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Oncology Nursing

Oncology
• Study of cancer
Oncology Nursing
• Branch of nursing that deals with the care
and treatment of clients with cancer
Incidence and Prevalence
• Males: 4 most common types of cancer are – prostate, lung
and bronchus, and colorectal
• Females: 4 most common types of cancer are – breast, lung
and bronchus and colorectal
Carcinogenesis
Initiation
Promotion
Progression
Comparison
Benign Tumor Malignant Tumor

• Cells are well differentiated • Cells are UNDIFFERENTIATED


• Tumor growth by • Tumor growth: infiltration
EXPANSION; usually (destroys surrounding tissue)
ENCAPSULATED • Growth is variable
• Growth is SLOW • (+) METASTASIS
• NO METASTASIS • (+) Generalized effect on
• No generalized effect on body: ex. Anemia, malaise
body; usually localized
• (+) tissue damage
• No tissue damage
• (+) Death
• Doesn’t cause Death!
RISK FACTORS FOR CANCER
Viruses and Bacteria
• Epstein-Barr: Burkitt’s lymphoma, nasopharyngeal cancer and
some types of Non-Hodgkin’s lymphoma and Hodgkin’s
Lymphoma
• Herpes simplex virus type II, cytomegalovirus and HPV:
cervical cancer
• Hepatitis B virus: Liver cancer
• Human T-lymphotropic virus: Lymphocytic leukemia and
Lymphomas
• HIV: Kaposi’s sarcoma
• Helicobacter pylori: gastric malignancy
Physical Agents
• Sunlight & radiation
• Tobacco use
• Diagnostic x-ray
Chemical Agents
• Smoking
• Asbestos and uranium
• Chewing tobacco
• Dyes, pesticides and formaldehyde
Genetic & Familial Factor
• Family history of certain cancer types
Dietary Factor
• Fats
• Alcohol
• Salt-cured or smoked meat
• Nitrates and nitrites and a high caloric
dietary intake
Hormonal Agents
• Hormonal Imbalances
• Diethylstilbestrol (DES) a synthetic
estrogen – vaginal carcinoma
• Oral contraceptives and prolonged
estrogen replacement therapy –
endometrial, breast and ovarian cancer
Reminder
• Refer to Public Health Nursing book
for risk factors for specific types of
cancer!
WARNING SIGNS OF CANCER
• C – changes 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 elsewhere
• I – Indigestion and difficulty in swallowing
• O – Obvious changes in wart or mole
• N – Nagging cough or hoarseness in voice

• U – Unexplained anemia
• S – Sudden weight loss
GUIDELINES FOR EARLY DETECTION
OF COMMON CANCERS
Breast Cancer
• BSE
• most cheapest
• done a week after menstrual period while taking a
shower facing the mirror standing up or lying down
• Tail of Spence: most common site of breast tumor
• Mammography
• Baseline mammography: done 35-39 years
• Yearly mammogram: starts at 40
• If with familial history of breast cancer: started at 30
Cervical Cancer
• Pap smear
• Done 2 weeks after menses
• Done annually for 2 consecutive year; then every 3
years until age 65 if findings are normal
• Prep: no douche, no intravaginal meds, no sex for 24
hours before test
• Who should undergo Pap Smear???
• Sexually active
• Have multiple partners
• Commercial sex workers
Colorectal Cancer
• Yearly digital rectal exam @ 40 and above
• Yearly occult blood test @ 50 and above
• Sigmoidoscopy every 3 years @ 50 and
above
• Colonoscopy every 10 years
Prostate Cancer
• Digital rectal exam for men
• Prostate Specific Antigen (PSA)
determine a blood test, confirms
diagnosis
Lung Cancer
• Chest X-Ray every 6 months for
patients who have history of smoking
2 packs per day
• Sputum cytology
Nursing Care/Interventions
Health Promotion
• Increase consumption of fresh vegetables
• Increase fiber
• Increase intake of Vitamin A and Vitamin C
• Practice weight control
• Reduce fat intake
• Practice moderation in consumption of:
• Salt cured, smoked and nitrate-cured foods
• STOP SMOKING cigarettes!
• REDUCE ALCOHOL intake!
• Avoid exposure to the sun
Diagnostic Tests
(Confirmatory/
Determination of Location)
• X-ray
• CT scan
• UTZ
• MRI
• Nuclear imaging
• Angiography
Direct Visualization
• Sigmoidoscopy
• Cystoscopy
• Endoscopy
• Bronchoscopy
• Exploratory surgery: lymph node biopsy to
determine metastasis
Other nonspecific tests
• CBC, differential
• Electrolytes
• Blood chemistry
• Liver enzymes
Tumor Markers
• PSA (Prostate-specific antigen)
• For Prostate cancer
• CEA (Carcinoembryonic antigen)
• For Colon cancer
• Alkaline Phosphatase
• For Bone metastasis
• BRCA1 & BRCA2
• For Breast and Ovarian Cancer
Tumor Staging
(TNM System)
Treatment
Treatment Options
• Surgery
• Chemotherapy
• Radiation Therapy
•C– CURE
•C – CONTROL
•P – PALLIATION