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ONCOLOGY NURSING
PROFESSOR EDILBERTO G. ERA
CANCER
A group of complex diseases with various
manifestations depending on which body system is
affected and the type of tumor cells involved
 It results when normal cells mutate into abnormal,
deviant cells that then perpetuate within the body
 A chronic disease that has acute episodes, that
the client often treated in the home, and that the
client is usually treated with a combination of
therapeutic modalities

ONCOLOGY
Study of cancer
 From the Greek word oncoma (“bulk’)

ONCOLOGIST
Specializes in caring for clients with cancer
 Maybe a medical doctors, surgeons,
radiologists, immunologists or researchers

ONCOLOGY NURSE
An important significant member of the
oncology team, who has received specialized
training in cancer care and treatment
 Must have special skills in assisting the client
and family with the psychosocial issues
associated with cancer and terminal illness

Leading Causes of Mortality
MORTALITY: TEN (10) LEADING CAUSES
NUMBER AND RATE/100,000 POPULATION
Philippines
5-Year Average (2001-2005) & 2006
CAUSES
5-Year Average
(2001-2005)
2006*
Number
Rate
Number
Rate
1. Diseases of the Heart
69,741
85.5
83,081
95.5
2. Diseases of the Vascular
System
52,106
64.0
55,466
63.8
3. Malignant Neoplasms
39,634
48.6
43,043
49.5
4. Accidents**
33,650
41.4
36,162
41.6
5. Pneumonia
33,764
41.5
34,958
40.2
6. Tuberculosis, all forms
27,017
33.2
25,860
29.7
7. Chronic lower respiratory
diseases
19,024
23.3
21,216
24.4
8. Diabetes Mellitus
15,123
18.5
20,239
23.3
9.Certain conditions originating
in the perinatal period
13,931
17.2
12,334
14.2
10. Nephritis, nephrotic
syndrome
and nephrosis
9,785
12.0
11,981
13.8
Leading Causes of Child Mortality
Ten (10) Leading Causes of Child Mortality
By Age-Group (1-4, 5-9, 10-14) & Sex
No. & Rate/100,000 population
Philippines, 2006
1-4 Years
Cause
Male
Female
Both Sexes
Rate*
1,046
930
1,976
23.18
2. Accidents
752
514
1,266
14,85
3. Diarrheas and gastoenteritis of presumed
infectious origin
592
446
1,038
12.18
4. Congenital anomalies
379
364
743
8.72
5. Ill-defined and unknown causes of mortality
324
260
584
6.85
6. Other diseases of the nervous system
236
179
415
4.87
7. Chronic lower respiratory diseases
185
226
411
4.82
8. Malignant neoplasms
223
175
398
4.67
9. Septicemia
200
164
364
4.27
10. Meningitis
166
143
309
3.63
1. Pneumonia
5-9 Years
Cause
Male
Female
Both Sexes
Rate*
1. Accidents
967
574
1,541
15.37
2. Pneumonia
287
244
531
5.30
3. Malignant Neoplasms
218
141
359
3.58
4. Dengue fever and
dengue hemmorhagic
fever
153
196
349
3.48
5. Congenital anomalies
159
148
307
3.06
6. Other diseases of the
nervous system
156
143
299
2.98
7. Ill-defined and
unknown causes of
mortality
163
107
270
2.69
8. Diarrheas and
gastroenteritis of
presumed infectious
origin
141
97
238
2.37
9. Nephritis, nephrotic
syndrome and nephrosis
87
81
168
1.68
10. Meningitis
92
67
159
1.59
10-14 Years
Cause
Male
Female
Both Sexes
Rate*
1. Accidents
884
511
1,395
14.18
2. Malignant neoplasm
203
172
375
3.81
3. Pneumonia
202
162
364
3.70
4. Diseases of the heart
149
160
309
3.14
5. Other diseases of the nervous system
140
112
252
2.56
6. Ill-defined and unknown causes of mortality
148
104
2.52
2.56
7. Congenital anomalies
120
96
216
2.19
8. TB all forms
120
74
194
1.97
9. Diseases of the muscoskeletal system and
connective tissue
88
63
151
1.53
10. Dengue fever and dengue hemorrhagic fever
70
61
131
1.33
MOST COMMON CANCERS IN THE
UNITED STATES
Male
most common (by
occurrence)
Female
most common (by
mortality)
most common (by
occurrence)
most common (by
mortality)
prostate cancer (25%)
lung cancer (31%)
breast cancer (26%)
lung cancer (26%)
lung cancer (15%)
prostate cancer (10%)
lung cancer (14%)
breast cancer (15%)
colorectal cancer (10%)
colorectal cancer (8%)
colorectal cancer (10%)
colorectal cancer (9%)
bladder cancer (7%)
pancreatic cancer (6%)
endometrial cancer (7%)
pancreatic cancer (6%)
non-Hodgkin
lymphoma (5%)
liver & intrahepatic bile
duct(4%)
non-Hodgkin
lymphoma (4%)
ovarian cancer (6%)
skin melanoma (5%)
leukemia (4%)
thyroid cancer (4%)
non-Hodgkin lymphoma
(3%)
kidney cancer (4%)
esophageal cancer (4%)
Skin melanoma (4%)
leukemia (3%)
oral and pharyngeal
cancer(3%)
bladder cancer (3%)
ovarian cancer (3%)
uterine cancer (3%)
leukemia (3%)
non-Hodgkin
lymphoma (3%)
kidney cancer (3%)
liver & intrahepatic bile duct
(2%)
pancreatic cancer (3%)
kidney cancer (3%)
leukemia (3%)
brain and other nervous
system (2%)
other (20%)
other (24%)
other (22%)
other (25%)
HISTORY OF CANCER
The earliest written record regarding cancer is from 3000 BC in the Egyptian Edwin
Smith Papyrus and describes cancer of the breast. Cancer however has existed for all of
human history. Hippocrates (460 BC – 370 BC) described several kinds of cancer,
referring to them with the Greek word carcinos (crab or crayfish). This name comes from
the appearance of the cut surface of a solid malignant tumour, with "the veins stretched
on all sides as the animal the crab has its feet, whence it derives its name". The
Greek, Celsus (25 BC – 50 AD) translated carcinos into the Latin cancer, also meaning
crab and recommended surgery as treatment. Galen (2nd century AD) disagreed with
the use of surgery and recommended purgatives instead. These recommendations
largely stood for 1000 years.
In the 15th, 16th and 17th centuries, it became more acceptable for doctors to dissect
bodies to discover the cause of death. The German professor Wilhelm Fabry believed
that breast cancer was caused by a milk clot in a mammary duct. The Dutch
professor Francois de la Boe Sylvius, a follower of Descartes, believed that all disease
was the outcome of chemical processes, and that acidic lymph fluid was the cause of
cancer. His contemporary Nicolaes Tulp believed that cancer was a poison that slowly
spreads, and concluded that it was contagious.
The physician John Hill described tobacco snuff as the cause of nose cancer in
1761. This was followed by the report in 1775 by British surgeon Percivall Pott that
cancer of the scrotum was a common disease among chimney sweeps. With the
widespread use of the microscope in the 18th century, it was discovered that the 'cancer
poison' spread from the primary tumor through the lymph nodes to other sites
("metastasis"). This view of the disease was first formulated by the English surgeon
Campbell De Morgan between 1871 and 1874.
RISK FACTORS:
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Heredity
Age
Gender
Poverty
Stress
Diet
Occupation
Infection
Tobacco use
Alcohol use
Recreational drug use
Obesity
Sun exposure
RISK FACTORS:
1)
2)
Heredity (5%-10%) – familial history of breast,
colon, lung, ovarian and prostate cancers
Age – 76% of cancer diagnoses occur after age
55
- Long-term exposure to high doses of
promotional agents
- Immune response alters with aging
- Free radicals (molecules resulting from the
body’s metabolic and oxidative processes) tend to
accumulate in the cells overtime, causing
damage and mutation
RISK FACTORS:
- Hormonal changes: Postmenopausal women
receiving exogenous estrogen have an increased
risk for breast and uterine cancers; Older men are
at risk for prostate cancer, possibly due to
breakdown of testosterone into carcinogenic forms
- Severe or cumulative losses: death of a
spouse or friends, loss of position and status in
the society, and a decline in physical abilities
3) Gender – Females: breast and thyroid cancers;
Males: prostate and bladder cancers
RISK FACTORS:
4) Poverty – the poor are at higher risk for cancer
- Major factor: inadequate access to health
care, diet and stress
5) Stress – continuous unmanaged stress that
keeps hormones such as epinephrine and cortisol
at high levels can result in systematic “fatigue”
and impaired immunologic surveillance
Stages:
A) Alarm Reaction – adrenal hormones
increases allowing the body to cope to the
stressors
RISK FACTORS:
B) Stage of Resistance – stress hormones
are reduced indicating that adaptation had
occurred; if the stressor is managed, the body
returns to the prealarm functioning
C) Stage of Exhaustion – it results in
general wear-and-tear and depression of the
immune system; depression is a major risk
factor especially if it is chronic or related to
multiple or major losses
RISK FACTORS:
6) Diet – some foods are genotoxic like nitrosamines and
nitrous indoles found in preserve meats and pickled, salted
foods.
- high-fat low fiber foods – promote colon, breast sexhormone dependent tumors
- excessive fried or boiled fish and meat – has a potent
carcinogenic compound that may cause tumors in the
mammary glands, colon, liver, pancreas and bladder
- fat or fry foods in high temperature – produces high
levels of polycyclic hydrocarbons
- others: sodium saccharine, red food dyes and both
regular and decaffeinated coffee
RISK FACTORS:
7) Occupation – farmers and construction
workers are exposed to solar radiation
- healthcare workers (xray technicians and
biomedical researchers) are exposed to ionizing
radiation and carcinogenic substances
- people working in an old building are
exposed to asbestos (walls)
8) Infection – some viruses are linked to cancer
(eg. Epstein-Barr virus)
RISK FACTORS:
9) Tobacco Use – lung cancer is considered highly
preventable because of its relationship to the smoking
- large dose and longer use increases risk for
developing cancers like cancers in oropharyngeal,
esophageal, laryngeal, gastric, pancreatic and bladder
- additional research has documented the
deleterious effects of the secondhand tobacco smokers
- tobacco-specific nitrosamines were recovered in
the urine of children living with smokers
RISK FACTORS:
10) Alcohol Use – enhancing contact between
carcinogens such as those in tobacco
11) Recreational Drug Use – drug users often do
not maintain adequate nutrition (marijuana)
12) Obesity – linked to increase risk of hormonaldependent cancer (breast, bowel, ovary,
endometrium and prostate)
13) Sun Exposure – light colored person are
prone to cancer