Rectal cancer

cancer of rectum is the abnormal proliferation of the rectal cells this ppt will help the nursing students to know the disease process and its management and also this help the students to apply these in their clinical practice and to improve their academic performance

1. RECTAL CANCER DEPARTMENT OF MEDICAL SURGICAL NURSING

2. Learning Objectives At the end of this lecture, students should be able to: define rectal cancer. enlist the stages of cancer of rectum . explain the causes of cancer of rectum. describe the clinical features of rectal cancer. describe the management of rectal cancer. enumerate the complications of rectal cancer.

3. DEFINITION Abnormal proliferation & differentiation of cell of rectum is called as cancer of rectum.

4. CAUSES & RISK FACTORS 1.Smoking 2. Increasing age 3. Family history 4. High fat diet 5. Personal history of polyps 6. Physical inactivity

5. Race Inflammatory bowel disease Diabetes Obesity Drinking alcohol Radiation therapy for any genital cancer

6. STAGES The stages of rectal cancer are as follows: STAGE-1: The tumor involves only the first or second layer of the rectal wall & no lymph nodes are involved. STAGE-2: The tumor penetrate into the mesorectum but no lymph node are involved.

7. Cont--- STAGE-3: The tumor invade the lymph nodes. STAGE-4: Metastasis in the other part of the body takes place

8. CLINICAL FEATURES Rectal bleeding- mixed with stool. Anemia, Shortness of breath, fatigue Light headache Severe constipation Abdominal pain or cramping Weight loss

9. DIAGNOSTIC EVALUATION History collection Physical examination Fecal occult blood test Endoscopy A digital rectal examination Rigid sigmoidoscopy

10. Cont--- Colonoscopy Endoscopic Biopsy specimen Chest X-ray CT Scan Routine blood & urine investigations.

11. Surgical Management Transanal Excison Mesorectal surgery Low anterior resection Abdominoperineal resection

12. Radiation therapy Goal:- Shrink the tumor to make its surgical removal easier . Kill - cancer cells after surgery to reduce the risk of the cancer returning or spreading .

13. Radiation therapy Typically radiation therapy is given daily ,5days a week for upto 6 wks . and is completely painless . Side effect of radiation therapy - mild skin irritation ,diarrhea ,rectal or bladder irritation and fatigue .

14. Chemotherapy This therapy is often given for stages II and III rectal cancer . Preoperative chemotherapy is sometimes given to reduce the size of the tumor .

15. Chemotherapy drugs used 5 Flurouracil Capecetabine Oxaliplatin Camptosar Avastin Cetuximab

16. Nursing management Reduction of the anxiety Alleviation of pain Attainment of an optimum level of nutrition . Maintenance of fluid and electrolyte balance . Prevention of infection . Adequate information.

17. Complications Prolapse of stoma Perforation Stoma retraction Skin irritation

18. Complications Leakage from anastomatic site Abdominal distension and rigidity Temperature elevation Signs of shock

19. Prevention Colorectal Screening Dietary Management Appropriate elimination habits

20. Summary So far we have discussed about definition, stages of cancer, causes, clinical manifestations, complications and managements of rectal cancer.

21. Bibliography Lewis et al, Medical Surgical Nursing, Mosby Elsevier,7 th edition. Joyce.M.Black et al, Medical Surgical Nursing, Saunders publication. Brunner and Siddhartha, Medical Surgical Nursing, Lippincott Williams and Wilkins.

22. Thank You