cancer concept and prevention phases in detail

1. Presented by: Smita Pillai (2nd PB BSC)
Presented to: Mrs. Rita Lakhani

2. At the end of the session students will be able to conceptualize what are the risk
factors,signs & symptoms,screening & the different measures for its prevention

3. • Students sill explain the term cancer
• Students will rationalize the types of neoplasms/cancer
• Students will enlist the risk factors for cancer
• Students will perceive the term CAUTION
• Students will rationalize the various preventive mesasures for cancer
• Students will enculcate the different screening tests for cancer

4. Cancer is a group of diseases involving abnormal cell growth with the potential to
invade or spread to other parts of the body. They form a subset of Neoplasm.
Types of Cancer
a) Benign Cancer
b) Malignant Cancer
Neoplasm - Neoplasm or tumor is a group of cells that have undergone
unregulated growth & will often form a mass or lump, but may be distributed
diffusely.

5. CHARACTERISTICS BENIGN NEOPLASM MALIGNANT
NEOPLASM
1. Speed of growth Grows slowly Grows rapidly
Have periods of Regress spontaneously
remission
2. Mode of growth Localized, never Usually infiltrates other tissues
infiltrates surrounding
tissues
3. Capsule Always contained within Never contained within
a fibrous capsule capsule
Can be removed Surgical removal of tumor is
surgically difficult

6. CHARACTERISTICS BENIGN NEOPLASM MALIGNANT
NEOPLASM
4. Cell characteistics Well differentiated Poorly differentiated
Analplastic cells absent Cells tend to be anaplastic
5. Recurrence Unusual Common
5. Metastasis Never occur Very common
6. Effect of Neoplasm Not harmful to host Always harmful to host,
causes death
Does not produce Almost always produces
cachexia cachexia
5. Prognosis Very good Depend on cell type & speed of
diagnosis

8. • Prognosis - Average 5 years of survival
• Frequency - 90.5 millions (2015)
• Deaths - 8.5 millions (2015)
• Tobacco use is the cause of about 22% of cancer death
• Another 10% is due to obesity, poor diet, lack of physical activity & excessive
drinking of alcohol
• Other factors include certain infections, exposure to ionizing radiation &
environmental pollutants
• In developing countries 20% of cancer are due to infection such as Hepatitis B,
Hepatitis C & HPV
• Approximately 5-10% of cancer are due to inherited genetic defects from a
persons parents

9. contd…

10. • Age
• Tobacco
• Alcohol
• Radiation
• UV Rays
• Obesity
• Diet
• Carcinogens
• Choronic inflammation
• Hormones
• Immunosuppression
• Infectious Agents
• Hereditary

11. • Fatigue
• Lump or area of thickening that can be felt under the skin
• Weight changes, including unintended loss or gain
• Skin changes, such as yellowing, darkening or redness of the skin, sores that
won't heal, or changes in existing moles
• Changes in bowel or bladder habits
• Persistent cough or trouble breathing
• Difficulty swallowing
• Hoarseness
• Persistent indigestion or discomfort after eating
• Persistent, unexplained muscle or joint pain
• Persistent, unexplained fevers or night sweats
• Unexplained bleeding or bruising
contd…

12. CAUTION
• Change in bowel or bladder habits
• A sore that does not heal
• Unusual bleeding or discharge
• Thickening or lump in the breast or elsewhere
• Indigestion or difficulty in swallowing
• Obvious change in a wart or mole
• Nagging cough or hoarseness

13. DUE TO MASS OF THE TUMOR eg.
• Lung Cancer - Can block the bronchus resulting in cough/pneumonia
• Esophageal Cancer - Causes narrowing of esophagus, making it
difficult/painful to swallow
• Colorectal Cancer - Leads to narrowing/blockages in the bowel, affecting
bowel habits
• Masses in breast/testicles - May produce observable lumps
• Ulceration - Causes bleeding. In lungs - Haemoptysis, in bowels -
Anaemia/Rectal bleeding, in bladder - Hematuria, in uterus - Vaginal bleeding
contd…

14. • Localised Pain - May occur in advanced cancer
• Some cancer can cause a build up of fluid within the chest or abdomen

15. It is defined as active measures to reduce the risk of cancer. Greater than 30% of
cancer deaths could be prevented by avoiding risk factors.
PREVENTION MEASURES FOR CANCER:
• Don’t use tobacco - Avoid smoking & chewing tobacco
• Eat healthy diet - Eat plenty of vegetables / Avoid obesity / Consume alcohol
occasionally & in minimum amount / Limit processed meats / Avoid
preserved foods / Maintain a healthy weight & be physically active
• Protect yourself from Sun - Avoid midday sun / Stay in the shade / Cover
exposed areas / Don’t skimp on sunscreen / Avoid tanning beds & sun lamps
• Get Immunized - Hepatitis B / HPV
• Avoid risky behaviours - Practice Safe Sex / Don’t share needles
• Get regular medical care

16. If you have a healthy lifestyle 70% of known causes of cancer are avoidable,
which are related to lifestyle.
Thomas A Sellers, PHD
Associate Director for Cancer prevention & control at Moffitt Cancer Center in Tampa
contd…

17. Primary & Secondary prevention are effective measures in reducing mortality &
morbidity of many cancers.
PRIMARY PREVENTION
• Make appropriate lifestyle changes
• Quit smoking
• Limit alcohol intake
• Eat healthy diet
• Maintain healthy weight
• Regular exercise
• Those at high risk of certain cancer should consider genetic counselling &
testing
contd…

18. CHEMO PREVENTION
• Aspirin - Low dose aspirin reduce risk of colon cancer in patient with history
of polyps
• Tamoxifen & Raloxifen - Reduce risk of breast cancer in women who are at
high risk of 50%
• Finasleride - Reduces risk of prostate cancer
• COX-2 inhibitors - Reduces risk of GI cancer
• Vitamin D - Reduces breast cancer
• Statins - Reduces colon, breast & haematologic malignancies
• HPV vaccines for females age 11-12 - as early as 9 yrs the concept is prior to
sexual contact
contd…

19. SECONDARY PREVENTION
• Routine Screening - Screening should be based on individual’s age, sex, family
history of cancer, ethnic group/race, previous iatrogenic factors & history of
exposure to environmental carcinogens
• Annual prostate specific antigen (PSA) & digital rectal examination for men
over age 50 & even at 40 for high risk male
• Breast cancer examination every 3 years from 20-39 years & thereafter
annually
Mammography begins at 40
• Colon Cancer screening for both men & women over age 50
• Yearly fecal occult blood test, sigmoidoscopy every 5 years
contd…

20. • Double contrast barium enema every 5 years
• Colonoscopy every 10 years
• Diagnostic evaluation
• Complete medical history & physical examination
• Biopsy of tumor site

21. • Filter your tap water - Home filtered tap water is safer than bottled water. It
reduces your exposures to known or suspected carcinogens & hormone
disrupting chemicals
• Marinate meat first - Add rosemary & thyme to your favourite marinade &
soak meat for at least an hour before cooking
• Prefer coffee than tea as coffee prevents brain cancer
• Water down your risk - Drinking plenty of water & other liquids may reduce
the risk of bladder cancer by diluting the concentration of cancer causing
agents
• Load up on green greens - It decreases risk of colon cancer
• Snack of Brazil nuts - They are a stellar source of selenium, an antioxidant
that lowers the risk of bladder cancer in women. It not only protects but also
contd…

22. may enhance immune function & suppresses formation of blood vessels that
nourishes tumors.
• Burn of your risk - Moderate exercise such as brisk walking half an hour per
day can reduce risk of breast cancer by 18% which burns fat, as fats produces
its own estrogen which is a know contributor to breast cancer
• Lower the breast density - Breast density of 75% or more (as per
mammograph) have 4 - 5 times at higher risk for breast cancer; so do regular
exercise
• Skip the dry cleaners - This is for laundry workers
• Head off cell phone risks - Use your cell phone only for short calls or text
and use hands free device as it keeps the phone & radio frequency energy
away from your head
contd…

23. • Block cancer with color - Blue & red fabrics offered significantly better
protection against the sun’s UV rays than white & yellow ones did; Protect
head by hats
• Eat clean food - As pesticides contain 40 carcinogens. Proper washing &
consuming organic food lowers the risk
• Up your calcium intake
• Do a folic acid check - As consuming more than 400 mcg/day increases risk
• Commit to whole grains
• Pay attention to pain - If you are experiencing a bloated belly, pelvic pain &
an urgent need to urinate see your doctor. As these symptoms signals to
ovarian cancer particularly if they are sever & frequent
contd…

24. • Avoid unnecessary scans - CT scans are a great diagnostic tool as they
deliver much more radiations than Xrays. High doses of radiations can trigger
leukemia
• Drop 10 pounds - i.e don’t extend the weight beyond BMI

26. • Identify patients at high risk for cancer
• Participate in primary & secondary prevention
• Help individuals adopt healthy living habits
• Spread awareness regarding the risk factors, signs & symptoms, early
detections, screening measures & preventive measures for cancer in clinic,
OPD & community
• At school level provide information regarding HPV virus & it’s vaccine
• Emphasis on quit smoking & promotion of ban of Tobacco usage
• Asses the patients need for cancer prevention i.e learning needs, desire &
capabilities
contd…

27. • Identify the nursing problems of Patients & family
• Asses the social support networks available to the patient
• Plan appropriate interventions with the Patient & family
• Assist patient to identify strengths & limitations
• Assist patient to design short term & long term goals for cancer prevention

28. MALES
• Lung Cancer
• Prostate Cancer
• Colorectal Cancer
• Stomach Cancer
• Bladder Cancer
• Oral Cancer
• Skin Cancer
FEMALES
• Breast Cancer
• Colon Cancer
• Endometrial
Cancer
• Cervical Cancer
• Ovarian Cancer
• Skin Cancer
CHILDREN
• Leukamia
• Brain & Spinal cord
tumors
• Neuroblastoma
• Wilms tumor
• Lymphoma (Hodgkin)
• Retinoblastoma
• Rhabdomyosarcoma
• Bone Cancer

29. Cancer screening is looking for cancer before a person has any symptoms.
Screening test can help, find cancer at an early stage before symptoms appears.
When abnormal tissue or cancer is found early, it may be easier to treat or cure.
By the time symptoms appear the cancer may have grown and spread.
PURPOSES OF SCREENING TEST:
• Reduce the no. of people who die from the disease or eliminates death from
cancer all together
• Reduce the no. of people who develop the disease

30. Each type of cancer has it’s own screening test. Some are listed below:
BREAST CANCER
• Mammography
• Clinical breast examination
• Breast self examination
• MRI
CERVICAL CANCER
• Human papillomavirus (HPV) testing
• Pap Test
contd…

31. COLORECTAL CANCER
• Colonoscopy
• Sigmoidoscopy
• Fecal Occult Blood Test (FOBT)
• Double contrast barium anaemia
• Stool DNA test
PROSTATE CANCER
• Digital rectal examination (DRE)
• Prostate specific antigen test (PSA)
contd…

32. SKIN CANCER
• Complete skin examination by doctor
• Skin self examination
• Dermoscopy
LUNG CANCER
• Low-dose helical or
spiral computed tomography (CT) scan

33. • Complete blood count (CBC)
• Alpha-fetroprotein (AFP) blood test
• Barium enema
• Biopsy
• Bone marrow aspiration & biopsy
• Bone scan
• Bronchoscopy
• Cancer antigen 125 (CA-125)
• Carcinoembryonic antigen (CEA)
• Chemistry screen
contd…

34. • Colposcopy
• Cystoscopy
• Endoscopic Retrograde Cholangiopancreatography (ERCP)
• Estrogen & Progesterone receptor status
• Human chorionic gonadotropic (HCG)
• Intravenous pyelography
• Liver function test (LFT)
• Lumbar punture (LP)
• Mediastinoscopy
• Positron emission tomography (PET) scan
contd…

35. • Ultrasound
• Serum electrophoresis or blood protein testing
• Sputum cytology
• Thoracentesis
• Thyroid scan and radioactive iodine uptake test

36. • Over Diagnosis
• False Positives
• False Reassurance

37. • Medical Surgical Nursing
Joyce M. Black
8th Edition
Reed Elsevier India Private Limited
Chapt. 17, Pg. 266-268
Chapt. 32, Pg. 661-663
Chapt. 37, Pg. 860-863
Chapt. 40, Pg. 941-947
Brunner & Suddarth’s
11th Edition, Vol. 1
Lippincott Williams & Wilkins
Chapt. 16, Pg. 382-389
• htpps://www.prevention.com
• www.cancer.net/cancer -types
• www.mayoclinic.org/disease-conditions/cancer/basics