Cancer

Question 1

What is Cancer

Answer 1

Group of more than 200 diseases
Characterized by uncontrolled and unregulated growth of cells
Occurs in people of all ethnic groups and all ages

Question 2

Tumors can be classified as?

Answer 2

benign or malignant neoplasms

Question 3

Benign neoplasm

Answer 3

Well differentiated
Usually encapsulated
Expansive mode of growth

Question 4

Progression of cancer

Answer 4

Characterized by
Increased growth rate of tumor
Invasiveness
Metastasis

Question 5

Most frequent sites of metastasis are

Answer 5

lungs

brain

bone

liver

adrenal glands.

Question 6

The pathogenesis of cancer metastasis.

Answer 6

To produce metastases, tumor cells must detach from
the primary tumor and enter the circulation, survive in the circulation to arrest in the capillary bed, adhere
to capillary basement membrane, gain entrance into the organ parenchyma, respond to growth factors,
proliferate and induce angiogenesis, and evade host defenses.

Question 7

Metastasis process begins with?

Answer 7

rapid growth of primary tumor.
Develops its own blood supply
Critical for survival and growth of tumor
Tumor angiogenesis is formation of blood vessels within tumor.
Certain segments of primary tumor can detach and invade surrounding tissues.

Detached cells can invade lymph nodes and vascular vessels to travel to distant sites.
Most mobile tumor cells do not survive.
Surviving tumor cells must create an environment conducive to growth and development.

Question 8

Tumors can be classified by

Answer 8

Anatomic site
Histology
Grading severity
Extent of disease
Staging

Question 9

Four grades of abnormal cells

Answer 9

Grade 1

Grade 2

Grade 3

Grade 4

Question 10

Grade I

Answer 10

Cells differ slightly from normal cells and are well differentiated.

Question 11

Grade II

Answer 11

Cells are more abnormal and moderately differentiated

Question 12

Grade III

Answer 12

Cells are very abnormal and poorly differentiated.

Question 13

Grade IV

Answer 13

Cells are immature and primitive and undifferentiated.
Cell of origin is difficult to determine.

Question 14

Clinical staging classifications

Answer 14

0: Cancer in situ
1: Tumor limited to tissue of origin; localized tumor growth
2: Limited local spread
3: Extensive local and regional spread
4: Metastasis

Question 15

Lifestyle habits to reduce risks:

Answer 15

Avoid or reduce exposure to known or suspected carcinogens.
Cigarette smoke, excessive sun exposure
Eat a balanced diet.
Exercise regularly.
Obtain adequate rest.

Have a regular health examination.
Change perceptions of stressors.
Know seven warning signs of cancer.- C-Change in habits(bowel or others)-A- a sore not healing, U-Unusual bleeding/discharge,T-Thickening of lump, I-Indigestion, O- Obvious change in wart mole, N-Nagging cough
Practice recommended cancer screenings.
Practice self-examination.
Seek medical care if cancer is suspected.

Question 16

Diagnoses of Cancer

Answer 16

Patient may experience fear and anxiety.
Nurse should
Give clear explanations, repeat if necessary
Give written information for reinforcement
Actively listen to patient’s concerns

Question 17

Diagnostic plan includes

Answer 17

Health history
Identification of risk factors
Physical examination
Specific diagnostic studies
PET/CT/MRI
Biopsy-Benign or malignant/Staging

Question 18

Surgical Therapy

Answer 18

Prevention
Cure or control
Supportive- Feeding tubes, surgical fixation of bone.
Palliative

Question 19

Treatment

Answer 19

Pain control- around the clock analgesics- Don’t wait until pain starts. Should also have medcation for break through pain
Chemo
Radiation

Question 21

Radiation Therapy for Cancer

Answer 21

Purpose – Destroy cancer cells with minimal damaging effects of surrounding normal cells; maintain safe environment
Local treatment
Exposure – Amount of radiation delivered
Radiation dose – Amount of radiation absorbed

Question 22

Side Effects of Radiation Therapy

Answer 22

Acute and long-term site-specific changes
Vary according to site
Local skin changes and hair loss
Altered taste sensations
Fatigue- may last for months or years
Bone marrow suppression

Question 23

Patient-Centered Collaborative Care

Answer 23

Provide accurate information to help patients cope
Skin care needs during radiation therapy-Loose clothing, avoid harsh fabrics, Use mild soaps and lotions without perfume
Do not remove temporary ink markings
Avoid skin irritation
Avoid exposure to direct sunlight
Follow radiation-oncology department’s policy for skin care product use-

Nutritional support
Care for xerostomia (dry mouth)
Teach about risk for fractures (for bone exposed to radiation)
Exercise and sleep interventions for fatigue

Question 24

Chemotherapy

Answer 24

Treatment of cancer with chemical agents
Used to cure and increase survival time
Adjuvant therapy = Chemotherapy + surgery or radiation
Cytotoxic effects exerted on healthy cells and cancer cells

Question 25

Chemotherapy Drugs

Answer 25

Alkylating agents
Antimetabolites
Antimitotic agents
Antitumor antibodies
Topoisomerase inhibitors
Miscellaneous chemotherapeutic agents

Question 26

Treatment Issues

Answer 26

Dosage
Administration
Extravasation- Look up
Vesicants- Chemo drugs that cause blistering-

Question 27

Extravasation

Answer 27

• Most important nursing intervention is prevention*
• If IV site is swelling then stop, check F/C, better to have central sites

Question 28

Health Care Provider Safety

Answer 28

Specific protocol for handling chemotherapy drugs, or excreta from patients receiving IV chemotherapy-
Same precautions with oral chemotherapy & IV-
PPE
Eye protection
Masks
Double gloves (or “chemo” gloves)
Gown
Double flush when they go to the bathroom

Question 29

Patient-Centered Collaborative Care: Protection from Side Effects

Answer 29

Infection risk

Anemia, thrombocytopenia risk

Question 30

Infection risk

Answer 30

Bone marrow suppression
Neutropenia
Decreased immune function –older population at higher risk

Question 31

Anemia, thrombocytopenia risk

Answer 31

Bone marrow suppression
Impaired clotting

Question 32

Patient-Centered Collaborative Care: Protection from Side Effects

Answer 32

Chemotherapy

Mucositis

Alopecia

Cognitive changes

Question 33

Chemotherapy side effects prevention

Answer 33

Chemotherapy-induced nausea and vomiting (CINV)-Give anti-emetics 1 hour before chemotherapy

Chemotherapy-induced peripheral neuropathy (CIPN)

Question 34

Mucositis side effects prevention

Answer 34

saline solution rinses not antiseptic they are more irritating, soft toothbrush, no hydrogen peroxide anesthetic gel before meals-to decreased pain

Question 35

Alopecia side effect prevention

Answer 35

wigs, hat, scarves to help keep up self esteem

Question 36

Biologic and Targeted Therapy

Answer 36

Biologic therapy – derived from living organisms

1. Have direct antitumor effects
2. Restore, modulate host immune system mechanism
3. Interfere with cancer cell’s ability to metastasize or differentiate.

Targeted Therapy- work at sites that are on cell surface, intracellular level or extracellular domain
Less damage to normal cells as compared to chemotherapy
Interfere with cancer cells and are less damaging to regular cells then chemotherapy

Question 37

Hematopoietic Stem Cell Transplantation

Answer 37

Bone marrow transplantation
Peripheral stem cell transplantation