CANCER

PREPARED BY:
GLYZZA ANN B. BATENGA

Cancer
Is a condition that results from abnormal cellular DNA. It is a condition wherein cells mutate and increase number, with changes in their morphology and without any function. Is not a single disease with a single cause; rather, it is a group of distinct disease with different causes, manifestation, treatments, and prognosis. Second leading cause of death according to the Centers for Disease Control and Prevention.

RISK FACTORS

Viruses and Bacteria: Viruses - Are thought to incorporate

themselves in the genetic structure of cells, thus altering future generations of the cell populations, perhaps leading to cancer.
Bacteria have been evaluated as a cause

of cancer over a years but with little evidence to support the link of bacteria to cancer

Physical agents :
Exposure to sunlight or radiation excessive

exposure to ultraviolet rays of the sun, increases the risk of skin cancer. Factors such as clothing styles (sleeveless shirts or shorts), use of sunscreens; occupation; recreational habits
Exposure to ionizing radiation - can occur with

repeated diagnostic x-ray procedures

Chemical agents : Tobacco smoke thought to be the single most lethal chemical carcinogen, accounts as 30% of cancer deaths. Cigarettes contain hundreds of carcinogens and other harmful chemicals.
Alcohol- Excessive consumption of alcohol is a

risk factor in certain cancers, such as liver cancer. Alcohol, in combination with tobacco, significantly increases the chances that an individual will develop mouth, pharynx, larynx, and esophageal cancers.

 Other suspected chemical substances continues to grow includes aromatic amines, aniline dyes, pesticides and formaldehydes; arsenic, soot and tars, etc. Genetics and familial factors: Genetic factors play a role in cancer cell development. Abnormal chromosomal patterns and cancer have been associated with extra chromosomes, too few chromosomes, or translocated chromosomes. Some genes carry a code for the transcription of cancer and malignancy.

Dietary factors: It has been noted in studies that a diet high in nitrates (processed foods), benzopyrenes (grilled foods), alcohol, red meat and fat increases cancer risk. Also, a diet low in vegetables and other greens significantly increase the risk for colon cancer.

Hormonal Agents: Doctors may recommend hormones (estrogen alone or estrogen along with progestin) to help control problems (such as hot flashes, vaginal dryness, and thinning bones) that may occur during menopause. However, studies show that menopausal hormone therapy can cause serious side effects. Hormones may increase the risk of breast cancer, heart attack, stroke, or blood clots.

PATHOPHYSIOLOGY

Abnormal cell is transformed by the genetic mutation of the cellular DNA

Abnormal cell forms a clone and begins to proliferate abnormally Immune system failure to destroy cancer cells

Malignant cell survival

Malignant cellular deprivation of normal cell of nutrition and other substances for sustenance Malignant cell compression of normal cells Normal cell death

ASSESSMENT

Cancer symptoms depend on the severity and specific type of cancer. Most cancers however are asymptomatic and will only produces signs once they are at advances stages. Early detection and treatment is the key to cancer survival. There are many symptoms of cancer but some of the potentiallyserious warning signs are: C-hanges in bladder or bowel habits A-sore that doesnt heal U-nusual bleeding or discharges T-hickening or lumps I-ndigestion od diffuclty swallowing O-bvious changes in warts, moles, or the skin N-agging cough or hoarseness of voice U-nexplained anemia S-udden loss of weight

MANAGEMENTS

Diagnostic Surgery such as biopsy, to obtain a tissue sample for analysis of cells suspected to be malignant. Biopsy types: Excisional- is most frequent used for easily accessible tumors of the skin, breast, and upper or lower gastrointestinal and upper respiratory tracts Incisional- is performed if the tumor mass is too large to be removed Needle biopsies- are performed for suspicious masses that are easily accessible, such as some growths in the breast. Thyroid, lung, liver and kidney

Chemotherapy is the use of drugs to kill cancer

cells. It destroys the hard-to-detect cancer cells that have spread and are circulating in the body. Chemotherapeutic drugs can be taken either orally (by mouth) or intravenously, and may be given alone or in conjunction with surgery, radiation or both. Immunotherapy uses the body's own immune system to destroy cancer cells. This form of treatment is being intensively studied in clinical trials and is not yet widely available to most cancer patients.

Nursing Management Grieving process: Encourage verbalization of fears, concerns, and questions regarding disease, treatment and future implications Explore previous successful coping strategies Encourage active participation of patient or family in care and treatment Pain and discomfort: Use pain scale to asses pain and discomfort characteristics: location, quality, frequency, duration, etc Administer analgesics to promote optimum pain relief within limits of physicians' order Teach pt. new strategies to releive pain and discomfort: distraction, imagery, relaxation, cutaneous stimulation

Disturbed body image and Situational low self-esteem: Assess pts. Feeling about body image and level of selfesteem Encourage to continued participation in activities and decision making Assist pt. in self care when fatigue, lethargy and other symptoms to prevent independence Individualized care of the pt. Imbalanced Nutrition: Prevent unpleasant sights, odors and sounds in the environment Encourage frequent oral hygiene Adjust diet before and after drug administrations according to patient preferences and tolerance

Powerlessness Encourage verbalization of feelings, perceptions, and fears about making Enhance the patients sense of autonomy. Do this by involving the patient in decision making, by giving information, and by enabling the patient to control the environment as appropriate. Encourage patient to identify strengths. Encourage increased responsibility for self Hopelessness Review clients and significant others (SOs) previous experience with cancer. Determine what the doctor has told client and what conclusion client has reached. Encourage client to share thoughts and feelings. Provide open environment in which client feels safe to discuss feelings or to refrain from talking. Maintain frequent contact with client. Talk with and touch client, as appropriate.

 Assist client and SO in recognizing and clarifying fears to begin developing coping strategies for dealing with these fears. Explain the recommended treatment, its purpose, and potential side effects. Help client prepare for treatments.

HEALTH EDUCATION eating plenty of vegetables and fruits exercising regularly for at least 20 minutes every day avoiding excessive weight gain avoiding tobacco (even second hand smoke) decreasing or avoiding consumption of animal fats and red meats avoiding excessive amounts of alcohol avoiding the midday sun (between 9 A.M. and 3 P.M.) when the sun's rays are the strongest avoiding risky sexual practices avoiding known carcinogens in the environment or work place