. GENETICS AND FAMILIAL FACTORS. Almost every type of cancer has been shown to run in families.Genetic factors plays a fundamental role in cancer cell develooment . Cancer has been associated with extra chromosomes,too few chromosomes or translocated chromosomes.cancers with these underlying genetic abnormalities include chronic myelogemous leukemia,meningiomas , acute leukemia, retinoblastomas, and wilms tumor. In these families the associated genetic mutation is found in all cells( it is germ line or somatic) and represents an inherited susceptiblity to cancer for all family members who carry mutation. The hallmark of families with a hereditary cancer syndome include cancer in two or more first degree relatives( the parent,sibling,or child of an individual),onset of cancer in family member with more than one type of cancer, and a rare cancer in one or more family member.

11. LIFE STYLE FACTORS. Around one third of the cancer deaths are due to the 5 leading behavioral and dietary risks: high BMI, low fruit and vegetable intake, lack of physical activity, tobacco use and alchol use. Heavy alchol use increases the risk oh cancer of mouth,phrynx,larynx , esophagus, liver, colon,rectum and breast. Poor diet and obesity have been identified as contributing factors to the development of cancers of the breast, colon , endometrium,esophahus , and kidney. Obesity is also associated with an increased risk of of cancer of of the pancreas,gallbladder ,thyroid , ovary , cervix,and for multiple myeloma,and an aggressive form of prostate cancer.

12. HORMONAL AGENTS Tumor growth may be promoted by disturbance in hormonal balance,either by body own (endogenous),hormone prosuction,or by adminstration of exogenous hormone. Cancer of breast,prostate ,and utreus are thougt to depend on endogenous hormone level.Hormonal changes asociated with female reproductive cycle are also associated with cancer incidence. Early onsetof menses before age 12 and delayed onset of menopause after age 55, nullparity , and delayed birth after ahe 30are all associated with increased risk of breast cancer.Increased number of pregnancies are associated with a decreased incidence of breast ,endometrial ,ovarian cancer. Woman who take estrogen after menopause appear to have an increased risk of ovarian cancer.Combination estrogen and progestrone threapy is linked to a higher risk of breast cancer .The longer the combined threapy is used , the higher is the risk.

13. TUMOR STAGING AND GRADING. A complete diagnostic evaluation includes identifying the stage and grade of tumor.Treatment options and prognosis are based are based on tumor stage and grade. Staging determines the size of the tumor,the exsitence of local invasion, lymph node involvment,distant metastasis. Several system exist for classifying the anatomic extent of disease. The tumor,nodes,and metastasis(TNM)system is one system used to describe solid tumor.

14. TUMOR GRADING. Tumor grade describes how normal or abnormal cancer cells look under a microscope. The objective of a grading system is to provide information about the probable growth rate of tumor and its tendency to spread. The more normal the cell look the less aggressive the cance r and the more slowly it grows and spreads.On the other hand the more abnormal the cells look ,the more aggressive the cancer and faster it is likely to grow and spread. The grade corresponds with a numeric value ranging from I to IV.Grade 1 tumor also known as well differentiated tumors, closely resemble the tissue of origin in structure and function. Tumors that do not clearly resemble the tissue of origin in structure or function are described as poorly differentiated or undifferentiated and are assigned grade IV. These tumors tend to be more aggressive less responsive to treatment ,and associated with poorer prognosis as compared to well differentiated grade I tumor.

15. CLINICAL MENIFSTATIONS.