cancer

• patho of cancer: the abnormal and unchecked growth of human cells in the body that destroy surrounding tissue and depleting their resources
• most common types of cancer: lung, breast, colorectal, prostate, skin, and stomach
• malignant: cancerous; rapid rate of growth; invasive; no capsule; metastasis (spreads), suffix of carsoma
• benign: NOT cancerous; slow rate of growth; non invasive; capsule present; suffix oma
• metastasis: spreading; lymphatic system and blood flow (circulation)
• nadir: LOW POINT; each chemotherapy treatment comes with a nadir point
• TNM classification system

  T = tumor size and invasiveness (X, 0-4)

  N = spread to lymph nodes (X, 0-3)

  M = metastasis (X, 0, 1)
• risk factors for cancer: carcinogens (smoking; predisposes you to DNA destruction or mutations), carcinogenesis, environment, hormones, lifestyle, infectious disease, medications, immune status, and nutrition
• primary prevention of cancer: risk factor modification, immunization, chemo prevention
• secondary prevention of cancer: screening for early detection (mammogram yearly for females 45-54, clinical breast exams every 3 years for females 20-39, colonoscopy at 50 years old, fecal testing every 3 years, prostate screening at 50 years old (earlier if higher risk), pap test for females 21-29 every 3 years)
• CAUTION signs of cancer (warning signs of cancer):

  C - change in bowel or bladder habits

  A - A sore that does not heal

  U - unusual bleeding or discharge

  T - thickening or lump in the breast or any other part of the body

  I - indigestion or difficulty swallowing

  O - obvious change in a wart or mole

  N - nagging cough or hoarseness
• tertiary prevention of cancer: reducing morbidity and mortality once disease is diagnosed (AKA what can we do NOW that you have cancer to help you live longer)
• antineoplastic medications: chemotherapy (affects rapidly dividing cells), immunological therapy (drugs that boost the immune system and ends in -MAB), targeted agents (drugs that attack proteins or genes and end in -IB), and hormonal agents (estrogen/testosterone stimulants or blockers)
• lab monitoring: CBC (gives an idea of what the nadir is and do daily trending labs to see the cycle) and electrolytes
• tumor lysis syndrome: quick breakdown of rapid growing cells due to damage or chemotherapy
• tumor lysis syndrome causes sudden release of cellular content into the blood stream especially potassium and phosphorus
• tumor lysis syndrome is typically seen when?

  medication is working well OR the tumor is rapidly growing
• nursing goal for cancer: protect patients from further complications of the disease process and the treatments
• use pharmacological and non pharmacological pain relief and provide emotional support
• reverse isolation: neutropenic precautions to protect the PATIENT not the staff
• soft gentle foods for frequent GI issues; cancers patients typically have upset stomachs often from the chemo meds so they need soft gentle food
• chemotherapy agents must be given by a certified chemotherapy nurse
• reverse/protective isolation: private room with a closed door and HEPA filtration, MASK for everyone entering the room, good HAND HYGIENE for everyone, do not go in if sick, NO flowers or plants, cooked foods only NO fresh fruit or salads, no PEPPER or paprika, avoid invasive procedures, report temperatures of 100 or greater
• key points:

  • cancer is scary and anxiety provoking for patients and their family
  • the treatments can cause discomfort - work to alleviate that discomfort
  • protect the patient from incidental harm and infection
  • be knowledgeable about type of treatment your patient is on (meds are constantly changing)