ONCOLOGY

HYPERTROPHY (INCREASE IN TISSUE SIZE NO INCREASE IN CELLS)

HYPERPLASIA (INCREASE IN TISSUES D/T INCREASE NUMBER OF CELLS) EX: BPH

BENIGN
GROWN IN THE WRONG PLACE AT THE WRONG TIME
EX: ARE UTERINE FIBROID TUMORS

MAGLINANT
NOT PERFORMING THEIR USUAL FXN IN AN USUAL WAY
MAY APPEAR ABNORMALLY LARGE OR SMALL CELLS
CANT TELL WHAT TYPE OF CELL IT IS BEFORE MITOSIS
LARGE NUCLEUS
WILL MIGRATE TO PLACES THAT ARE PROXIMAL AND DISTAL TO THEIR ORIGINAL LOCATIONS

CANCER DEVELOPMENT**

THE STEPS OF MATASTISIS**

CLASSIFYING AND STAGES
ACCORING TO ANATOMICAL SITE, GRADING, EXTENT AND LOCATION OF DISEASE

WARNIGN SIGNS OF CANCER: CHANGE IN BOWEL, A SORE THAT DOESNT HEAL, UNUSUAL BLEEDING,
THICKENING OF LUMPS (BREAST), INDIGESTION/DIFF SWALLOWING, OBVIOUS CHANGE IN WARTS,
NAGGING COUGH

EXTERNAL FACTORS: SMOKING, CHEMICALS, RED MEATS, ENVIRONMENT, PHYSICAL
PERSONAL FACTORS: IMMUNE FXN, AGE, GENETICS

DX TEST: CBC, PSA/CEA (PROTEIN TUMOR MARKERS: BLOOD WORK), XRAY & SCANS, IV DYES (HOLD
METFORMING B4 GIVING AND AFTER), BIOPSY ARE DEFINITIVE AND WILL HELP WITH DEFRENTIATING,
THREE TYPES OF BIOPSIES ARE NEEDLE BIOPSY (ASPIRATION SAMPLE), INCISION (WITH SCAPLE) OR
EXCISIONAL BIOPSY (REMOVAL OF ENTIRE TUMOR), ENDOSCOPY AND LAPROSCOPY

SURGERIES:
DIAGNOSTIC IS REMOVAL OF ALL OR PART OF SUSPECTED TISSUES
PROPHYLATIC IS REMOVAL OF AT RISK TISSUES
CURATIVE IS REMOVAL OF ALL CANCEROUS TISSUES
CYTOREDUCTIVE IS REMOVAL OF PART BUT NOT ENTIRE AKA DEBULKING SURGERY
PALLATIVE IS DONE TO IMPROVE QUALITY OF LIFE (NOT A CURE)
RECONSTRUCTIVE/REHAB IS DONE TO INCREAS THE FX OR ENHANCE THE TREAT

RADIATION IS TO KILL CANCER CELLS WITH MINIMUM EXPOSURE TO NORMAL CELLS
EFFECTS OF RADIATION IS A LOCAL TX
TOTAL DOSE DEPENDS OF SIZE, LOCATION, SENSITIVITY OF TUMOR AND NEARBY TISSUES
CELLS USUALLY DIE
TYPES OF ENERGY RAYS: GAMMA, BETA AND ALPHA
TYPES OF METHODS OF DELIVERY ARE
BRADYTHERAPY (INTERNAL RADION): CONSISTS OF IMPLANTATION OR INSERTION OF A RADIOACTIVE
MATERIAL DIRECTLY INTO THE TUMOR, MAY BE LEFT IN PT DO ADMINISTER CONTINUOUSLY (LOW DOSE
RATE), HIGH DOSE RATES ARE LEFT IN FOR SHORT AMTS OF TIME
TELETHERAPY (EXTERNAL THERAPY): MOST COMMON FORM OF RADIATION THERAPY, PT EXPOSED TO
RADITION FROM THE MACHINE, IS NOT DIRECTLY EXPOSED, IS NOT RADIOACTIVE AND NOT HAZARDOUS
TO OTHERS
SIDE EFFECTS TO RADIATION ARE SKIN CHANGES, HAIR LOSS, ALTERED TASE, TISSUE
FIBROSIS/SCARRING, SKIN BECOMES DARK AND BREAKDOWN

CHEMOTHERAPY IS USED TO CURE AND INCRASE SURVIAL TIME
EFFECTS ARE SYSTEMIC AND FXNS TO KILL MATASTIC CELLS
METHODS OF DELIVER ARE INTRATHECUL (ARE INJECTED INTO THE SPINAL CAVITY), INTRAVENTRICULAR
(INJECTED INTO VENTRICLES OF THE BRAIN), INTRA PERITONEAL (INTO THE ABDOMINAL CAVITY),
INTRAVESCULAR (PLACED IN THE BLADDER), ORAL AND IV ARE THE MOST COMMON TYPES OF
CHEMOTHERAPY
IF GIVEN IV: CONCERNS WOULD BE TISSUES BREAKING DOWN, PAIN IS CARDINAL PAIN, PPE

SIDE EFFECTS: BONE MARROW SUPRESSIONS
ANEMIA (DECREASE IN THE NUMBER OF RBC): ASSESS FOR SOB, WEAKNESS, PALLOR, MAY GET EPOGEN
VIA SQ OR DURING DIALYSIS, CHECK CBC,
NEUTROPENIA (A DECREASE IN THE NUMBER OR WBD): RISK FOR BACTERIAL, FUNGAL OR VIRAL
INFECTIONS,
THROMBOCYTOPENIA (A DECREASE IN THE NUMBER OF CIRCULATING PLATELTS): WILL BE AT RISK FOR
BLEEDING WHEN COUNT IS BELOW 50K, AT RISK FOR SPONTANEOUS AND UNCONTR UNCONTROLLED
BLEEDING WHEN COUNT IS BELOW 20K, AVOID ALL INJURIES,

REGULAR SIDE EFFECTS:
NAUSE AND VOMITING IS MOST COMMON SIDE EFFECT, VOMIT MAY OCCUR IN 1HR AND LAST 24HRS
AFTER TX, PROVIDE FREQUENT MOUTH CARE, PLAN ALL MEALS, WAIT 1HR AFTER TX B4 EATING,
PROVIDE ANTIEMTICS,
XEROSTOMIA/STOMATITIS/MUCOSITIS ARE SORES IN MUCUS MEMBRANS. WILL NEED ORAL
ASSESSMENT COMPLETED, WILL HAVE CHANGES IN TASTE, CHECK FOR SORES, WHITE PATCH,
TREATMENT MAY INCLUDE ORAL ANTISTETIC, ATB, ANTIFUNGAL, SALIVA SUBSTITUES AND PAIN MEDS,
AVOID ALL COMMERCIAL MOUTHWAS D/T ALCOHOL, USE SOFT BRISTLE TOOTHBRUSH, RISE WITH HALF
PEROXIDE/NORMAL SALINE
PATIENTS MAY REPORT ABD PAIN, MONITOR I & O, MAY HAVE DIARRHEA, DRINK PLENTY OF FLUIDS,
STAFF WEAR DOUBLE GLOVES AND CORRECT PPE, SEXUAL CHANGES (TOO TIRED, OR NOT INTERESTED
IN SEX, WORRIED OR STRESSED ABOUT SEX), FERTILITY MAY BE AN ISSUE WITH WOMEN RECEIVING
CHEMO, WEAR COTTON UNDERWEAR, NO TIGHT FITTING SHORTS, ENCOURAGE MEN TO WEAR
CONDOM BECAUSE CHEMO COULD BE IN THE SEMEN
ALOPECIA: NOT ALL AGENTS CAUSE IT, MAY HAVE JUST HAIR THINNING, HAIRGROWTH USUALLY
RETURNS APPROX A MONTH AFTER CHEMO, PT WILL BE INCREASED FOR INJURY D/T HAIRLESS SCALP
(*AVOID DIRECT SUN, WEAR HAT, SUNSCREEN)
PATIENT MAY HAVE PERIPHERAL NEUROPATHY: MAY BE PRESENT WITH TINGLING, BURING, WEKNESS,
NUMBING IN HANDS AND FEET. ASSESS FOR BALANCE, DIZZY, SHAKING, TREMING OR PAIN WHEN
WALKING
GOALS FOR NUTRITION: PREVENT WEIGHT LOSS AND MAINTAIN LEAN BODY MASS: ENCOURAGE TO
EAT 5-6 SMALL MEALS, LOW BACTERIA DIET, HEALTHY SHAKES, HIGH IN CARBS AND PROETIN, PROVIDE
PLENTY OF REST, PATIENT MAY HAVE FATIGUE, ENCOURAGE EXERCISES. PATIENT MAY HAVE CACHEXIA
(EXTREME MUSCLE WEAKNESS AND WASTING/MALNUTRITION OF MUSCLES)

EMERGENCIES:
SEPSIS S/S (MILD HYPOTENSION, LOW URINARY OUTPUT, INCREASED RESP RATE, MAY/MAY NOT HAVE
A TEMPERATURE) MANAGEMENT OF SEPSIS WOULD INCLUDE PREVENTION, ID AT RISK PTS, PRACTICE
ASEPTIC TECHNIQUE
DIC: DISCIMINATED INTRAVASCULAR COAGULATION (PROBLEM WITH BLOOD CLOTTING PROCESS THAT
CAN BE TRIGGERED BY SEPSIS OR BY RELEASE OF CLOTTING FACTORS BY CANCER CELLS) MGT: REDUCE
INFECTION TO STOP PROCESS, ATB, ANTICOAGS IF CAUGHT EARLY TO LIMIT THE CLOTTING PROCESS , IF
THEY ARE ALREADY BLEEDING GIVE CLOTTING FACTORS IF ITS PROGRESSED TO HEMMHORAGING,

SIADH: MOST COMMON CAUSE IS MILAGNANCY (ESPECIALLY IN SMALL CELL LUNG CANCER) WEAKESS,
MUSCLE CRAMPS, IN CREASE WEIGHT GAIN, LOW URINE OUTPUT, MGT: RESTORE NORMAL FLUIDS,
FLUID RESTRICTIONS, SAFETY, HYPERTONIC SOLUTION 3-3%

HYPOCALCEMIA: OCCURS WITH BONE CANCER, CANCERS OF THE LUNG, BREST, KIDNEYS CAUSE THE
BONES TO RELEASE CALCIUM, SEVERE MUSCLE WEAKNESS, EKG CHANGES, TREAT WITH HYDRATION,
MAY NEED DIALYSIS

SUPERIOR VENA CAVA SYNDROM IS WHEN THE VENA CAVA IS COMPRESSED BY A TUMOR GROWTH OR
BY CLOTS IN THE BLOOD VESSELS, OCCURS WITH PATIENTS MOSTLY TO HAVE HODGKINS OR
LYMPHOMA, LUNG OR BREAST CANCER PT HAS DISTENTION OF VEINS IN NECK/CHEST FACIAL EDEMA,
HEADACHE SEISURE, LATE MANIFESTATIONS ARE HEMMHORAGE AND CYANOSIS, OR MSCHANGE
TREAT WILL BE HIGH DOSE OF RADIATION THERAPY IN THE CHEST AREA

TUMOR LYSIS SYNDROME: MATABOLIC SYNDROME IS WHEN A LARGE NUMBER OF TUMOR CELLS ARE
DESTROYED RAPIDLY, HALL MARK SIGN IS HYPERURICEMIA OR HYPERKALEMIA, USUALLY OCCURS IN
48HRS AFTER; ENCOURAGE PTS TO DRINK FLUIDS, DIURETICS MAY ALSO BE USED;

PREVENTION: REDUCE OR EXPOSURE TO CHEMICAL CARCINOGENS, EAT BALANCE DIET, NO SMOKED
SALTS OR CURED MEATS, EXERCISE, REST ADEQUATE, HEALTH SCREENINGS, SELF EXAMS KNOW 7
WARNING SIGNS OF CANCER (CAUTION)