Section 5 Exemplar MDS, Hodgkin`s, Nonhodgkin`s Lymphoma, Skin

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Transcript Section 5 Exemplar MDS, Hodgkin`s, Nonhodgkin`s Lymphoma, Skin

NRS 220
Alterations in Cellular Metabolism
MDS is a group of disorders that is caused by the
formation of abnormal cells in the bone marrow which can
cause anemia, neutropenia, and thrombocytopenia. It is
most common over the age of 60.
 Treatment options for MDS include blood and platelet
transfusions, and management of symptoms.
Erythropoietin can be prescribed. Chelation therapy may
also be indicated due to the need for frequent blood
transfusions which can result in iron overload. Chelation
therapy is the chemical binding of iron and removal from
the body.
 There are also some medications that can be prescribed
for iron overload sucn as deferasirox and deferoxamine
mesylate
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Lymphomas are cancers of the lymphoid
tissues which is part of the immune system.
Lymphomas are an abnormal overgrowth of
one type of leukocyte- the lymphocyte.
This type of lymphoma can affect any age group however,
it appears to peak in two different age groups:
1) teens and young adults
2) adults in their 50's and 60's
 Testing van be done and if a marker called the ReedSternberg cell is present then a diagnosis of Hodgkin's
Lymphoma can be made.
 When performing an assessment on a patient they may
present with large, painless lymph nodes, usually in the
neck, which becomes painful when alcohol ingested.
Other symptoms include fever, drenching night sweats,
and unexplained weight loss
 The disease can be confirmed by a biopsy of node or mass.
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Hodgkins lymphoma is one of the most
treatable types of cancer.
Treatments include external radiation,
chemotherapy and combination radiation
and chemotherapy
http://www.youtube.com/watch?v=ZvwuAaq
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Non Hodgkin's Lyphomas are all lymphoid
cancers that do not have the Reed-Sternberg
cell. There are more than 12 types of nonHodgkin's lymphoma that represents 3% of
all cancer related deaths ( ACS, 2008). The
incidence has nearly doubled over the past 3
decades. Treatments include chemotherapy
and stem cell transplant.
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Multiple myeloma is a white blood cell cancer
that involves a more mature lymphocyte called a
plasma cell.
The disease is rare in people younger than 40.
Patients may be asymptomatic or experience
symptoms such as fatigue, anemia or bone pain
Interventions include chemotherapy, autologous
stem cell transplant, analgesics and alternative
approaches for pain management
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There are different types of skin cancer that can be
present. The incidence of skin cancer is highest among
light-skinned races and people older than 60 years (
ACS,2008). recommends for me to come every 6 months
to have a full body check.
Actinic keratoses- premalignant lesions of the cells of the
epidermis
Squamous cell carcinomas- cancers of the epidermis. They
can invade locally and are potentially metastatic.
Basal cell carcinomas- arise from the basal cell layer of the
epidermis
Melanomas— this cancer is highly metastatic; survival
depends on early diagnosis and treatment
ABCD Rule
When people are performing skin checks on
themselves the ABCD rule should be followed.
This stands for:
 A-asymmetry
 B-border
 C- color
 D-diameter
 http://www.youtube.com/watch?v=I6JsQ1rwP6
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There are different types of surgery that can be
performed to help treat skin cancer. It is the most
common mean of managing any type of skin cancer.
These are nice to know but not need to know!
Cryosurgery is when liquid nitrogen is placed on the
skin and causes cell death. Curettage and
electrodesiccation is used for small lesions not
melanoma. Excision is used for biopsy of small lesions
Mohs' surgery- is a specialized form of excision, used
to treat basal and squamous cell and Wide excision- is
used for deeper melanoma or other skin cancers that
are large or invasive.
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Drug therapy may involve topical or systemic
chemotherapy. Psychosocial support once again
will be very important since the treated areas
can become inflamed as the lesions crust, ooze
and erode. Biotherapy is another accepted
treatment. There are also other types of
experimental drugs available.
Radiation therapy for skin cancer is usually
limited to older patients with large, deeply
invasive basal cell tumors and to those who are a
poor risk for surgery