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Chapter 40
Cancer, Immune System,
and Skin Disorders
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Cancer
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Cells reproduce for tissue growth and repair.
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Cell division and growth are sometimes out of
control.
• A mass or clump of cells develops. This new growth of
abnormal cells is called a tumor.

Tumors are benign or malignant.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 2
Cancer (cont’d)
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Benign tumors
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Do not spread to other body parts
Can grow to a large size, but rarely threaten life
Usually do not grow back when removed
Malignant tumors (cancer)

Invade and destroy nearby tissue
 Can spread to other body parts
 May be life-threatening
 Sometimes grow back after removal
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 3
Cancer (cont’d)

Metastasis is the spread of cancer to other
body parts.
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Cancer cells break off the tumor and travel to
other body parts.
New tumors grow in other body parts.
Cancer can occur almost anywhere.
Cancer is the second leading cause of death
in the United States.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 4
Cancer (cont’d)
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The National Cancer Institute describes these risk
factors:
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Growing older
• Most cancers occur in persons over 65 years of age.
Tobacco
Sunlight
Ionizing radiation
Certain chemicals and other substances
Some viruses and bacteria
Certain hormones
Family history of cancer
Alcohol
Poor diet, lack of physical activity, and being overweight
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 5
Cancer (cont’d)
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Treatment depends on:
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The tumor type
Tumor site and size
If the tumor has spread
The treatment goal may be to:

Cure the cancer.
 Control the disease.
 Reduce symptoms for as long as possible.

Some cancers respond to one type of
treatment.

Others require two or more types.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 6
Cancer (cont’d)
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Surgery removes tumors.
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It is done to cure or control cancer.
It relieves pain,
Radiation therapy (radiotherapy)
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Destroys certain tumors
Shrinks a tumor before surgery
Destroys cancer cells that remain after surgery
Controls tumor growth to prevent or relieve pain
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 7
Cancer (cont’d)

Chemotherapy involves drugs that kill cells.
It is used to:
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Shrink a tumor before surgery
Kill cells that break off the tumor
Relieve symptoms caused by the cancer
Side effects depend on the drug used.

Hair loss (alopecia)
 Gastro-intestinal irritation
 Decreased blood cell production
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 8
Cancer (cont’d)
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Hormone therapy prevents cancer cells from
getting or using hormones needed for their
growth.
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Drugs are given to prevent the production of
certain hormones.
Organs or glands that produce a certain hormone
are removed.
Biological therapy (immunotherapy) helps
the immune system fight the cancer.
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It also protects the body from the side effects of
cancer treatments.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 9
Cancer (cont’d)
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Other therapies
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Stem cell transplants
• A stem cell is a cell from which new cell types develop.

•
Some persons need high doses of chemotherapy or
radiation therapy.
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The new cells have certain functions (blood cells, brain cells,
bone cells).
Such therapies kill cancer cells and blood cells in the bone
marrow.
Fewer blood cells are produced.
• A person is given blood-forming stem cells.
• New blood cells develop from the stem cells.
Complementary and alternative medicine (CAM)
• Used along with standard cancer treatments
• Used instead of standard cancer treatments
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 10
Cancer (cont’d)
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Persons with cancer have many needs, including:
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Pain relief or control
Rest and exercise
Fluids and nutrition
Preventing skin breakdown
Preventing bowel problems
Dealing with treatment side effects
Psychological and social needs
Spiritual needs
Sexual needs
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 11
Immune System Disorders
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The immune system
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Protects the body from microbes, cancer cells,
and other harmful substances
Defends against threats inside and outside the
body
Immune system disorders occur from
problems with the immune response.
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The response may be inappropriate, too strong,
or lacking.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 12
Immune System Disorders (cont’d)
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Autoimmune disorders can occur.
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The immune system attacks the body’s own normal
cells, tissues, or organs.
One of the following may occur.
• One or more types of body tissues are destroyed.
• An organ grows abnormally.
• There is a change in how an organ functions.
Common autoimmune disorders include
• Graves’ disease (the most common form of
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hyperthyroidism)
Lupus (an inflammatory disease that affects the blood
cells, joints, skin, kidneys, lungs, heart, or brain)
Multiple sclerosis
Rheumatoid arthritis
Type 1 diabetes
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 13
Immune System Disorders (cont’d)
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Signs and symptoms depend on the type of disease.
• Fatigue, dizziness, not feeling well, and fever are
common.
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Most autoimmune disorders are chronic.
Treatment depends on the:
• Type of disorder
• Tissues and organs affected
Treatment is aimed at:
• Reducing symptoms
• Controlling the autoimmune response
• Maintaining the body’s ability to fight disease
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 14
Immune System Disorders (cont’d)
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Acquired immunodeficiency syndrome (AIDS)
is caused by the human immunodeficiency
virus (HIV).
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HIV attacks the immune system.
HIV is spread through body fluids (blood, semen,
vaginal secretions, and breast milk).
HIV is transmitted mainly by:
• Unprotected anal, vaginal, or oral sex with an infected
person

•
•
“Unprotected” means without a new latex or polyurethane
condom.
Needle and syringe sharing among IV drug users
HIV-infected mothers
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 15
Immune System Disorders (cont’d)
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HIV cannot:
• Live outside the body
• Be spread by casual, everyday contact
• Be transmitted by food prepared by the infected person
Some HIV-infected persons have symptoms
within a few months.
• Others are symptom-free for more than 10 years.
(They carry the virus and can spread it to others.)

The person with AIDS can develop other health
problems.
• The immune system is damaged.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 16
Immune System Disorders (cont’d)
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The person with AIDS is at risk for:
• Pneumonia
• Tuberculosis
• Kaposi’s sarcoma (a cancer)
• Nervous system damage
Many new drugs
• Help slow the spread of HIV in the body
• Reduce complications
• Prolong life
You may care for persons with AIDS or those
who are HIV carriers.
• Protect yourself and others.
• Follow Standard Precautions and the Bloodborne
Pathogen Standard.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 17
Skin Disorders
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Shingles (herpes zoster)
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Shingles is caused by the same virus that causes
chickenpox.
 The virus lies dormant (inactive) in nerve tissue.
 The virus can become active years later.
 Persons at risk include those who:
• Are over 50 years of age
• Have had chickenpox
• Have weakened immune systems
 The doctor orders anti-viral drugs and drugs for
pain relief.
 A vaccine is now available to prevent shingles.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Slide 18