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Diagnosis, Staging &Chemotherapy for Cancer

Diagnosis, Staging &Chemotherapy for Cancer. Cheryl A. Yarde RN, MSN Clinical Assistant Professor. Benign Vs. Malignant. What is the difference between a benign tumor and a malignant t tumor? Malignant tumors are ambitious. They have two goals in life:

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Diagnosis, Staging &Chemotherapy for Cancer

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  1. Diagnosis, Staging &Chemotherapy for Cancer Cheryl A. Yarde RN, MSN Clinical Assistant Professor

  2. Benign Vs. Malignant What is the difference between a benign tumor and a malignant t tumor? • Malignant tumors are ambitious. • They have two goals in life: • To survive • To conquer new territory

  3. Benign vs. Malignant Benign Malignant Undifferentiated Invades and infiltrates Rate of growth is variable Spreads to other areas of the body- metastasizes • Well differentiated • Tumor does not infiltrate surrounding tissue • Growth is slow • Does not spread

  4. Benign vs. Malignant Benign Malignant Can Cause anemia, weakness, Systemic inflammation, weight loss Causes extensive tissue damage Eventually causes death unless growth can be controlled • Does not cause generalized effects Cause localized effects • Does not usually cause tissue damage • Does not usually cause death unless location interferes with vital function

  5. CANCER/MALIGNANCY • Metastasize (Mets)

  6. Carcinogenesis • Process of transforming normal cells into cancer cells • Every phase of this process is affected by multiple gene mutations • Some gene mutations- inherited • 90% acquired mutations in specific cells

  7. Genetics Examples of some Cancers influenced by genetics: • Breast • Ovarian • Colorectal • Prostate Ca • Retinoblastoma • Familial melanoma syndrome

  8. Family History Family history assessment for specific Oncology disorders: • H/O of maternal and paternal sides • Three generations- parent, sibling, child • Clusters of Ca that occur at young ages • Multiple cancers in one individual • Two or more close relatives with the same cancer

  9. Family history • Referral for genetic testing • Need support if genetic testing is positive • Need to know options • Support groups

  10. Factors inducing carcinogenesis • Viruses: HPV, HepB, Epstein Barr • Bacteria: H. plylori • Physical agents: sunlight, radiation, tobacco, asbestos • Hazardous Chemicals: Alter DNA structure • Tobacco smoke, passive smoke, cigars, pipes, chewing tobacco • Workplace chemicals • Asbestos

  11. Carcinogens • Tobacco smoke – single most lethal chemical carcinogen • Accounts for 1/3 of all cancer deaths • Lung • Head and neck • Esophagus • Stomach • Pancreas • Kidney • AML • Second hand smoke- • Non - smokers who live with smokers have a 20%-30% greater risk of developing lung cancer

  12. Factors inducing carcinogenesis Lifestyle factors: • Diet - long term ingestion of carcinogens: • Fats, alcohol, salt cured or smoked meats, nitrate containing foods, red and processed meats • Obesity • Insufficient physical activity

  13. Diagnosis and Staging

  14. Diagnosis of Cancer • Determining presence/Type of malignancy • Obtain tissue, cells for analysis: • Biopsy • Fine needle aspiration **The only way to confirm whether a tumor is cancerous or benign is with a biopsy/ fine needle aspiration

  15. Diagnosis of Cancer Staging: • Size of tumor • local invasion • Lymph node involvement • Distant mets

  16. *Staging • Done prior to treatment • Provides baseline data • Treatment options and prognosis are based on staging

  17. Staging • Stage I-IV • stage 1 is localized cancer, • further local spread will take it to stage 2; stage 2 also usually includes spread to the nearest lymph nodes; • stage 3 usually indicates more extensive lymph node involvement and • stage4 always indicates distant spread.

  18. Grading • Determine the type of tumor the tissue originated from • Differentiation does the tumor cells retain the function and histologic characteristics of the tissue of origin- differentiation • Helps with prognosis • Grade l: • well differentiated • Resembles the tissue of origin • Grade lV • Poorly differentiated • More aggressive, less responsive to treatment

  19. Chemotherapy

  20. Treatment • Chemotherapy

  21. Chemotherapy • What is chemotherapy? • Drugs used for cancer treatment • Used to kill tumor cells by interfering w/cellular functions and reproduction • Kills rapidly dividing cells • Administration of chemotherapy

  22. Extravasation

  23. Side Effects of Chemotherapy

  24. Side Effects • Myelosuppression • Neutropenia • Thrombocytopenia • Anemia

  25. GI Effects Nausea & Vomiting (N/V): Most common side effect

  26. GI Effects 5-14 days Stomatitis: • Mouth Mucositis • Oral cavity & • GI tract *

  27. Thrush

  28. Fatigue • Cancer fatigue is distressing • Rest helps but does not make it go away • A little activity may be exhausting • Interferes w/family, work, recreation, and social life

  29. Psychosocial distress • Actual/potential losses • Fear • Symptoms • Changes in family and social roles • Financial issues • Loss of control

  30. Grieving

  31. Alopecia • Destruction of hair follicles by chemotherapy or radiation to head and neck • Hair loss usually temporary w/chemotherapy • usually permanent in response to radiation

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