Cancer care basics

• 7 warning signs of cancer


  • Change in bowel or bladder habits (constipation, diarrhea, change in color)
  • A sore that does not heal
  • Unusual bleeding or discharge from any body orifice (Colon Cancer?)
  • Thickening or a lump in the breast or elsewhere (monthly breast self-breast exam & mammograms every 1-2 years)
  • Ingestion or difficulty swallowing (Heartburn)
  • Obvious change in a wart or mole
  • Nagging cough or hoarseness
• How would someone describe signs of cancer?


  • Vague symptoms
  • Subjective or objective
• Primary preventions for cancer


  • Maintain a healthy weight
  • Get adequate rest
  • Eat a balanced diet
  • Limit alcohol intake
  • Exercise regularly
  • Eliminate, reduce, or cope with stress
  • Avoid or reduce exposure to known carcinogens such as cigarette smoking & excessive sun exposure
• Secondary preventions for cancer


  • Practice self-examination (monthly)
  • Practice recommended cancer screenings
  • Mammograms: start at 40 yrs old every 1-2 years
  • Pap Smear: 5 yrs with HPV screening, 3yrs without HPV screening
  • Seek medical care if anything is suspicious
  • Have a regular health examination
  • Be familiar with your family history & known your risk factors
• Different ways to diagnose cancer


  • Cytologic examination
  • Tissue biopsy
  • Chest x-ray
  • Complete blood count & chemistry profile
  • Liver dysfunction studies endoscopy procedures
  • Radiographic studies
  • MRI, CT, Mammogram
  • Radioisotope scans
  • PET scans
  • Tumor markers
  • Genetic markers
  • Molecular receptor status
  • Hormones
• Prostate-specific antigen (PSA)


  Blood can contain PSA which can increase the likelihood of prostate cancer in men
• Psychological support needed during diagnosis


  • Proper coping mechanisms
  • Anxiety & stress from waiting for results
• Different goals for cancer treatment


  • Cure
  • Control
  • Palliation/Hospice
• Hospice


  Goal is facilitating a peaceful & dignified death; projected to <6 months; not seeing curative treatment (care > cure)
• Palliative Care


  Goal is on improved quality of life and facing problems associated with life threatening illness (cure < care)
• Chemotherapy & radiation are not the only options for cancer patients
• Different types of surgeries for cancer treatment


  • Diagnosis
  • Prevention (r/t exploratory ex. laparoscopy)
  • Cure/Control (possible r/t family history ex. Elective mastectomy)
  • Supportive
  • Palliation
  • Reconstruction
• Different types of therapies for cancer treatment


  • Chemotherapy
  • Radiation therapy
  • Immunotherapy
  • Targeted therapy
  • Hormone therapy
  • Growth factors
  • Hematopoietic Stem cell Transplantation (HSCT)
  • Complementary therapies
• Cell cycle-specific chemotherapy


  Acting on it all the time
• Cell cycle-nonspecific chemotherapy


  Isn't working on reproductive
• Central venous access device (CVAD)


  Reduce trauma to veins & less sticks
• Cells targeted by chemotherapy

  • Bone marrow stem cells
  • Neutrophils
  • Epithelial cells lining GI tract
  • Cells in hair follicle
  • Cells in reproductive system
• Internal radiation (Teletherapy)


  Most common, concerns: Watching for skin changes
• External radiation (Brachytherapy)


  Associated with Low energy, concerns: Periods of radioactive, Limited contact with people, Time distancing & shielding with medication
• Ways to administer brachytherapy

  • High-dose-rate
  • Low-dose-rate
  • Permanent implants
• Common side effects of chemotherapy & radiation


  • Bone marrow suppression
  • Fatigue
  • GI Disturbances (Nausea & Vomiting)
  • Integumentary and Mucosal reactions
  • Pulmonary Tissue damage
  • Cardiac Tissue damage
  • Cognitive dysfunction
  • Reproductive dysfunction
• Types of adverse bone marrow suppression


  • Neutropenia (<1,000)
  • Thrombocytopenia (Not clotting)
  • Anemia
• Integumentary and mucosal reactions


  Killing normal flora giving pathogens a chance to grow, C. Difficile & Thrush
• Immunotherapy


  Uses the body's immune system to either boost/manipulate the immune system to create an environment that is not conductive for cancer growth or attack cancer cells directly
• Targeted therapy


  Interferes with cancer by targeting specific cell receptors and pathways that are important in tumor growth
• Examples of hormone therapy for cancer treatment


  • Estrogen
  • Progesterone
  • Testosterone
• Growth factors


  Build blood system up after chemo
• Hematopoietic Stem Cell Transplantation (HSCT)


  Replace sick cells with healthy ones
• Complementary therapies


  • Botanical agents
  • Nutritional supplements
  • Dietary regimens
  • Mind-body modalities
  • Energy healing
  • Spiritual approaches
• Complementary therapies


  Individualized (each choose)
• Complications of cancer & cancer treatment


  • Nutritional Problems: Malnutrition, Altered taste, Anorexia causing cachexia, Wasting syndrome of malnutrition
  • Infection: decrease in immune system
• Oncologic emergencies


  • Superior vena cava syndrome
  • Spinal cord compression
  • Third space syndrome
  • Syndrome of inappropriate Antidiuretic hormone
  • Hypercalcemia
  • Tumor lysis syndrome (TLS)
  • Pericardial effusions and cardiac tamponade
  • Carotid Artery Rupture
• Categories of pain syndromes in cancer patients

  • Pain associated with direct tumor involvement
  • Pain associated with treatment
  • Pain from a cause not related to either cancer or therapy
• Morphine


  Can aid in relaxation/pain relief and decrease air hunger
• There are multiple ways of administering morphine
• Goals of pain therapy


  • Provide relief that allows patient to function
  • Die relatively free of pain
• Other therapies of pain management


  • Injection of anesthetic drugs into spinal cord or nerve plexuses
  • Surgical severing of nerves
  • Radiation of reduce tumor size & pressure
  • Behavioral approaches
• Psychological and emotional responses for cancer patients


  • Gulit, fear, grief, and anger
  • Powerlessness and hopelessness
  • Body image concerns
• Family and/or caregivers can experience body image concerns for the patient
• Interventions for continuity of care


  • Order equipment and supplies needed for home care
  • Provide referral to a home health nurse for patient who will need complex care
  • Hospice care