Cancer

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Author:
tiffanydawnn
ID:
129564
Filename:
Cancer
Updated:
2012-01-23 00:04:13
Tags:
Cancer
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Description:
Cancer
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  1. cancer
    • leading cause of cancer deaths - lung cancer
    • most common in women - breast cancer
    • most common in men - prostate cancer
    • most at risk for prostate cancer - AA men
    • most at risk for multiple myeloma - AA men
    • most at risk for bladder cancer - white men
    • most at risk for melanoma - white people (fair skin)
    • % over 55 - 76%
  2. cancer risk - increased age
    • longer exposure
    • change in immune response
    • hormone changes
    • severe cumulative losses
    • increased cell mitosis
  3. cancer cells
    • dysregulation of cell division
    • divides without limits
  4. cancer risk factors
    • smoking
    • alcohol
    • sun exposure
    • drug use
    • stress
    • occupation
    • infection - mono, HPV
  5. cancer terms
    • highly differentiated: cell looks like parent
    • undifferentiated: no resemblance to parent
    • intravasation: cancer gains access to blood
    • extravasation: cancer leaves circulation and implants in new tissue
    • angiogenesis: cancer creates own blood supply
    • **no heat over tumors**
  6. benign vs malignant
    • benign
    • --encapsulated
    • --localized
    • --non-metastasized
    • --slow growth
    • --contact inhibition
    • --well differentiated
    • ----lipoma
    • ----hemangioma
    • ----neurofibroma
    • malignant
    • --non-encapsulated
    • --irregular shape
    • --poorly differentiated
    • --invasive spread – through blood and lymphatics
    • ----carcinoma: epithelial tissue (lung, breast, prostate, colon, rectum, pancreas)
    • ----sarcoma: supportive tissue (bone, cartilage, fat, muscle, vascular,
    • ----leukemia: blood/bone marrow
    • ----lymphoma: lymphocytes
    • ----melanoma: skin
    • angiogenesis (grows new blood vessels)
  7. cancer s/s
    • depends on site
    • pressure on other structures
    • pain usually late sign
    • weakening of structures
    • hypercatabolism -> hyperurecemic (allopurinol, fluids)
    • metastasis
  8. cancer effects
    • infection
    • hemorrhage
    • anorexia cachexia
    • pain
    • physical/psychological stress
  9. paraneoplastic syndrome
    • indirect effects of cancer
    • endocrine - cancer sets up ectopic sites
    • neurologic - cancer damages nervous system
    • breast, ovarian, renal - ectopic PTH sites - hypercalcemia
    • oat cell/lung - ectopic insulin, PTH, ADH, ACTH
  10. SVC syndrome
    • tumor pressing on SVC
    • blood backs up
    • increased venous pressure, venous stasis, engorgement of veins
    • facial, periorbital, arm edema
    • resp distress, dyspnea, cyanosis, tachypnea, LOC, neuro defecits
    • **resp support - possible trach**
    • monitor VS
    • steroids, antifibrinolytic/anticoagulant
    • seizure precautions
    • chemo/radiation later
  11. chemotherapy
    • destroys hair, GI, oral mucosa
    • bone marrow suppressed (intented for some cancers) - pancytopenia
  12. ANC
    • absolute neutrophil count
    • WBC x % neutrophils
    • ANC > 500 needed to fight infection
    • NADIR - lowest point that ANC drops
  13. immuno-incompetent
    • ANC < 500
    • unable to mount immune response - reduced s/s of infection (no sputum, reduced temp)
    • pancultre: urine, stool, sputum, lines, blood, CXR
    • assess for PNA
  14. neutropenic precautions
    • Avoid people who have colds or the flu
    • Do not visit crowded areas such as malls or movie theaters
    • Avoid anyone who has received a live vaccination (shot) within the last three weeks
    • Maintain a well-balanced diet and eat healthy foods, but avoid raw or uncooked foods, including raw vegetables and fruits
    • Speak with your doctor before having any dental work done
    • Do not have fresh flowers in your hospital room or house
    • Limit exposure to pet feces (e.g., litter box)
    • Do only as much activity as you can tolerate
    • Wash your hands frequently with soap and water
    • Take your temperature when you have chills or are not feeling well
    • Take a bath or shower daily
    • Do not get cuts, punctures or scratches on your skin
    • Rinse your mouth with warm salt water
    • Use a soft toothbrush
    • Prevent constipation
    • Wipe front to back after a bowel movement
    • Drink lots of fluids (water, juice, etc.) to prevent dehydration
    • Use sanitary napkins (pads) rather than tampons
  15. hypercalcemia
    • excessive ectopic production of PTH
    • breast, lung, esophageal, thyroid, head, neck CA, bone mets and multiple myeloma
    • rate of calcium from bones exceeds renal excretion
    • calcium is bound to albumin in serum - can displace meds
    • corrected calcium - albumin low 1 gram, add 0.8 calcium
  16. hypercalcemia
    • s/s: fatigue, anorexia, nausea, polyuria, constipation, muscle weakness, lethargy, apathy, diminished reflexes
    • without tx: changes in mental status, psychotic behavior, cardiac arrhythmias, seizures, coma, death
    • lasix
    • calcitonin/Zometa
    • dialysis
  17. tumor lysis syndrome
    • side effect of chemo
    • destroyed cancer cells empty contents into body - cannot be excreted fast enough
    • **combination of 2 or more metabolic abnormalities**
    • --hyperuricemia - allopurinol, IV fluids
    • --hyperphosphatemia - phos-lo
    • --hyperkalemia - kayexalate, lasix, IV calcium gluconate, insulin, D5W (push potassium back into cells)
    • --hypocalcemia - "dates phosphate"
    • s/s: abnormal labs, N&V, SOB, arrythmia, cloudy urine, lethargy, joint pain

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