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NOTES ON MEDICAL-SURGICAL NURSING
O N C O L O G Y
Divina S. Fernandez RN, MAN

Cancer
– A neoplastic disorder that can involve all body organs. Cells lose their normal growth-controlling mechanism, and the cell growth is uncontrolled. – Cancer produces serious health problems such as impaired immune and hematopoietic (blood producing) function, altered gastro-intestinal tract structure and function, motor and sensory deficits, and decrease respiratory function.

Metastasis
– Cancer cell moves out from their original location to other sites

Routes of Metastasis
Local Seeding – distribution of shed cancer cells occurs in the local area of the primary tumor. Blood-Bourne metastasis – tumor cells enter the blood, which is the most common cause of cancer spread. Lymphatic spread – primary sites rich in lymphatics are more suscepticble to early metastatic spread.

Cancer Classification
Solid Tumors – associated with the organs from which they develop, such as breast cancer or lung cancer Hematological Cancer – originate from blood cell-forming tissues, such as the leukemias and lymphomas

Factors that Influence Cancer Development
Environmental Factors
a) Chemical Carcinogen – factors include industrial, chemical, drugs and tobacco b) Physical Carcinogen – factors include ionizing radiation (diagnostic and therapeutic x-rays) and ultraviolet radiation (sun, tanning beds, and germicidal lights), chronic irritation, and tissue trauma. c) Viral Carcinogen – viruses capable of causing cancer are known as oncoviruses (Epstein-Barr virus, hepatitis B virus, human papillomavirus)

Dietary Factors
- Factors include high-fat and low-fat diets, high animal fat intake, preservatives, contaminants and additives and nitrates.

Genetic Predisposition
- Factors include an inherited predisposition to specific cancers, inherited condition associated with cancer, familial clustering, and chromosomal aberrations.

Age
- advancing age is significant risk factor for the development of cancer

Immune Function
- Incidences of cancer are higher in immunosuppressed individuals, organ transplant recipient who are taking immunosuppressive medication, and individuals with acquired immunodeficiency syndrome.

Early Detection
1. Mammography
2. Papanicolaou’s smear
3. Stools for occult
4. Sigmoidoscopy, Colonoscopy
5. Breast Self Examination
6. Testicular Examination
7. Skin inspection

Beast Self-Examination (BSE)
1. Perform 7-10 days after menses
2. Postmenopausal clients or clients who have has a hysterectomy should select a specific day of the month to perform BSE monthly on that day

Testicular Self-Examination
1. Performing testicular self-examination: Select a day of the month and perform the examination on the same day each month.

DIAGNOSTIC TEST
|Biopsy | |Bone Marrow Examination | |Chest Radiograph | |Complete Blood Count | |Computed Tomography Scan | |Cystological Studies (Papanicolaou’s smear) | |Liver Function Studies | |Magnetic Resonance Imaging | |Presence of oncofetal antigens such as | |carcinoembryonic antigen and alpha fetoprotein | |Proctoscopic Examination | |( including guaiac for occult blood) | |Radiologic Studies (mammogram) | |Radioscope scans (liver, brain, bone, lung) |

Characteristics of Neoplasia
• Uncontrolled growth of Abnormal cells
1. Benign...
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