This document provides an introduction to cancer including definitions, types, causes, risk factors, screening recommendations, and diagnostic tools. It defines cancer as uncontrolled cell growth and outlines the differences between normal and cancerous cells. Common cancer types are described as well as factors that can increase cancer risk such as viruses, chemicals, radiation, genetics, and lifestyle choices. The document also discusses how cancers are classified and diagnosed.

2. INTRODUCTION
OF CANCER

3. PRESENTED BY
deepika .r
m.sc (n) i-year
college of nursing
madras medical college
chennai-03

4. GLOSSERY
– Carcinogenesis: process of transforming normal cells into
malignant cells
– Benign: not cancerous; benign tumors may grow but are unable
to Spread to other areas
– Malignant: having cells or processes that are characteristic of
cancer
– Anaplasia: cells that lack normal cellular characteristics and
differ in shape and organization with respect to their cells of
origin; usually , anaplastic cells are malignant

5. GLOSSARY
– Hyperplasia: increase in the number of cells of a tissue; most often
associated with periods of rapid body growth
– Dysplasia: bizarre cell growth resulting in cells that differ in size, shape ,
or arrangement from other cells of the same type of tissue
– Metaplasia: conversion of one type of mature cell into another type of
cell
– Neoplasia: uncontrolled cell growth that follows no physiologic demand
– Staging: process of determining the extent of disease, including tumor
size and spread or metastasis to distant sites

6. GLOSSARY
– Apoptosis: programmed cell death
– Biopsy: a diagnostic procedure to remove a small sample of
tissue to be examined microscopically to detect malignant cells
– Neutropenia: abnormally low absolute neutrophil count
– Oncology: field or study of cancer
– Thrombocytopenia: decrease in the number of circulating
platelets; associated with the potential for bleeding

7. GLOSSARY
– Graft-versus-host disease (GVHD): an immune response
initiated by T lymphocytes of donor tissue against the
recipient’s tissues (skin, gastrointestinal tract, liver); an
undesirable response
– Graft-versus-tumor effect: the donor cell response against the
– Malignancy; a desirable response
– Biologic response modifier (BRM) therapy: use of agents or
treatment methods that can alter the immunologic relationship
between the tumor and the host to provide a therapeutic
benefit

8. GLOSSARY
– Brachytherapy: delivery of radiation therapy through internal
implants
– Chemotherapy: use of medications to kill tumor cells by
interfering with cellular functions and reproduction
– Control: containment of the growth of cancer cells
– Palliation: relief of symptoms and promotion of comfort and
quality of life
– Radiation therapy: use of ionizing radiation to interrupt the
growth of malignant cells

9. GLOSSARY
– Myelosuppression: suppression of the blood cell–producing
function of the bone marrow
– Tumor-specific antigen (TSA): protein on the membrane of
cancer cells that distinguishes the malignant cell from a benign
cell of the same tissue type
– Vesicant: substance that can cause tissue necrosis and damage,
particularly when extravasated

10. GLOSSARY(CANCER TYPES)
– CARCINOMA is a cancer that begins in the skin or in tissues that
line or cover internal organs.
– SARCOMA is a cancer that begins in bone, cartilage, fat, muscle,
blood vessels, or other connective or supportive tissue.
– LEUKEMIA is a cancer that begins in blood-forming tissue, such
as the bone marrow, and causes too many abnormal blood cells
to be made.
– LYMPHOMA and MULTIPLE MYELOMA are cancers that begin in
the cells of the immune system.

11. GLOSSARY (CANCER TYPES)
– Central nervous system cancers are cancers that begin in the
tissues of the brain and spinal cord. Also called malignancy.

12. Origin of the word cancer
In Greek, These Words Refer To A Crab,
Most Likely Applied To The Disease Because The Finger-like
Spreading Projections From A Cancer Called To Mind The
Shape Of A Crab.

13. THE DEFINITION OF CANCER
– Cancer is a group of diseases characterized by
uncontrolled and unregulated growth of cells.
– A term for diseases in which abnormal cells
divide without control and can invade nearby
tissues. Cancer cells can also spread to other
parts of the body through the blood and lymph
systems.
– Cancer can start almost anywhere in the
human body, which is made up of trillions of
cells.

14. NORMAL VS CANCER CELL
– Normal human cells grow and multiply (through a process
called cell division) to form new cells as the body needs them.
– Sometimes this orderly process breaks down, and abnormal or
damaged cells grow and multiply.
– These cells may form tumors, which are lumps of tissue. Tumors
can be cancerous or not cancerous (benign).

16. DIFFERENCE BETWEEN NORMAL AND CANCER CELL

17. INCIDENCE
– Cancer incidence and mortality statistics reported by the
National Cancer Institute and other resources were used to
create the list.
– To qualify as a common cancer for the list, the estimated annual
incidence for 2023 had to be 40,000 cases or more.
– The most common type of cancer on the list is breast cancer,
with 300,590 new cases expected in the United States in 2023.
The next most common cancers are prostate cancer and lung
cancer.

18. INCIDENCE
– Because colon and rectal cancers are often referred to as
"colorectal cancers," these two cancer types are combined for
the list.
– For 2023, the estimated number of new cases of colon cancer
and rectal cancer are 106,970 and 46,050, respectively, adding
to a total of 153,020 new cases of colorectal cancer.
– The following table gives the estimated numbers of new cases
and deaths for each common cancer type in 2023:

19. CANCER TYPE ESTIMATED NEW CASES ESTIMATED DEATHS
Bladder 82,290 16,710
Breast (Female – Male) 297,790 – 2,800 43,170 – 530
Colon and Rectal (Combined) 153,020 52,550
Endometrial 66,200 13,030
Kidney (Renal Cell and Renal Pelvis) 81,800 14,890
Leukemia (All Types) 59,610 23,710
Liver and Intrahepatic Bile Duct 41,210 29,380
Lung (Including Bronchus) 238,340 127,070
Melanoma 97,610 7,990
Non-Hodgkin Lymphoma 80,550 20,180
Pancreatic 64,050 50,550
Prostate 288,300 34,700
Thyroid 43,720 2,120

20. GENDER DIFFERENCES
– MEN:
– More men than women die from cancer-related deaths each
year.
– Mortality rate from lung cancer is higher in men than in women.
– Cancer with the highest incidence among men is lip/oral cancer.
– Men are more likely to develop liver cancer than women.

21. GENDER DIFFERENCES
– WOMEN:
– Head and neck cancer occurs more frequently in men than in
women.
– Cancer with the highest death rate among women is lung cancer.
– Cancer with the highest incidence among women is breast cancer.
– Thyroid cancer is more prevalent in women than in men.
– Women are less likely to have colon cancer screenings than men.
– Considerable progress has been made in controlling cancer for long
periods .

22. BENIGN VS MALIGNANT NEOPLASMS

23. BENIGN VS MALIGNANT NEOPLASMS
– BENIGN:
– Not cancerous; benign tumors
may grow but are unable to
spread to other areas
– MALIGNANT:
– Having cells or processes that
are characteristic of cancer

24. BENIGN VS MALIGNANT NEOPLASMS

26. COMMON ETIOLOGY
– VIRUSES AND BACTERIA
– Viruses are difficult to evaluate as a
cause of human cancers because
they are difficult to isolate.
– For example,
– the Epstein-Barr virus is highly
suspect as a cause in Burkitt
lymphoma, nasopharyngeal
cancers, and some types of non-
Hodgkin and Hodgkin lymphoma .

27. VIRUSES AND BACTERIA
– In the early 1990s, the International Agency
for Research on Cancer (IARC) identified
Helicobacter pylori (H. pylori ) as the first
bacterium to be termed a definite cause of
cancer in humans.
– H. pylori has been associated with an
increased incidence of gastric malignancy
related to chronic superficial gastritis, with
resultant atrophic and metaplastic changes to
the gastric mucosa.

28. ETIOLOGY-Physical Agents
– Physical factors associated with
carcinogenesis include exposure to sunlight
or radiation, chronic irritation or
inflammation, and tobacco use.
– Excessive exposure to the ultraviolet rays of
the sun,
– Use of sunscreens;
– Occupation;
– Recreational habits; and
– Environmental variables, including humidity,
altitude, and latitude,

29. CHEMICAL AGENTS
– About 75% of all cancers are thought to be
related to the environment.
– Most hazardous chemicals produce their
toxic effects by altering DNA structure in
body sites distant from chemical exposure.
– Aromatic amines and aniline dyes;
– Pesticides and formaldehydes;
– Arsenic, soot, and tars;
– Asbestos; etc,,.

30. Genetics and Familial Factors
Abnormal chromosomal patterns and cancer have been
associated with extra chromosomes,
– too few chromosomes, or translocated chromosomes
– Burkitt lymphoma, chronic myelogenous
– meningiomas,
– acute leukemias,
– retinoblastomas,
– Wilms tumor, and skin cancers, including malignant melanoma.

31. Genetics and Familial Factors
– Cancers associated with familial
inheritance syndromes include
– Nephroblastoma ,
– Pheochromocytomas, and
– Breast, ovarian, colorectal,
stomach, thyroid, renal, prostate,
and lung cancers

32. Dietary Factors
– Long-term ingestion of carcinogens or cocarcinogens or chronic
absence of protective substances in the diet.
– Dietary substances that appear to increase the risk of cancer
include
– Fats,
– Alcohol,
– Salt-cured or smoked meats, nitrate-containing and nitrite-
containing foods, and red and processed meats.

34. Dietary Factors
– Alcohol increases the risk of
cancers of the mouth, pharynx,
larynx, esophagus, liver,
colorectum, and breast.
– obesity

35. Hormonal Agents
– Diethylstilbestrol (DES) has long been recognized as a cause of
vaginal carcinomas.
– Oral contraceptives and prolonged estrogen therapy are
associated with an increased
– Incidence of hepatocellular, endometrial, and breast cancers, but
they decrease the risk of ovarian cancer.
– Menses under age 12 and delayed onset of menopause after age
55, nulliparity (never giving birth), and delayed childbirth after
age 30 are all associated with an increased risk of breast cancer.

36. Causative Factors
– CARCINOGENS
– Common Carcinogenic
Substances
– SUBSTANCE TYPE OF CANCER
– Asbestos = Lung, peritoneal,
pericardial

37. CAUSATIVE FACTORS
– Benzene = Acute myelocytic leukemia
– Tobacco= Lung, mouth, pharynx, larynx, esophagus, pancreas,
bladder, kidney, colon, liver
– Alcoholic beverages = Mouth, pharynx, larynx, esophagus, liver
– Radon = Lung
– Ionizing radiation = Leukemia, tumors of most organs
– Sunlight (ultraviolet rays) = Skin
– Diethylstilbestrol (prenatally) = Vaginal

38. CAUSATIVE FACTORS
Estrogens, synthetic = Endometrial
– Androgens , synthetic = Liver
– Vinyl chloride = Liver
– Aromatic amines = Bladder
– Arsenic (inorganic) = Lung, skin
– Chromium = Lung
– Nickel dust = Lung, nasal sinuses
– Chronic hepatitis B or C infection = Liver

39. CAUSATIVE FACTORS
– Human T-cell lymphotropic virus type 1 (HTLV-1) = Adult T-cell
leukemia and lymphoma
– Human papillomavirus (HPV) = Cervix, vagina, vulva, penis, anus,
mouth, throat
– Phenacetin = Renal pelvis, bladder
– Alkylating agents (used for chemotherapy) = Acute myelocytic
leukemia
– Cyclosporine (used to prevent transplant rejection) = Non-
Hodgkin lymphoma

40. CLASSIFICATION OF CANCER
– TUMORS CAN BE CLASSIFIED ACCORDING TO
– ANATOMIC SITE,
– HISTOLOGY (GRADING), AND
– EXTENT OF DISEASE (STAGING).

41. ANATOMIC CLASSIFICATION OF TUMOUR

43. HISTOLOGIC CLASSIFICATION
– Grade I: Cells differ slightly from normal cells (mild dysplasia) and
are well differentiated (low grade).
– Grade II: Cells are more abnormal (moderate dysplasia) and
moderately differentiated (intermediate grade).
– Grade III: Cells are very abnormal (severe dysplasia) and poorly
differentiated (high grade).
– Grade IV: Cells are immature and primitive (anaplasia) and
undifferentiated; cell of origin is difficult to determine (high grade).
– Grade X: Grade cannot be assessed.

44. Extent of Disease Classification
– CLINICAL STAGING.
– The clinical staging classification system determines the
anatomic extent of the malignant disease process by stages:
– Clinical staging has been used as a basis for staging a variety of
tumor types, including cancer of the cervix and Hodgkin's
lymphoma. Other malignant diseases (e.g., leukemia) do not
use this staging approach.

45. Extent of Disease Classification
– Stage 0: cancer in situ
– Stage I: tumor limited to the tissue of origin; localized tumor
growth
– Stage II: limited local spread
– Stage III: extensive local and regional spread
– Stage IV: metastasis

46. TNM Classification System
– TNM Classification System
– T The extent of the primary tumor
– N The absence or presence and extent of regional lymph
– node metastasis
– M The absence or presence of distant metastasis
– The use of numerical subsets of the TNM components indicates
the progressive extent of the malignant disease
– Primary Tumor (T)
– Tx Primary tumor cannot be assessed

47. TNM Classification System
– T0 No evidence of primary tumor
– Tis Carcinoma in situ
– T1, T2, T3, T4 Increasing size and/or local extent of the
– primary tumor
– Regional Lymph Nodes (N)
– Nx Regional lymph nodes cannot be assessed.

48. TNM Classification System
– N0 No regional lymph node metastasis
– N1, N2, N3 Increasing involvement of regional lymph
– nodes
– Distant Metastasis (M)
– Mx Distant metastasis cannot be assessed
– M0 No distant metastasis
– M1 Distant metastasis

49. COMMON CANCER TYPES
– This list of common cancer types includes cancers that are
diagnosed with the greatest frequency in the United States,
excluding nonmelanoma skin cancers:
– Bladder Cancer
Breast Cancer
Colon and Rectal Cancer
Endometrial Cancer
Kidney Cancer
Leukemia
Liver

50. Cancer types
– Lung Cancer
Melanoma
Non-Hodgkin Lymphoma
Pancreatic Cancer
Prostate Cancer
Thyroid Cancer

67. AMERICAN CANCER SOCIETY (ACS) RECOMMENDATIONS FOR
THE EARLY DETECTION OF CANCER
IN AVERAGE-RISK ASYMPTOMATIC PEOPLE
– Cancer Site Test or Procedure
– Breast = Breast self-examination (BSE), Clinical breast
examination (CBE)
– Colorectal = Mammography, Fecal occult blood test (FOBT), flexible sigmoidoscopy.
contrast barium enema (DCBE), fecal immunochemical test (FIT).
Prostate = Digital rectal examination (DRE) and prostate-specific antigen (PSA) test.
Cervix = Pap test.
Endometrial = At the time of menopause.
Cancer-related checkup = On the occasion of a periodic health examination.

68. DIAGNOSTIC AIDS USED TO DETECT CANCER
– TUMOR MARKER IDENTIFICATION
– Analysis of substances found in
body—tissues, blood,
– or other body fluids that are made
by the tumor or cancers
– by the body in response to the
tumor
– example
– Breast, colon, lung, ovarian,
testicular, prostate

69. GENETIC PROFILING
– Analysis for the presence of mutations (alterations) in genes found
in tumors or body tissues.
– Assists in diagnosis, selection of treatment, prediction of response
to therapy, and risk of progression or recurrence
– EXAMPLE:
– Breast, Jung, kidney, ovarian, brain cancers, leukemia, and
lymphoma (many uses of genetic profiling are considered
investigational)

70. GENETIC PROFILING

71. DIAGNOSTIC EVALUATION
– MAMMOGRAPHY
– Use of x-ray images of the breast.
– EXAMPLE:
– Breast cancer.
– MAGNETIC RESONANCE
IMAGING(MRI).
– Use of magnetic fields and
radiofrequency signals to create
sectioned images of various body
structures

72. MAGNETIC RESONANCE INDEX

73. Computed tomography (CT)
– Use of narrow-beam x-
ray to scan successive
layers of tissue for a
cross-sectional view.
– EXAMPLE:
– Neurologic, pelvic,
skeletal, abdominal,
thoracic cancers.

74. Fluoroscopy
– Use of x-rays that identify
contrasts in body tissue
– densities; may involve the
use of contrast agents.
– EXAMPLE.
Skeletal, lung,
gastrointestinal cancers

75. Ultrasonography (ultrasound)
– High-frequency sound waves
echoing off body tissues are
converted electronically into
images; used to assess tissues
deep within the body
– EXAMPLE:
– Abdominal and pelvic cancers

76. Endoscopy
– Direct visualization of a body cavity or
passageway insertion of an endoscope
into a body cavity or opening;
– allows tissue biopsy, fluid aspiration,
and
– excision of small tumors. Used for
diagnostic and
– therapeutic purposes
– EXAMPLE:
– Bronchial, gastrointestinal cancers

77. Nuclear medicine imaging
– Uses intravenous injection or
ingestion of radioisotope
– substances followed by
imaging of tissues that have
– concentrated the
radioisotopes
– EXAMPLE:
– Bone, liver, kidney, spleen,
brain, thyroid cancers

78. Bone scan
– A procedure to check for
abnormal areas or damage
in the bones.
– A very small amount of
radioactive material is
injected into a vein and
travels through the blood.
– The radioactive material
collects in the bones and is
detected by a scanner

79. Positron emission tomography (PET)
– Through the use of a
tracer, provides black and
white or color-coded
images of the biologic
activity of a particular
area, rather than its
structure. Used in
detection of cancer or its
response to treatment

80. Positron emission tomography (PET)
– EXAMPLE:
– Lung, colon, liver,
pancreatic, head and
neck cancers; Hodgkin
and non-Hodgkin
lymphoma , melanoma

81. PET fusion
– Use of a PET scanner and a
CT scanner in one
– machine to provide an
image combining
anatomic
– detail, spatial resolution,
and functional metabolic
– abnormalities

82. Radioimmunoconjugates
– Monoclonal antibodies
are labeled with a
radioisotope and injected
intravenously into the
patient; antibodies that
aggregate at the tumor
site are
– visualized with scanners.

83. Radioimmunoconjugates
– EXAMPLE:
– Colorectal, breast, ovarian,
head and neck cancers; the
lymphoma and melanoma

84. OTHER COMMON LAB INVESTIGATION
– Blood chemistry test
– Complete blood count
(CBC)
– Cytogenetic analysis
– Immunophenotyping
– Liquid biopsy
– Sputum cytology
– Tumor marker tests
– Urinalysis
– Urine cytology

85. Management of Cancer
– Treatment options offered to cancer patients should be based
on treatment goals for each specific type of cancer.
– The range of possible treatment goals may include complete
– Eradication of malignant disease (cure), prolonged survival
– And containment of cancer cell growth (control), or
– Relief Of symptoms associated with the disease (palliation).

87. common Management of Cancer
– There are three traditional modes of therapy for malignancies:
surgery,
Radiation, and
Chemotherapy.
Hormone manipulation,
Immunotherapy with biologic response modifiers, and
Bone marrow or
Stem cell transplantation are treatments combined with traditional
therapies.

89. Surgery
– Surgical removal of the entire cancer remains the ideal and most
frequently used treatment method.
– the specific surgical approach may vary for several reasons.
– it may be
– Diagnostic Surgery
– Surgery as Primary Treatment
– Prophylactic Surgery
– Palliative Surgery
– Reconstructive Surgery

90. Diagnostic Surgery
– Diagnostic Surgery
– Diagnostic surgery, such as a
biopsy, is usually performed to
– Obtain a tissue sample for analysis
of cells suspected to be malignant.
– Biopsy Types
– The three most common biopsy
methods are the
– Excisional,
– Incisional, and
– Needle methods

91. EXCISIONAL BIOPSY

92. Incisional biopsy

93. NEEDLE METHOD

94. Surgery as Primary Treatment
– The goal is to remove the entire tumor or as much as is feasible
(a procedure sometimes called debulking) and any involved
surrounding tissue, including regional lymph nodes.
– Two common surgical approaches used for treating primary
– Tumors are local and wide excisions.
– LOCAL EXCISION,
– Often performed on an outpatient basis, is warranted when the
mass is small. It includes removal of the mass and a small
margin of normal tissue that is easily accessible.

95. Cont…
– WIDE OR RADICAL EXCISIONS
– include removal of the primary tumor, lymph nodes, adjacent
involved structures, and surrounding tissues that may be at high
risk for tumor spread
– Video-assisted endoscopic surgery is increasingly replacing
– surgery associated with long incisions and extended
recovery
– periods to minimize surgical trauma

96. Cont….
– Salvage surgery is an additional
treatment option that uses an
extensive surgical approach to
treat the local recurrence of a
cancer after the use of a less
extensive primary approach.

97. Prophylactic Surgery
– Prophylactic surgery
involves removing nonvital
tissues or organs that are
at increased risk to
develop cancer.

98. Palliative Surgery
– Palliative surgery is performed in an attempt to relieve
complications of cancer, such as ulceration, obstruction,
hemorrhage, pain, and malignant effusion.
– Example, In pancreatic cancer,
– Palliative surgery- cancer cannot be removed completely, and is used to relieve
symptoms and prevent complications.
– Stent placement- a small tube is placed in a blocked bile duct to keep it
open.
– Bypass Surgery- relieving a blocked bile duct, by rerouting bile from the
common bile duct to the small intestine.
–

100. Reconstructive Surgery
– Reconstructive surgery may follow curative or radical surgery in
an attempt to improve function or obtain a more desirable
cosmetic effect.

102. Radiation Therapy
– Radiation therapy may also be
used to control malignant disease
when a tumor cannot be
removed surgically or when local
nodal metastasis is present, or it
can be used neoadjuvant (prior to
local definitive treatment)
– with or without chemotherapy to
reduce the size of a tumor to
enable surgical resection.

103. Cont,,,
– Radiation therapy may
be used
prophylactically
– to prevent the spread
of a primary cancer to
a distant area ( eg ,
irradiating the brain to
prevent leukemic
infiltration or
metastatic lung cancer)

104. Radiation Therapy
– Two types of ionizing
radiation—
– electromagnetic radiation(x-
rays and gamma rays)and
– particulate radiation( électrons
, beta particules , protons,
neutrons, and alpha particules
)

107. Radiation Protection

108. Toxicity
– Alopecia (hair loss).
– Stomatitis (inflammation of the oral tissues),
– Xerostomia(dryness of the mouth),
– Change and loss of taste, and
– Decreased salivation.
– The entire gastrointestinal mucosa may be involved, and
– Esophageal irritation with chest pain and
– Dysphagia

109. Toxicity
– Certain systemic side effects are also commonly experienced
– By patients receiving radiation therapy. These side effects
– Include fatigue, malaise, and anorexia
– Late effects (months to years after treatment) of radiation
– Decreased vascular supply, and are irreversible.
– Severe late effects may affect the lungs, heart, central nervous
– System, and bladder.

110. Chemotherapy
– In chemotherapy,
antineoplastic agents are
used in an attempt
– to destroy tumor cells by
interfering with cellular
– functions, including
replication.

111. Classification of chemotherapy
– Chemotherapeutic agents are also classified by chemical
– Group, each with a different mechanism of action.
– These include
– The alkylating agents,
– Nitrosoureas,
– Antimetabolites,
– Antitumor
– Antibiotics,
– Plant alkaloids,
– Hormonal agents, and miscellaneous
– Agents.

112. – Implanted infusion port for administration of chemotherapy
drugs or continuous morphine

113. Toxicity
– Gastrointestinal System. Nausea and vomiting
– Hematopoietic System. Most chemotherapeutic agents
– cause myelosuppression
– Renal System. renal damage
– Cardiopulmonary System. signs of
– heart failure must be monitored closely.
– Neurologic System, neurotoxicity

114. – Hormone Therapy
– Hormone therapy is used as an adjunct to other types of cancer
therapy. It can slow tumor growth
– or prevent cancer recurrence
– Immunotherapy Using Biologic Response Modifiers
– Biologic response modifiers (BRMs) are agents that manipulate
the immune system in the hope of
– controlling or curing a malignancy with little or no toxic effect on
normal cells. These agents either
– stimulate or suppress immune activity

115. – Bone Marrow and Stem Cell Transplantation
– Bone marrow transplantation (BMT) is mainly used to
correct the severe bone marrow damage
– caused by chemotherapy or radiation
– Gene Therapy
– As research reveals the genes believed to be responsible
for various types of cancers, the possibility
– of gene splicing or replacement becomes a reality

116. Complementary and Integrative Medicine
– Traditional Chinese medicine
– (Including acupuncture), Ayurveda , homeopathy, and
naturopathy; mind-body interventions,
– Which include meditation, hypnosis, dance, music, and art
therapy;
– Herbal and plant therapies, nutrition, and biologic pharmacology;
and manipulative and
– Body-based methods, which include chiropractic and osteopathic
manipulation and massage therapy.

118. Patient Teaching
– Cancer Treatment and Infection Prevention
– Wash your hands well with an antimicrobial soap or alcohol-based
hand rub:
– Before eating
– After using the toilet
– After blowing your nose
– After handling items many people have handled, such as railings,

119. Cont…
– money, shopping carts, library books, newspapers, and pieces of
– mail
– After touching a pet
– After spending time out in public
– Do not share personal care items (razor, toothbrush, toothpaste, washcloth,
towels, deodorant,
– hand lotion, lipstick, etc.).
– Clean toothbrushes by running them through the dishwasher or soaking them
in a bleach or
– hydrogen peroxide solution.

120. Cont….
– Stay away from people with respiratory or other infections.
– Bathe daily if possible; use an antimicrobial soap.
– Examine the mouth daily for sores or white patches; perform
mouth care frequently.
– Examine the skin, especially the feet, for signs of broken areas
daily.
– Wash dishes, utensils, and items used in cooking in hot sudsy
water or run them through a
– dishwasher.

121. – Drink only fresh, bottled water.
– Do not reuse drinking cups or glasses without washing them.
– Keep lips moist with lip balm or petroleum jelly to avoid cracking.
– Stay out of crowded places.
– Eat only canned or cooked foods.
– If leukocyte count is extremely low, maintain a low-bacteria diet
by avoiding salads, raw fruits
– and vegetables, undercooked meat, pepper, or paprika.

122. Cont…
– Do not handle garden flowers, plants, or earth.
– Do not clean out cat litter boxes or bird cages.
– Have someone else change the water in flower arrangements if
they are allowed.
– Monitor temperature daily.

123. – Cont….
– Be careful not to nick or scratch the skin.
– Report the following signs of infection to the provider immediately:
– Temperature over 100° F (38° C)
– Persistent cough
– Colored or foul-smelling drainage from wound or nose

124. – Colored or foul-smelling drainage from wound or nose
– Presence of a boil or abscess
– Cloudy, foul-smelling urine or burning on urination
– The diet is modified to avoid irritating foods. Stool softeners are
given to keep the stool soft and
– to prevent the Valsalva maneuver that occurs with constipation.
No rectal suppositories or enemas are given, and rectal
temperatures are contraindicated.

125. ONCOLOGY EMERGENCICES

126. Common Nursing Problems for Patients With Cancer
– Altered nutrition due to increased metabolic demand and
nausea, vomiting, diarrhea, or mucositis
– Potential for infection due to bone marrow depression
– Pain, acute or chronic, due to effects of tumor on body
structures or cancer therapy
– Altered skin integrity due to surgical or radiation therapy
– Altered body image due to weight loss or hair loss
– Potential for injury to patient, staff, and visitors due to exposure
to a radioactive implant

127. Cont,,,,
– Altered physical mobility due to restricted activity secondary to a
radioactive implant
– Diarrhea and dehydration due to effects of cancer treatment
– Constipation due to effects of chemotherapy
– Altered urinary elimination due to radiation therapy or secondary
to effects of chemotherapy
– Fatigue
–

128. Cont….
– Insufficient knowledge of drugs and their potential side effects
– Altered self-care ability due to weakness and fatigue
– Fear of dying
– Limited coping due to the significance of cancer
– Altered family coping due to a anxiety over patient's prognosis