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PARTICULAR CANCER

BREAST CANCER

 is a malignant ( cancerous) tumor that starts from


cells of the breast. The disease occurs mostly in
women, but in men can get breast cancer as well
 most breast cancers begin in the ducts ( ductal
carcinoma), some begin in the lobules ( lobular
carcinoma), and rest in other tissues
 if breast cancer cells reach the underarm lymph
nodes and continue to grow, they cause the nodes to
swell. Once cancer cells have reached these nodes
they are more likely to spread to other organs of the
body as well
BREAST CANCER
ETIOLOGY

- Unknown, but areas under


investigation includes:
 Smoking
 Age
 Family history
 Early menarche
 Late menopause
 Nulliparous or first child after age 34
 High fat
 Use of oral contraceptive
CLINICAL
MANIFESTATION

 Non tender lump, usually in


upper quadrant pain (late)
 Axillary Lymphadenopathy (late)
 Fixed nodular breast mass (late)
PROTECTIVE FACTORS

 Exercise
 Breast feeding
 Pregnancy before 30 years old
ASSESSMENT FINDINGS

 Mass – the most common


location is the upper outer
quadrant (UOQ)
 Mass is NON-tender. Fixed, hard
with irregular borders
 Skin dimpling
 Nipple retraction
 Peau d’ orange
LABORATORY FINDINGS

 Biopsy procedure
 Mammography
BREAST CANCER
STAGING

- TNM staging
 I - < 2cm
 II – 2 to 5 cm, ( + ) LN
 III - > 5cm, ( + )LN
 IV – metastasis
MEDICAL MANAGEMENT

 Chemotherapy
 Tamoxifen therapy – blocks
estrogen receptor sites
 Radiation therapy
SURGICAL MANAGEMENT

 Radical Mastectomy – removal of


tumor, pect. Major, pect. Minor + LN
 Modified Radical Mastectomy –pect.
Minor remains, removal of tumor,
pect. major + LN ( most commonly
done
 Lumpectomy
 Quadrantectomy
Radical Mastectomy
NURSING INTERVENTION

PRE-OP
 Explain breast cancer and treatment
options
 Reduce fear and anxiety and improve
coping abilities
 Promote decision making abilities
 Provide routine pre-op care:
 Consent, NPO, meds, teaching about
breathing exercise
NURSING
INTERVENTION
POST-OP
 Position patient
 Supine
 Affected extremity elevated to reduce edema
 Relieve pain and discomfort
 Moderate elevation of extremity
 IM/IV injection meds
 Warm shower on 2nd post-op
 Maintain skin integrity
 Immediate post-op, snug dressing with drainage
 Maintain patency of drain
 Monitor for hematoma with in 12 hour and apply bandage and
ice refer to surgeon
 Drainage is removed when the discharge is ledd than 30 ml in
24 hour, inform the doctor to remove JP
 Lotions, creams are applied only when the incision is healed in
4-6 weeks
NURSING
INTERVENTION
 Promote activity
 Support operative site when moving
 Hand, shoulder exercise done on 2nd day
 Post-op mastectomy exercise 20 minutes TID
 No BP or Iv procedure on the operative site
 Heavy lifting is avoided
 Elevate the arm at the level of the heart
 On a pillow for 45 minutes TID to relieve transient
edema
 Gardening is prohibited
 Arm > elbow
 Elbow > shoulder
LUNG CANCER

 rapid growth of abnormal cells in


the lungs
 caused by smoking, second
smoke, exposure to harmful
substance such as arsenic,
asbestos, radioactive dust, or
radon
LUNG CANCER
LUNG CANCER
TYPES

a. Small cell lung cancer


 less common but they grow more quickly
and are more likely to metastasize

b. Non-small cell lung cancer


1. adenocarcinoma
 most common type of lung cancer
2. squamous cell carcinoma
 -second most common type of lung cancer
MEDICAL MANAGEMENT

 Radiation therapy
 Chemotherapy
 Surgery
Surgical Procedures
Surgical Procedures
ASSESSMENT FINDINGS

1.Persistent cough ( may be productive of blood tinged )


2.Chest pain
3.Dyspnea
4.Unilateral wheezing
5.Friction rub
6.Possible paralysis of the diaphragm
7.Fatigue
8.Anorexia
9.Nausea and vomiting
10.Pallor
11. Diagnostic tests :
- Chest X-ray may show presence of tumor or evidence of
metastasis to surrounding structures
- Sputum or cytology reveals malignant cell
- Bronchoscopy: biopsy reveals malignancy
- Thoracentesis: pleural fluid contains malignant cells
NURSING
INTERVENTIONS
 Provide support and guidance to the client as
needed
 Provide relief/control pain
 Administer medications as ordered and monitor
effects/side effects
 Control nausea: administer medications as
ordered, provide oral hygiene, provide small and
more frequent feedings
 Provide nursing care for a client with thoracotomy
 Provide client teaching and discharge planning
concerning
 Disease process, diagnostic and therapeutic
interventions
 Side effects of radiation and chemotherapy
 Realistic information about prognosis
OVARIAN CANCER

 The ovary is common site of primary as well


as metastatic lesions from other cancers.
Most cases affect women ages 50 to 59.
Hereditary plays part and many physician
advocate pelvic examination every 6
months for women who have one or two
relatives with ovarian cancer. Transvaginal
ultrasound and Ca-15 antigen testing are
helpful in those at high risk for this
condition.
OVARIAN CANCER
Clinical Manifestation

 Increased abdominal girth


 Pelvic pressure
 Bloating
 Indigestion, flatulence, increased
waist size
 Leg pain and pelvic pain
 Slight anorexia
Medical Management

 Total hysterectomy
 Bilateral salpingo-oophorectomy
 Chemotherapy
 Radiation therapy
 Pharmacologic
 cyclophosphamide
 doxubricin
 Cisplastin
 Caboplastin
Nursing Intervention

 Administer intravenous therapy to


alleviate fluid and electrolyte imbalances
 Provide adequate nutrition
 Provide post-operative care after intestinal
bypass to alleviate obstruction
 Provide pain relief and managing drainage
tubes
 Provide small frequent meals
 Decrease fluid intake
 Administer diuretic agents
 Provide quite environment
Complications

 spread of the cancer to other organs


 progressive function loss various
organs
 ascites ( fluid in the abdomen)
 blockage of the intestines
Diagnostic Exams

 Pelvic Exam
 Ultrasound
 CA-125 assay
 Lower GI series or Barium enema
 CT Scan
 Biopsy
CT Scan
UTERINE CANCER

 Most uterine cancers are endemetriod. It is


fourth most common cancer in the world.
Cumulative exposure to estrogen is
considered the major risk factors. It is a
shaped like an upside down pear and sits
inside the pelvis. it is also known as cancer
of the womb, endometrial cancer, cancer of
the lining of the womb
UTERINE CANCER
Risk Factors

 Age : at least 55 years; median


age 61 years
 Postmenopausal bleeding
 Obesity
 Unopposed estrogen therapy
Assessment

 abnormal uterine bleeding


 pre or post menopause
 hyperplasia
 prolonged menstruation
Diagnostic

 Physical examination
 Dilatation and curettage
 X-rays
 Blood tests
Dilatation and Curettage
Medical Managements

 Total hysterectomy
 Bilateral salpingo-oophorectomy
 Radiation therapy
 Chemotherapy
Bilateral Salpingo-
Oophorectomy
Nursing Interventions
 Institute routine pre and post-op care
 Assess for hemorrhage, infection or other post
surgical complications
 Support woman and family through procedure
encourage expression of feelings and reactions to
procedure
 Allow woman to verbalize concerns about sexuality
post surgery
 Maintain the patient on low residue diet to prevent
bowel movements which might dislodge apparatus
 Observe for symptoms of radiation sickness –
nausea, vomiting and elevated temperature
 Observe for any symptoms that might suggest
radiation injury to the intestine diarrhea, report
these if they occur
 Tell the patient the importance of monthly follow
up visits to her physician for the first 6 months to
assess effects of radiation on tumor
OROPHARYNGEAL CANCER

 Is a disease in which cancer cells


are found within the anatomical
borders of the oropharynx. The
majority of oropharyngeal
cancers are squamous
carcinomas.
OROPHARYNGEAL CANCER
Etiology

 Use of alcohol
 Use of Tabacco
 Being infected with the human
papilloma virus (HPV)
Clinical Manifestation

 A sore throat that persist


 Pain of difficulty with swallowing
 Unexplained weight loss
 Voice changes
 Ear pain
 A lump in the back of the throat of
mouth
 A lump in the neck
Treatment

 Radiation therapy
 A clinical trial of chemotherapy that is
followed by surgery or radiation
therapy
 A clinical trial of chemotherapy
combined with radiation therapy
 A clinical trial of new ways to provide
radiation therapy
Radiation Therapy
CANCER OF THE LARYNX

 Is a malignant tumor in the larynx (voice


box ), potentially curable if detected early
 Less than 1% of all cancers, common in men
than in women ages 50-70 years of age.
 Occurs in : glottic area ( vocal cords ),
supraglottic area, subglottis area
CANCER OF THE
LARYNX
Risk Factors for laryngeal cancer

 Carcinogens :
- tobacco
- asbestos
- paint fumes
- wood dust
- chemicals
Risk Factors for laryngeal
cancer

 Others
- straining the voice
- chronic laryngitis
- nutritional deficiencies
- history of alcohol abuse
- age
- gender
- race
- weakened immune system
Clinical Manifestations

 Hoarseness of more than 2 weeks


 Cough or sore throat
 A lump felt on the neck
 Dysphagia, dyspnea, unilateral nasal
obstruction
 Pain radiating to the ear
Assessment and Diagnostic
Findings

 History, Physical Assessment


 Indirect laryngoscopy
 Biopsy
 CT
 MRI
 PET
Indirect Laryngoscopy
Medical Management

 Surgery
 Radiation therapy
 Chemotherapy
 Speech therapy
Surgical Management

 Laryngectomy- surgical removal


of part of all of the larynx and
surrounding structures
 Partial laryngectomy
 Hemilaryngectomy
 Total laryngectomy
Surgical Procedure
Nursing Diagnosis

 Ineffective airway clearance related to


excess mucus production secondary to
surgical alterations in the airway
 Imbalance nutrition less than body
requirement related to inability to ingest
food
 Self care deficit related to pain, weakness,
fatigue, musculoskeletal impairement
Complications

 Respiratory distress
 Hemorrhage
 Infection
 Wound breakdown
Nursing Interventions

 Teaching the patient preoperatively


 Reducing anxiety and depression
 Maintaining a patent airway
 Promoting alternative communication
methods
 Adequate nutrition
 Promoting positive body image and self-
esteem
 Monitoring and managing potential
complications
COLORECTAL CANCER

 The colon and rectum are part of the


digestive tract. Together, they comprise the
large intestine, or large vowel, which is
located in the abdomen between the small
intestine and the anus. Cancer that
originate in the colon or rectum may be
called colon cancer, rectal cancer or
colorectal cancer. Colon cancer is the term
most commonly used to refer to this type of
cancer.
COLORECTAL CANCER
Etiology

 Family history
 Chronic inflammatory bowel
disease
 Polyps
 Low fiber diet
Clinical Manifestation

 Change in bowel habits


 Passage of blood in stools
 Unexplained anemia
 Anorexia,
 Weight loss
 Fatigue
 Right side abdominal pain
 Left side abdominal pain, cramping,
narrowing stools, constipation and
distention
Diagnosis

 Digital rectal examination


 Fecal occult blood test
 Fiber optic sigmoidoscopy
 Biopsy
 Colonoscopy
Colonoscopy
Treatment

 Chemotherapy
 Radiation therapy
 Segmental resection with
anastomosis
 Abdomino perineal traction with
sigmoid colostomy
 Ileostomy
CANCER OF THE STOMACH

 Most often develops the distal third and


may spread thru the walls of the stomach
into adjacent tissues, lymphatics and
abdominal organs
 Most death occur in 40 years of age but
occasionally occur in younger people
 Men have higher incidence of gastric
cancer than women
CANCER OF THE
STOMACH
Symptoms

Early
 Indigestion or burning sensation
( heartburn)
 Loss of appetite specially meat
Late
 Abdominal pain
 Nausea and vomiting
 Diarrhea or constipation
 Bloating of the stomach after meals
 Weight loss
 Weakness and fatigue
 Bleeding which can lead to anemia
Clinical Manifestation

 Pain relieved by antacids


 Anorexia
 Dyspepsia
 Weight loss
 Constipation
Medical Management

 Chemotherapy
 Radiation therapy
 Pharmacologic drugs
 cisplastin
 Irrinotecan
 Doxorubicin
Nursing Intervention

 Encourage the family to support the


patient
 Offer reassurance and support coping
measures
 Explain the procedures and treatment
 Encourage the patient to eat small
frequent portion of non irritating foods
 Monitor IV therapy
 Record intake and output
 Monitor daily weights
 Assess for signs of dehydration
LIVER CANCER

 Hepatic tumors may be malignant or


benign. Benign liver tumors were the
uncommon until the wide spread use
of oral contraceptives. Primary liver
tumors are associated with chronic
liver diseases Hepatitis B and C
infection and Cirrhosis.
LIVER CANCER
LIVER CANCER
Clinical Manifestation

 Weakness
 Anorexia
 Nausea and vomiting
 Right upper quadrant discomfort
 Blood tinged ascites
 Friction rub over liver
Diagnostic Findings

 Increase serum levels of bilirubin


 Alkaline phosphates
 Lactic dehydrogenase
Medical Management

 Chemotherapy
 Percutaneous biliary drainage
 Lobectomy
 Radiation therapy
Nursing Intervention

 Provide emotional support to the


client
 Provide care of the client receiving
radiation therapy
 Provide care with abdominal surgery
 Provide nutritional status
WILM’S TUMOR
 is a malignant tumor that rises from
the metanephric mesoderm cell of the
upper role of the kidney.
 It occurs in association with
congenital anomalies such aniridia
( lack of the color in the iris )
 Also known as “ Nephroblastoma ”
Wilm’s tumor
Assessment

 nephroblastoma is usually
discovered early in life (6 mos to
5 yr; peak at 3 to 4yr)
 Although it apparently arises
from an embryonic structure
present in child before birth.
Nephroblastoma may manifest
w/ hematoria and low grade
fever occurs between of rennin
production
Diagnosis

 CT- scan
 Glomerular filtration rate
 Blood urea nitrogen
Therapeutic
Management

 Nephrectomy ( excision of
affected kidney)
 Chemotherapy w/ dactinomycin
Nephrectomy
STAGING
NEPHROBLASTOMA

 I - tumor confined to the kidney and


completely removes surgically.
 II - tumor extending beyond the kidney
but completely removes surgically.
 III - Regional spread of the diseases
beyond the kidney w/ residual abdominal
dse.
Post operative.
 IV - metastases to lung, liver, bone
distance lymph nodes or other distance
sites
 V - Bilateral diseases.
Complication

 small bowel Obstruction


 Fibrotic scarring
 Hepatic damage from radiation to
the lesion can occurs
 Nephritis
 In girls, radiation related damage to
the ovaries may result sterility
 Interstitial pneumonia
 Scoliosis
PROSTATE CANCER

 is the most common cancer in the men other than


non melanoma skin cancer
 the second most common cause of cancer death in
American men older than 55 y/o
 It is estimated that 189,000 new cases of prostate
cancer and 30,200 death occurs annually
 Increase risk prostate cancer only 47 % of the men in
sample who were 40 y/o or Older had prostate
cancer screening as part of annual physical
examination.
PROSTATE CANCER
PROSTATE CANCER
PROSTATE CANCER
Risk Factors

 Increasing age rapidly with the age


of 50 years.
 Prostate cancer is common in the
United states and northwestern
Europe but is rare in Asia, Africa,
Central America and South America.
 Familial predisposition
 Diet high in red meat and fat
increase.
Sign and Symptoms

 Difficulty and frequency of urination


 Urinary retention
 Decrease size and force of urinary
stream
 Blood in the urine or semen
 Painful ejaculation
 Hematoria
Symptoms related to
metastases

 backache
 hip pain
 perineal and rectal discomfort
 anemia
 weight loss
 weakness
 nausea
 oligoria
Diagnosis

 every man older than 40 y/o should have


DRE as part of the regular health checkup
 Rectal palpitation of the gland
 Transurethral section
 Open Prostatectomy
 Transrectal needle biopsy
 Transrectal Ultrasound ( TRUS)
 X- ray ( to identify bone metastasis
 CT- scan
Medical Management

1. Surgical management
- Radical prostatectomy (removal of
the prostate and seminal vesicle)
2. Radiation therapy
- teletherapy w/ linear accelator or
interstitial irradiation ( implantation
of radioactive seeds of iodine or
palladium)
Medical Management

3. Hormonal therapy- used to control rather than


cure prostate cancer.
A. TURP – the most common procedure used, can
be carried out through endoscopy.
B. SUPRAPUBIC PROSTATECTOMY
- Is one method of removing the gland
through an abdominal incision
C.PERINEAL PROSTATECTOMY
- Removing the gland through an incision in
the perineum
D. RETROPUBIC PROSTATECTOMY
- is more common then the supra pubic
approach. This procedure is suitable
For large gland located high in the pelvis.
NURSING INTERVENTION

 Reducing anxiety
 Relieving discomfort
 Providing instruction
 Preparing patient
 Maintaining fluid balance
 Relieving pain
 Monitoring for hemorrhage and
infection
From the looks of the expression
on the dog's face, he is really into
saying his prayers 
The End!!!

GOD BLESS !!!

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