Transcript Cancer Unit 47

Cancer Unit 47
Adonis K. Lomibao, R.N.
Objectives
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Spell & define terms
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List methods of reducing the risk of cancer
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Explain the importance of good nutrition in
cancer prevention and treatment
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List 7 S&S of cancer
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Describe 2 types of cancer treatment
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Describe nursing assistant responsibilities
when caring for patients with cancer
Introduction
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Cancer: a disease in which the normal
mechanisms of cell growth are disturbed.
Benign: stays in one place and does not
spread
Metastasis: spread to other parts of the body
through the blood & lymphatic system
Malignant:cancers that are spread to other
parts of the body
Carcinogen: substance that causes cancer
Risk Factors
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Age-most occur over 55
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Lifestyle & habits
-smoking
-alcohol
-diet
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Family history, genetics
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Environmental pollution
Risk Factors Cont.
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Harmful
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Substances in environment:
-asbestos
-benzene
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Chemicals
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Radiation
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Prolonged sun exposure
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Infections & some viruses
Nutrition & Cancer
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Direct relationship between certain foods and
certain cancers
Obesity: gallbladder, uterus, colon, & breast
CA
Prevention:
-30% or less calories from fat
-<300mg cholesterol/Daily
-55% of calories from complex carbs
-no more than 1 tsp. salt
Cancer Prevention & Detection
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Preventative measures:
-not smoking
-limit alcohol
-food pyramid
-regular exercise
-healthy weight
-avoid sun exposure between 10a-3p
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Genetic testing if at risk
S&S of Cancer
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CAUTION
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C-change in bowel or bladder habits
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A-a sore that doesn't heal
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U-unusual bleeding or discharge
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T-thickening or lump
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I-indigestion or difficulty swallowing
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O-obvious changes in a wart, mole, skin cond.
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N-nagging cough or hoarseness
Screening
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Regular screening for early detection
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Screening based on risk factors
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Monthly personal screening:
-breast self-examination
-testicular self-examination
Treatment
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Treatment is determined by:
-type of cancer
-location
-benign/malignant
-the stage (how advanced)
-general pt. condition
Surgery
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Biopsy: minor surgery used to diagnose a
cancer
If cancerous, surgical procedure done to try to
completely remove cancerous tissue
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May be part or all of an organ, & lymph tissue
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Reconstructive surgery
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Preventative surgery: done with strong genetic
link to CA
Chemotherapy
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Uses medications or drugs to destroy the CA
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Healthy cells may also be destroyed
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Goals:
-eliminate,
-control & slow growth-prolong life
-reduce size-eliminate pain n improve quality of life
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Drugs can be oral, I.V., etc.
Drugs very potent & irritating-require special
handling and disposal
Side Effects of Chemotherapy
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Targets rapidly regenerating cells
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Also affects: blood cells, hair/nail cells,GI Cells
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Side Effects:
-Alopecia-within 2 weeks after therapy
-N&V
-Anorexia, loss of appetite—taste,nausea
-Anemia,Fatigue
-Low WBC
-low platelets
-Destruction of mouth mucous membranes
Disposal of Body Fluids & Wastes
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May excrete drugs in waste & body fluids
Special PPE instructions & policies for
discarding
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Discard in leak-proof container
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Biohazard!
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Gloves!
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Standard Precautions
Special Care of the Chemo Pt.
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Observe for side effects & report to nurse
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Nursing comfort measures, mouthcare & bath
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Prevent injuries & infection
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Encourage deep breathing,
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Vitals
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Report S&S of infection (p.842)
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Prevent bleeding
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Promote good nutrition & hydration(p.842)
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Report IV infilitration, change in mental status, change in
VS
Emotional support with body image!
Radiation Therapy
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High-energy, ionizing beams at the cancer site
Destroys cancerous tissue without damaging
healthy tissue
Side effects:
-fatigue
-N & V
-loss of appetite
-p.843
Special Care of RT Pt.
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Radiation may be irritating to the skin
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Do not wash markings on skin off
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Skin care!!:
-wash with lukewarm water & mild or no soap
-avoid rubbing on skin
-avoid shaving near treatment
-avoid tape near area
-p.843
Brachytherapy
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Tiny radioactive seeds or pellets implanted
inside the body
Fewer side effects
Used for localized cancers such as breast,
prostate, lung, cervical CA
Seeds implanted-dosage depends on area &
type of CA
May be used in combination with radiation
Brachytherapy Pt. Care
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Special precautions to reduce radiation
exposure
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Private room
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Visitors restricted on time & distance
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Pregnant women & below 18 not permitted
Dosimeter-measures radiation dose
Immunotherapy
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Treatment alters immune response to
eliminate the cancer
Biological agents change normal immune
response
Care involves:
-monitor VS Q4 or more
-monitor cap refill
-Bedrest if systolic below 100 or as instructed
-weigh pt. & report weight gain
Immunotherapy Cont.
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Notify nurse:
-fever/chills
-rapid pulse/ respirations
-cyanosis
-SOB
-restless/apprehensive
-diarrhea, N&V
-itching
Pain
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Most common symptom
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May be caused by cancer or treatment
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Extended pain reduces quality of life
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WHO Analgesic ladder-model for pain
management
Pain evaluated regularly
Narcs may be necessary-low incidence of
addiction
Notify nurse
Mental & Emotional Needs
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CA Pts.Fear dying, anxious, depressed, grieving
process.
PCT Care:
-time to talk
-allow to talk about feelings/fears
-ADL's
-anticipate needs
-respect beliefs & wishes
-respect privacy
-make pt. Feel respected & valued as person
Palliative Care
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Care designed to treat symptoms of
discomfort, but not the disease
Advanced directive & DNR order
Comfort care till death-Hospice may be
involved
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Maintain quality of life as long as possible
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PCT care-hygiene & comfort
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Emotional support
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Report pain,SOB, anxiety