Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Neoplasia Oncology defined • Branch of medicine that deals with the study, detection, treatment and management of cancer and neoplasia “Root words” • Neo- new • Plasia- growth Neoplasia Uncontrolled growth of Abnormal cells • 1. Benign • 2. Malignant • 3. Borderline Characteristics of Neoplasia • • • • • • BENIGN Well-differentiated Slow growth Encapsulated Non-invasive Does NOT metastasize Characteristics of Neoplasia • • • • • • MALIGNANT Undifferentiated Erratic and Uncontrolled Growth Expansive and Invasive Secretes abnormal proteins METASTASIZES leiomyomas adenoma adenocarcinoma carcinoma Nomenclature of Neoplasia Tumor is named according to: 1. Parenchyma, Organ or Cell • Hepatoma- liver • Osteoma- bone • Myoma- muscle Nomenclature of Neoplasia Tumor is named according to: 2. Pattern and Structure, either GROSS or MICROSCOPIC • Fluid-filled CYST • Glandular ADENO • Finger-like PAPILLO • Stalk POLYP BENIGN TUMORS • • • • • • Suffix- “OMA” is used Adipose tissue- LipOMA Bone- osteOMA Muscle- myOMA Blood vessels- angiOMA Fibrous tissue- fibrOMA MALIGNANT TUMORnomenclature Glandular, Epithelial • Use the suffix- “CARCINOMA” • Pancreatic AdenoCarcinoma • Squamos cell Carcinoma MALIGNANT TUMOR 2. connective tissue origin • Use the suffix “SARCOMA • FibroSarcoma • Myosarcoma • AngioSarcoma “OMA” but Malignant – HepatOMA, lymphOMA, gliOMA, melanOMA dysplasia • denotes a loss of architectural organization and a loss of cell uniformity in epithelium • mild to moderate dysplasia is potentially reversible dysplasia normal epithelium dysplasia • Dysplasia is a non-neoplastic proliferation. • Dysplasia may or may not progress to cancer. differentiation • Well-differentiated tumors contain cells that resemble the normal cells of origin • poorly-differentiated or undifferentiated tumors contain cells that do not resemble their normal counterparts (ancillary studies may be needed to determine the cell of origin) well-differentiated poorly-differentiated • Benign tumors are composed of welldifferentiated cells. • Malignant tumors are characterized by a wide range of cellular differentiation. rate of growth • In general, well-differentiated malignant tumors have a slower rate of growth than poorly-differentiated malignant tumors. • There are exceptions. Blood supply, site, and hormonal stimulation are factors that can affect the growth rate of tumors. meningioma basal cell carcinoma melanoma metastasis • Distant spread of the tumor • Methods of metastasis include: lymphatic spread, and hematogenous spread. metastatic ovarian carcinoma MRI: metastatic adenocarcinoma metastatic adenocarcinoma Spread of Cancer • 1. LYMPHATIC • Most common • 2. HEMATOGENOUS – Blood-borne, commonly to Liver and Lungs • 3. DIRECT SPREAD – Surrounding organs Spread of cancer • Cancers commonly spread t bone,lungs liver and brain(secondary deposits) Cancer Diagnosis • 1. BIOPSY – The most definitive • 2. CT, MRI • 3. Tumor Markers grading and staging • Grading is based on the microscopic features of the cells which compose a tumor and is specific for the tumor type. • Staging is based on clinical, radiological, and surgical criteria, such as, tumor size, involvement of regional lymph nodes, and presence of metastases. Staging usually has prognostic value. Cancer Grading The degree of DIFFERENTIATION • Grade 1- Low grade • Grade 4- high grade Cancer Staging 1. Uses the T-N-M staging system • T- tumor • N- Node • M- Metastasis GENERAL MEDICAL MANAGEMENT • • • • • 1. Surgery- cure, control, palliate 2. Chemotherapy 3. Radiation therapy 4. Immunotherapy 5. Bone Marrow Transplant • • • • GENERAL Promotive and Preventive 1. Lifestyle Modification 2. Nutritional management 3. Screening 4. Early detection SCREENING • 1. Male and female- Occult Blood, CXR, and DRE • 2. Female-, Mammography and Pap’s Smear • 3. Male- DRE for prostate, Testicular self-exam Cancer –causes Etiology of cancer 1. PHYSICAL AGENTS • Radiation • Exposure to irritants • Exposure to sunlight • Altitude, humidity Etiology of cancer 2. CHEMICAL AGENTS • Smoking • Dietary ingredients • Drugs Etiology of cancer 3. Genetics and Family History • Colon Cancer • Premenopausal breast cancer Etiology of cancer 4. Dietary Habits Low-Fiber High-fat Processed foods alcohol Etiology of cancer 5. Viruses and Bacteria • DNA viruses- Hep, Herpes, EBV, CMV, Papilloma Virus • RNA Viruses- HIV, • Bacterium- H. pylori Etiology of cancer • 6. Hormonal agents OCP especially estrogen Etiology of cancer • 7. Immune Disease • AIDS Proposed Molecular cause of CANCER: • Change in the DNA structure altered DNA function Cellular aberration neoplastic change • • • • • CARCINOGENSIS Malignant transformation IPP Initiation Promotion Progression CARCINOGENSIS • INITIATION • Carcinogens alter the DNA of the cell • Cell will either die or repair • • • • CARCINOGENSIS PROMOTION Repeated exposure to carcinogens Abnormal gene will express Latent period CARCINOGENSIS • PROGRESSION • Irreversible period • Cells undergo NEOPLASTIC transformation then malignancy Colon cancer COLON CANCER • • • • • • • Risk factors 1. Increasing age 2. Family history 3. Previous colon CA or polyps 4. History of IBD 5. High fat, High protein, LOW fiber 6. Breast Ca and Genital Ca COLON CANCER • Sigmoid colon is the most common site • Predominantly adenocarcinoma • If early 90% survival COLON CANCER • PATHOPHYSIOLOGY • Benign neoplasm DNA alteration malignant transformation malignant neoplasm cancer growth and invasion metastasis (liver) COLON CANCER ASSESSMENT FINDINGS 1. Change in bowel habits- Most common • 2. Blood in the stool • 3. Anemia • 4. Anorexia and weight loss • 5. Fatigue • 6. Rectal lesions- tenesmus, alternating D and C Colon cancer • • • • • Diagnostic findings 1. Fecal occult blood 2. Sigmoidoscopy and colonoscopy 3. BIOPSY 4. CEA- carcino-embryonic antigen Colon cancer • • • • • Complications of colorectal CA 1. Obstruction 2. Hemorrhage 3. Peritonitis 4. Sepsis Colon cancer • MEDICAL MANAGEMENT • 1. Chemotherapy- 5-FU • 2. Radiation therapy Colon cancer • • • • SURGICAL MANAGEMENT Surgery is the primary treatment Based on location and tumor size Resection, anastomosis, and colostomy (temporary or permanent) Colon cancer NURSING INTERVENTION Pre-Operative care • 1. Provide HIGH protein, HIGH calorie and LOW residue diet • 2.Provide information about post-op care and stoma care • 3. Administer antibiotics 1 day prior Breast Cancer • The most common cancer in FEMALES • Numerous etiologies implicated Breast Cancer RISK FACTORS • 1. Genetics- BRCA1 And BRCA 2 • 2. Increasing age ( > 50yo) • 3. Family History of breast cancer • 4. Early menarche and late menopause • 5. Nulliparity • 6. Late age at pregnancy Breast Cancer RISK FACTORS • 7. Obesity • 8. Hormonal replacement • 9. Alcohol • 10. Exposure to radiation Breast Cancer PROTECTIVE FACTORS • 1. Exercise • 2. Breast feeding • 3. Pregnancy before 30 yo Breast Cancer ASSESSMENT FINDINGS • 1. MASS- the most common location is the upper outer quadrant • 2. Mass is NON-tender. Fixed, hard with irregular borders • 3. Skin dimpling • 4. Nipple retraction • 5. Peau d’ orange Breast Cancer • LABORATORY FINDINGS • 1. Biopsy procedures • 2. Mammography Breast Cancer • • • • • • Breast cancer Staging TNM staging I - < 2cm II - 2 to 5 cm, (+) LN III - > 5 cm, (+) LN IV- metastasis Breast Cancer • • • • MEDICAL MANAGEMENT 1. Chemotherapy 2. Tamoxifen therapy 3. Radiation therapy Breast Cancer • SURGICAL MANAGEMENT 1. Radical mastectomy 2. Modified radical mastectomy 3. Lumpectomy 4. Quadrantectomy Thank you…