chapter 17 care of the patient with cancer 17 care of the patient with cancer mosby items and...
Post on 14-Jul-2018
231 Views
Preview:
TRANSCRIPT
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 1
11
Chapter 17Care of the Patient with Cancer
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 2
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 3
OncologyOncology Branch of medicine that deals with the Branch of medicine that deals with the
study of tumorsstudy of tumors Lung cancer is the leading cause of Lung cancer is the leading cause of
cancercancer--related death in both men and related death in both men and womenwomen More children 14 years of age and More children 14 years of age and
younger die of cancer than of any other younger die of cancer than of any other diseasedisease
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 4
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 5
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 6
What types of diet may place a What types of diet may place a person at higher risk for person at higher risk for cancer? cancer?
1 2 3 4
44%
11%
22%22%
1.1. Diet high in fatsDiet high in fats2.2. High fiber diet High fiber diet 3.3. Diet with lots of vegetables Diet with lots of vegetables 4.4. Diet high in carbohydratesDiet high in carbohydrates
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 7
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 8
Development, Prevention, Development, Prevention, and Detection of Cancerand Detection of Cancer CarcinogenesisCarcinogenesis The process by which normal cells are The process by which normal cells are
transformed into cancer cellstransformed into cancer cells Various factors are possible origins of cancerVarious factors are possible origins of cancer
CarcinogensCarcinogens Substances known to increase the risk for the Substances known to increase the risk for the
development of cancerdevelopment of cancer
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 9
Development, Prevention, Development, Prevention, and Detection of Cancerand Detection of Cancer
Carcinogenesis and the prevention of Carcinogenesis and the prevention of cancer cancer (continued)(continued) Risk factorsRisk factors SmokingSmoking 87% of people who develop lung cancer are smokers87% of people who develop lung cancer are smokers
Dietary habitsDietary habits Play a role in development of colon, rectum, and Play a role in development of colon, rectum, and
breast cancerbreast cancer
Exposure to radiationExposure to radiation Ultraviolet rays are a factor in the development of Ultraviolet rays are a factor in the development of
basal and squamous cell skin cancers and melanomabasal and squamous cell skin cancers and melanoma
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 10
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 11
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 12
Hereditary CancersHereditary Cancers About 90% of cancers are NOT inheritedAbout 90% of cancers are NOT inherited Genetic susceptibilityGenetic susceptibility Incidence of breast cancer is higher in Incidence of breast cancer is higher in
women with a family history of this diseasewomen with a family history of this disease
Cancer risk assessment and cancer Cancer risk assessment and cancer genetic counselinggenetic counseling First step toward identifying hereditary First step toward identifying hereditary
cancer predispositioncancer predisposition
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 13
Cancer Prevention and Cancer Prevention and Early DetectionEarly Detection Planned periodic examination and Planned periodic examination and
recognition of cancerrecognition of cancer’’s warning signss warning signs Colorectal testsColorectal tests Prostate cancer detectionProstate cancer detection Pelvic examination with Pap smear for Pelvic examination with Pap smear for
womenwomen Breast cancer detection (selfBreast cancer detection (self--exams)exams) Skin examinationsSkin examinations
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 14
CancerCancer’’s seven warning s seven warning signssigns 1. Changes in bowel or bladder habits1. Changes in bowel or bladder habits 2. A sore that does not heal.2. A sore that does not heal. 3. Unusual bleeding or discharge.3. Unusual bleeding or discharge. 4. Thickening or lump in breast or 4. Thickening or lump in breast or
elsewhere.elsewhere. 5. Indigestion or difficulty eating. 5. Indigestion or difficulty eating. 6. Obvious changes in warts or molds.6. Obvious changes in warts or molds. 7. Nagging cough or hoarseness. 7. Nagging cough or hoarseness.
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 15
Pathophysiology of CancerPathophysiology of Cancer
Cell mechanisms and growthCell mechanisms and growth Normal cellsNormal cells When cells are destroyed, cells of the same type When cells are destroyed, cells of the same type
reproduce until the correct number have been reproduce until the correct number have been replenishedreplenished
Cancer cellsCancer cells Instead of limiting their growth to meet specific Instead of limiting their growth to meet specific
needs, they continue to reproduce in a disorderly needs, they continue to reproduce in a disorderly and unrestricted mannerand unrestricted manner
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 16
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 17
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 18
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 19
Grading and Staging of Tumors Grading and Staging of Tumors Stage I: Tumor limited to the Stage I: Tumor limited to the tissue origintissue originStage II: Limited local spreadStage II: Limited local spreadStage III: Extensive local and Stage III: Extensive local and regional spreadregional spreadStage IV: MetastasisStage IV: Metastasis
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 20
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 21
Diagnosis of CancerDiagnosis of Cancer
Biopsy Biopsy Incisional, excisional, needle aspirationIncisional, excisional, needle aspiration
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 22
Types of biopsy.
(From Belcher, A. E. [1992]. Cancer nursing. St. Louis: Mosby.)
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 23
Diagnosis of CancerDiagnosis of Cancer Laboratory testsLaboratory tests
Carcinoembryonic antigen (CEA)Carcinoembryonic antigen (CEA)PSA and CAPSA and CA--125125Stool examination for bloodStool examination for blood
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 24
Cancer TherapiesCancer Therapies
SurgerySurgery PreventivePreventive DiagnosticDiagnostic CurativeCurative
Palliative Palliative Radiation therapyRadiation therapy External radiation therapyExternal radiation therapy Internal radiation therapyInternal radiation therapy
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 25
Cancer TherapiesCancer Therapies
ChemotherapyChemotherapy Side effectsSide effects LeukopeniaLeukopenia AnemiaAnemia ThrombocytopeniaThrombocytopenia AlopeciaAlopecia StomatitisStomatitis Nausea, vomiting, and diarrheaNausea, vomiting, and diarrhea Tumor lysis syndromeTumor lysis syndrome
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 26
Cancer TherapiesCancer Therapies Bone marrow transplantationBone marrow transplantation Process of replacing diseased or damaged Process of replacing diseased or damaged
bone marrow with normally functioning bone bone marrow with normally functioning bone marrowmarrow
Peripheral stem cell transplantationPeripheral stem cell transplantation This procedure is based on the fact that This procedure is based on the fact that
peripheral or circulating stem cells are peripheral or circulating stem cells are capable of repopulating the bone marrowcapable of repopulating the bone marrow
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 27
Advanced CancerAdvanced Cancer Pain managementPain management OpioidsOpioids Morphine, hydromorphone, fentanyl, methadoneMorphine, hydromorphone, fentanyl, methadone SustainedSustained--release morphinerelease morphine MS Contin, Roxanol SRMS Contin, Roxanol SR
AdministrationAdministration IV drips and epidurallyIV drips and epidurally Avoids peaks and valleysAvoids peaks and valleys
Patient selfPatient self--controlcontrol Distraction, massage, relaxation, biofeedback, Distraction, massage, relaxation, biofeedback,
hypnosis, and imageryhypnosis, and imagery
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 28
Advanced CancerAdvanced Cancer
Pain management Pain management Patients should not be subjected to Patients should not be subjected to
severe suffering from potentially severe suffering from potentially controllable paincontrollable pain Fear of addiction should not be a factor Fear of addiction should not be a factor
when considering pain relief for the when considering pain relief for the terminally illterminally ill
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 29
Advanced CancerAdvanced Cancer
Nutritional therapyNutritional therapy ProblemsProblems MalnutritionMalnutrition Anorexia Anorexia Altered taste sensationAltered taste sensation Nausea/vomitingNausea/vomiting DiarrheaDiarrhea StomatitisStomatitis MucositisMucositis
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc. Slide 30
Advanced CancerAdvanced Cancer Terminal prognosisTerminal prognosis Most patients with advanced cancer know Most patients with advanced cancer know
they are dyingthey are dying Honesty and openness are the best Honesty and openness are the best
approachesapproaches Spiritual activities may provide mental and Spiritual activities may provide mental and
emotional strengthemotional strength Social worker assists the patient and family Social worker assists the patient and family
in planning for home carein planning for home care Hospice services can be arrangedHospice services can be arranged——efforts efforts
are directed toward relief from pain and are directed toward relief from pain and other problemsother problems
top related