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Transcript
Med/Surg-2015
CANCER
CANCER
 Oncology
is the specialty dealing with
cancer and treatment
CANCER DEVELOPMENT
 Characterized
by growth of cells that do
not have normal cellular function and may
occur in any tissue
 Can occur at any age, however there are
some cancers that only affect a certain
age group
 Tumors/neoplasms-Arise from normal
tissue
BENIGN

Benign tumors have slower growth, they
are encapsulated, composed of
differential cells, and they don’t
metastasize
MALIGNANT
Malignant tumors invade surrounding tissue
 These tumors have rapid growth and
replication, non-encapsulated which allows
them to invade, made up of anaplastic cells
that do not function like normal cells from
where they originate, malignant tumors send
abnormal cells to other sites via the blood or
lymphatic system

 Secondary
sites will also eventually grow into
malignant tumors
TYPES OF TUMORS


Histology-study of tissue
Carcinomas-largest
 Make
up about 90% of malignancies
 Develop from epithelial tissue (skin, GI sx, urinary
sx, repro organs, and glands)*

Sarcomas
 >5% of malignant tumors
 Arise from connective tissues (cartilage, bone,
muscle, fat, bone marrow and lymphatic
system) includes gliomas and neuroblastomas
of the brain,
 Ewing’s sarcoma-affects diaphysis with mets to
lung
 ages 4-25
 Dx: CT scan
 Tx: chemo/radiation
TYPES OF TUMORS

Leukemia


Blastoma


Originates in bone marrow
Malignant tumors of immature or embryonic tissue
Mixed-Tissue Tumor


Less common
Develop from epithelial and connective tissues; Wilm’s
tumor
CARCINOGENESIS AND CARCINOGENS





Carcinogenesis-transformation of normal cell into
malignant cell
Disruption occurs with DNA replication during
mitosis
The new protein production is damaged, resulting in
growth of cancerous cells
RNA then sends messages to develop more
abnormal proteins
Carcinogens-cause damage to DNA that leads to
development of cancer





Box 83-1**
Laryngeal cancer-from cigarettes and ETOH*
80% of cancers d/t smoking, diet, ETOH and
environmental factors such as radiation, chemicals
DNA can carry an oncogene (cancer-causing gene)
which is activated by mutation
Heredity may transfer defective DNA through sperm
or egg cells
CANCER GRADING AND STAGING
 Primary
site is the place where the
cancer starts
 Cancer in situ refers to tumor cells that
have not invaded surrounding tissue
 Evidence of metastasis to distant or
secondary sites
 Grading is a system that looks at
abnormal cells under a microscope to
determine the cells’ degree of
differentiation or lack of maturity
CANCER GRADING
 Grade
I-resemble normal cells, better
prognosis
 Grade II or III-intermediate phases of
differentiation, cells could be slightly to
extremely abnormal
 Grade IV or V-anaplastic tumor, little to no
resemblance to the tissue cells from which
they develop
STAGING



Identifies the spread of a tumor**
Box 83-3*
The tumor, node, and metastasis system is
called the TNM system of staging.
 Tumor size
 Local invasiveness
 Extent of lymph node involvement
 Each category uses a range from 0-4 or AD
A tumor T3N4M1 is a large tumor, with
node involvement and metastasis*
A tumor T1N0M0 is small without node
involvement or metastasis*
INCIDENCE
Cancer is second only to heart disease as the
major cause of adult deaths in the United
States.
 All cancers result from a mutation of genes that
causes malfunction of cell growth and division.
 Occurrence increases as an individual ages.
 Leading causes of cancer deaths: lung cancer
(both men and women)**, breast cancer,
prostate cancer, colorectal cancer

PREVENTION AND EARLY DETECTION
Reduce smoking, intake of total dietary fats and calories
Decrease total sun exposure
Avoid artificial sources of ultraviolet light
Perform self-examination for early detection of breast or prostate
cancers
Maintain routine and consistent exercise
Improve screening rates for breast, prostate, colorectal cancer
Improve educational strategies related to tobacco cessation and diet


SEE WARNING SIGNALS FOR CANCER
“CAUTION”
CANCER SCREENING GUIDELINES


Box 83-2
Breast Cancer



Women with increased family risk should start
mammograms/ultrasounds earlier
BSE by ACS recommends an up and down vertical pattern**
May be placed on doxorubicin hcl
Side effects include: left ventricular failure, complete alopecia 3-4
weeks, red discoloration of urine**
 *Myelosuppression may occur: teach patient to avoid those who
have recently been vaccinated or crowded areas, activities that may
cause bleeding, wash hands

TYPES OF MASTECTOMIES




Simple or total mastectomy: removal of the breast, with its skin and
nipple, but no lymph nodes. In some cases, a separate sentinel node
biopsy (sentinel node is the first node to receive drainage from a
cancer containing area of the breast) is performed to remove only the
first one to three axillary (armpit) lymph nodes.
Modified radical mastectomy; This procedure is a simple
mastectomy and removal of axillary (underarm) lymph nodes
Radical mastectomy:the entire breast, axillary lymph nodes, and
the pectoral (chest wall) muscles under the breast.
Imaginis Corporation (2008). Mastectomy. Retrieved on January 9, 2009 from
http://www.imaginis.com/breasthealth/sentinelnode.asp
MASTECTOMY



Possible side effects: As with other operations, pain, swelling,
bleeding, and infection are possible.
The main possible long-term effect of removing axillary lymph
nodes is lymphedema (swelling of the arm). This occurs
because any excess fluid in the arms normally travels back into
the bloodstream through the lymphatic system. Removing the
lymph nodes sometimes causes this fluid to remain and build
up in the arm.
American Cancer Society. (2008). Surgery for breast cancer. Retrieved January 9, 2009 from
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_5.asp?sitearea=
LYMPHEDEMA


Immediately after surgery, the affected arm or
breast area may swell. This swelling is usually
temporary and gradually disappears over the next 6
to 12 weeks
Avoiding Infection:
 Whenever possible, have your blood drawn, IVs,
and injections given in your unaffected arm.
 Keep your arm clean
 If necessary, use an insect repellent when
outdoors to avoid bug bites. If you get stung by a
bee in the affected arm, clean and elevate the
arm, apply ice, and contact your doctor or nurse
if it becomes infected
American Cancer Society. (2007). Lymphedema: What every woman with breast cancer should know. Retrieved January 9,
2009 from http://www.cancer.org/docroot/MIT/content/MIT_7_2x_Lymphedema_and_Breast_Cancer.asp
CANCER SCREENING GUIDELINES

Colorectal cancer


Start early or performed more frequently if they have
Crohn’s disease or inflammatory bowel disease
Cervical Cancer




Age 21 or about 3 years after they begin having vaginal
intercourse-have a regular pap test
Age 30, should have a pap test q 2-3 years if they have had
3 normal Pap tests in a row
Over 30, screened for PAP plus the HPV test
Post-menopausal, painless vaginal bleeding could be a sign
of uterine cancer**
FEMALE REPRODUCTIVE CANCERS
 Endometrial
Cancer
report any unexpected bleeding or spotting post
menopausal**
 Ovarian cancer
s/s-pelvic pain radiating to the thighs
Stages on next slide
OVARIAN CANCER STAGES


Stage I-The cancer is only within the ovary (or ovaries)
or fallopian tube(s). It has not spread to organs and
tissues in the abdomen or pelvis, lymph nodes, or to
distant sites.
*Stage II-The cancer is in one or both ovaries or
fallopian tubes and has spread to other organs (such
as the uterus, fallopian tubes, bladder, the sigmoid
colon, or the rectum) within the pelvis. It has not
spread to lymph nodes or distant sites.
 (American Cancer Society, 2015)
OVARIAN CANCER STAGES
Stage III-The cancer is in one or both ovaries or
fallopian tubes, and one or both of the following
are present:has spread beyond the pelvis to the
lining of the abdomenhas spread to lymph nodes
in the back of the abdomen (retroperitoneal lymph
nodes)
 Stage IV (any T, any N, M1)This is the most
advanced stage of ovarian cancer. In this stage the
cancer has spread to the inside of the spleen,
liver, lungs, or other organs located outside the
peritoneal cavity.


(American Cancer Society, 2015)
DIAGNOSTIC TEST

Cytology-study of cells
 Cytologic
examination is done on
 Sputum, bronchial washings, vaginal and cervical
secretions, prostatic secretions, pleural secretions,
and gastric washings
 Used most often to detect cervical cancer
 Pap test
LABORATORY TESTS

Tumor markers-specific enzymes, cancer
antigens that can indicate malignancies
 Found
in blood (enzymes, antigens, hormones,
misc. markers)
 EX.
–Philadelphia chromosome-CML*
 Ex-PSA-prostate cancer*
 Useful
to monitor tumor response to treatment
 Detect cancer recurrences
 Additional test may be needed: x-rays, CT, MRI and
ultrasound.
NONINVASIVE DIAGNOSTIC PROCEDURES






Radiology – Visualize body’s internal structures
Mammograms – detect abnormal cellular
growth in the breast
CT scan-sectional views of body structures,
useful for tumors of the chest, brain, and
abdominal cavity
Ultrasonography – uses sound waves to specific
tissues, useful for pelvic, retroperitoneal and
peritoneal tumors
MRI – detailed sectional images of the body
without ionizing radiation, can stage malignant
disease in the CNS, spine, head, neck, muscular
system.
Bone Scan
INVASIVE DIAGNOSTIC TECHNIQUES
Endoscopy
 Exploratory surgery and biopsy
 Biopsy is the single most important to test Dx
cancer

MOST ACCURATE!!
 Lymph node biopsy may be done to see if CA has
metastasized!!**


Frozen section – during biopsy, specimen is
removed and the tissue is frozen and sliced thin,
pathologist studies the specimen and reports
results
TREATMENT MODALITIES

Surgery
 Ideal treatment: complete removal
of malignant tissues
 Incisional tissue biopsy-helps with
Dx and staging
 Excisional biopsy – removes tumor
and a small margin around the
tumor
 Cryosurgery – malignant tissues are
spread
 Electrocauterization-burned
SURGERY
Fulguration – destroyed by high-frequency
current
 En bloc resection – removal of the tumor,
surrounding tissues and lymph nodes
 Exenteration – removal of tumor, organ
involved and surrounding tissue

SURGERY



Laser surgery – excise areas of tumors
Laser induced interstitial thermotherapy (LITT) – shrinks or
destroys tumor with hear; can be curative or palliative
Photodynamic therapy (PDT) – chemical introduced into
body and remains in or around the tumor cell vs. normal
cells; used mainly on tumors under that skin or lining the
internal organs that can be reached be fiberoptic
instruments or endoscope. The client must remain
indoors out of the sun for 6 weeks after therapy
SURGERY



Prophylactic surgery – used for tumors that
are known or suspected to be precancerous
Palliative surgery – performed to relieve
some of the complications of malignancies;
goal is to promote client comfort and quality
of life.
Bone Marrow Transplant (BMT) – replaces
stem cells that develop into blood cells.
Obtained from the hip or sternum using
small incisions and large bore needles.



Autologous – from client
Syngeneic – twin
Allogeneic – another person
BONE MARROW/STEM CELL TRANSPLANT






Autologous-self
Syngeneic-twin
Allogeneic –other person
Donated bone marrow is matched to the client’s tissuehuman leukocyte-associated antigen (HLA) on the surface
of WBC’s
Stem cells (immature cells) are found in peripheral blood,
umbilical cord blood, amniotic fluid and peripheral blood
stem cells
Peripherally obtained by aphaeresis-removal through a
large vein and sent to special collection filters in a
machine where they are harvested and frozen until
needed
BONE MARROW/STEM CELL TRANSPLANT
Client will receive the donated bone marrow
after chemo/radiation. Successful transplants
can offer full recovery in 6-12 months
 Risk of GVH RXN from donor marrow –

 Donated
marrow attacks tissues like liver, skin, GI
tract
 observe for development of skin rash
 Drugs are given to suppress this reaction
CHEMOTHERAPY


Goal of Chemo – cure or provide palliation if cancer is
not curable
Chemotherapy – using chemical agents to destroy
cancer cells; goal is to damage the DNA in these
abnormal cells and cause apoptosis (Self-destruction)


Can destroy normal cells*
Tx indications:





Widespread or metastic disease
Provide cure for certain types of cancer
*Temporarily control tumor-related difficulties; not a cure
Adjuvant (assistive) therapy after surgery to prevent
metastasis from occurring
**Palliative chemo-prolongs life and reduces incapacitating
sx’s
CHEMOTHERAPEUTIC AGENTS
Alkylating agents
 Antibiotics
 Antimetabolites
 Antimitotics
 Hormonal agents
 Are caustic substances and if they infiltrate will
cause extravasation. If this occurs:

 **Stop
medication, follow facilty policy, notify MD,
implement MD orders, document all s/s, and
monitor client closely
CHEMOTHERAPEUTIC AGENTS

Actions:





Affect cells that rapidly proliferate
Malignant neoplasms or cancerous tumors usually consist
of rapidly proliferating cells
Cancer cells have no biological feedback controls that stop
their aberrant growth or proliferation
Cancer cells are sensitive to antineoplastic drugs when the
cells are in the process of growing or dividing
Chemo is administered at the time the cell population is
dividing to optimize cell death
ACTIONS CONT….
 Chemo
is administered in cycles to allow recovery of the
normal cells and to destroy malignant cells
 Cell kill theory: 90% of the cancer cells should be killed
during the first course of treatment, second course of tx
targets the remaining cells and reduces these cells by
90%, continued courses of chemo reduces the # of
cancer cells until all cells are killed
 Every cancerous cell must be killed to be cured;
requiring repeated chemo courses
BIOTHERAPY (IMMUNOTHERAPY)
uses the body’s defenses against tumor cells
 Biologic response modifiers (BRM)-produced by
normal cells to repair, stimulate, or enhance
substances in the immune system to hopefully
kill cancer cells

BIOTHERAPY

CSF-part of hematopoietic growth factors that
encourage growth and maturation of blood cell
components
 If
successful, myelosuppression is reduced and the
client can receive higher doses of chemotherapy
agents
BIOTHERAPY


•
•
•
•
BRM’s produced in a lab include: Monoclonal antibodies,
Interferons, Colony-stimulating factors, Interleukins,
Retinoids
MOAB-produced by fusing cancer cells and normal cells
Specific antibodies to seek out and bind to specific
targets on cancer cells
Able to improve immune response to cancer and
interfere with normal cells
Currently used for renal transplant rejections
**Nursing Interventions: monitor for anaphylactic
reactions (MOAB’s), flushing, pallor, resp. distress,chills,
fever, diaphoresis, urticaria, n/v, hypotension
BIOTHERAPY

Interferons-made by lymphocytes to enhance
immune system
3
types: alpha, beta and gamma
 protect normal cells from parasitic invasion or
viruses
 appear to induce antitumor activity
 Nursing interventions: teach side effects of flu-like
such as fever, fatigue, chills, h/a, myalgia
HEMATOPOIETIC GROWTH FACTORS
Consist of substances that have the ability to
support tissues that are involved in the
production of blood, bone marrow and lymph
nodes
 3 main groups

 CSF
 Interleukin
3
 erythropoietin
INTERLEUKINS

Promote immune response of the T
lymphocytes to stimulate the immune system to
destroy neoplasms
BIOTHERAPY

Retinoids-derived from retinol or vitamin A
 Effect
of retinoids -antibody and immune responses
to suppress proliferation
 Retinoic acid syndrome-side effect; s/s: respiratory
distress, pleural effusions, weight gain
NURSING CONSIDERATIONS FOR CLIENTS
WITH CANCER
Diagnostic procedures and treatments
can be uncomfortable to intolerable
 Will need support after treatment d/t
side effects, especially depression
 Preop and postop teaching
 Allow clients to participate in their
treatment

CHEMOTHERAPY

Nurses need special training to administer and
monitor for side effects
 Safe
handling procedures, drugs extremely toxic
 Some can be administered orally
 Parenteral chemo must take special precautionssee book!!
Chemo induces vomiting by stimulating
neuroreceptors in the medulla
Anticipatory n/v may occur before chemo*
CHEMOTHERAPY ADMINISTRATION




Oral, IM, intracavitary, IV, intraperitoneal, intra-arterial,
intrapleural, topical
Intra-arterially access usually requires vascular access
devices such as PIC, PICC, central venous access
device, external catheters, infusion pump
**Maybe infused intermittently to enhance the kill
rate of cancer cells
**Chemo does not differentiate between normal and
abnormal cells
RADIATION THERAPY

May be used as primary therapy, combined with
chemo, or palliative tx





Reduces tumor size*
Directs ionizing radiation to target tissues for damage
or destruction of the cells
*Kills cells by preventing their ability to reproduce
Radiation does damage normal and abnormal cells
3 types of rays involved


alpha and beta penetrate the upper layer of the skin
gamma penetrate deeply into body tissues
RADIATION THERAPY

Safety when dealing with radiation: TIME,
DISTANCE, AND SHIELDING
 Employees in radiation dept. must wear
special badges that monitor radiation
exposure
RADIATION THERAPY

2 main types of radiation: using an internal or external
radiation beam
 External-given by machines called linear acceleratorsradiation aimed at cancer but most pass through normal
cells
 monitor side effects-decreased appetite, abd. Cramping,
diarrhea and cutaneous irritation , nausea, dysphagia,
bone marrow suppression**
Nursing Care-aimed at ensuring client and staff safety,
keeping healthy cells from hazards
Do Not wipe off ink marks!!
Avoid using creams and powders on irradiated skin
(increases irritation) use only tepid water
*if skin is red and warm 2 weeks after tx-notify MD!!
RADIATION THERAPY

Internal Radiation




placing radioactive substances directly into a tumor
delivers large amounts of radiation to destroy cancer cells
within
radioactive sources are encapsulated so as not to
contaminate body fluids
treat areas such as brain, tongue, breast, vagina, rectum,
prostate, etc.
RADIATION THERAPY
Explain procedure
 Area treated will not feel hot, notify MD if you
observe this
 Radioactive iodine may be given for thyroid
cancer-body fluids will be radioactive for a short
time
 Teach side effects
 Teach care of skin: Box 83-1 in book pg. 1385

MANAGEMENT OF SIDE EFFECTS

N/V
 Some
clients will postpone or forego treatments
 Antiemetics
 Guided imagery
 distraction
 Massage
MANAGE SIDE EFFECTS

Stomatitis or mucositis common
Avoid ETOH or foods that cause irritation
 Avoid flossing or using ETOH containing
products
 Rinse mouth after eating and at bedtime
 *use soft brush when cleaning the teeth and
rinse the mouth thoroughly after meals and at
bedtime
 MD may order a swish and swallow
preparation-do so in small amounts, the
mixture will anesthetize the throat and may
cause difficulty in swallowing, talking or even
breathing*

MANAGE SIDE EFFECTS
 Fatigue
After
pain, the second most distressing
symptom reported*
*due
assess
to chemo decreasing RBC’s
nutrition, rest, work,
psychological distress, you should
increase fluids and seek medical
management
MANAGE SIDE EFFECTS

Alopecia
 can occur in eyelashes, eyebrows, pubic and
body hair
 Affects
all frequently dividing cells (including cells of the
hair follicles in addition to cancerous cells)*
 encourage
wigs, purchase prior to losing hair
(can obtain similar color to hair and style)
 avoid harsh chemicals
 use mild shampoos
 monitor for emotional side effects
MANAGE SIDE EFFECTS

Secondary Infections
 WBC count is depressed (neutropenic
isolation)
 Teach to avoid activities that could injure
 Don’t take rectal temps, allow use of razor
blades, etc.
 Avoid persons and places with increased risk
for infection!
WASH
HANDS-STAFF AND VISITORS!!
MANAGE SIDE EFFECTS
 Pain
R/T
disease, treatment or procedures
Monitor pain level!!! Give round the
clock pain meds
Prevent, rather than tx pain!!
MANAGE SIDE EFFECTS
 Stress
Use
therapeutic visualization or guided
imagery
Provide diversional activities
MANAGE SIDE EFFECTS

Hormone-Related Effects
 Women who take tamoxifen for breast cancer
may experience menopause like sx’samenorrhea, hot flashes, insomnia and
depression*
 Tx: herbal products (check with MD first),
clonidine, or other combo drugs could be
useful
NUTRITIONAL NEEDS
Cancer can deplete proteins
 cachexia
 **Diet needs to be high in protein, CHO and
vitamins
Monitor for taste changes, supplements may
be needed
 Alternate forms of fluids, such as popsicles, or
foods such as liquid supplements can be helpful*
 Recommend drinking fluids after meals*
 Assess for cultural dietary practices

CLIENT AND FAMILY TEACHING
Self-exams
 Sign

 Can

be seen by someone else
Symptom
 Noticed
by the client like fatigue, nausea, malaise
If a patient is going to receive Hospice care
 The focus is on controlling the symptoms and
relieving pain, uses a multidisciplinary approach,
and bereavement care is provided to the family**
 *should have advance directives in place
HODGKIN’S DISEASE
Most common cancer in young adults

More common in men
 First recognized in 1832
 Etiology: viral infections, suppressed immune
functions
HODGKIN’S DISEASE
A&P review

Lymph nodes produce and store lymphocytes (2
types)

B lymphocytes-protect body from invading germs by
changing into plasma cells, then produce antibodies
which mark germs for destruction
 T lymphocytes-destroy infected bacteria or assist
immune system to perform their job better

Lymph nodes are connected by lymph vessels
HODGKIN’S DISEASE
Hodgkin’s disease can start anywhere, but
usually occurs in the upper chest, neck or axilla

S/S-enlarged lymph nodes, low-grade fever,
fatigue, night sweats, generalized pruritis
 Dx-biopsy revealing Reed-Sternberg cells
(abnormal B lymphocyte)

BOTH TYPES ARE MALIGNANT BECAUSE THEY
GROW AND COMPRESS VITAL ORGANS
Treatment:
 Radiation
 Chemo
 Combination
 monoclonal antibodies
 High-dose chemo and stem cell transplant
(American Cancer Society, 2015)

NON-HODGKIN’S LYMPHOMA (NHL)

There are many different types of nonHodgkin lymphoma. These types can be
divided into aggressive (fast-growing) and
indolent (slow-growing) types, and they can
be formed from either B-cells or T-cells.

B-cell non-Hodgkin lymphomas include Burkitt
lymphoma, chronic lymphocytic leukemia/small
lymphocytic lymphoma (CLL/SLL), diffuse large
B-cell lymphoma, follicular lymphoma,
immunoblastic large cell lymphoma, precursor Blymphoblastic lymphoma, and mantle cell
lymphoma.
(National Cancer Institute)
NON-HODGKIN’S LYMPHOMA (NHL)

S/S: painless, enlarged single lymph node in
the neck, abdominal discomfort, back pain, GI
c/o resulting from lymph node involvement
TX OF NON-HODGKIN’S LYMPHOMA
Chemo
 Immunotherapy
 Targeted therapy (newer class of drugs that
target these cells that cause cancer)
 Radiation
 peripheral stem cell transplant may be used

LEUKEMIA


Abundance of abnormal WBC’s
acute
 Immature
cells proliferate and accumulate in a
persons bone marrow

Chronic
 Mature
cells become diseased
Depends on which line is affected: lymphoid or myeloid
·
ACUTE LYMPHOCYTIC LEUKEMIA
Acute develops quickly
 Starts in WBC’ in bone marrow and moves
quickly to blood
 Develops from B or T lymphocytes
 “acute” means that the leukemia can
progress quickly

 If
left untreated, may probably be fatal within a few
months.
ACUTE MYELOID/MYELOGENOUS LEUKEMIA
 AML starts in the bone marrow
 quickly moves into the blood
 can sometimes spread to other parts of the
body including the lymph nodes, liver, spleen,
central nervous system (brain and spinal cord),
and testicles
 s/s-wt. loss, fever, unusual bleeding from a
minor cut*
 Tx-chemo, stem cell transplant, surgery,
radiation*
CHRONIC LYMPHOCYTIC LEUKEMIA




the cells can mature partly but not completely, may
look fairly normal, but they are not.
do not fight infection as well as normal white blood
cells do
leukemia cells survive longer than normal cells, and
build up, crowding out normal cells in the bone
marrow
Mainly affects older adults
TX:
ALL
 chemotherapy
 Targeted therapy
 Stem cell transplant
 Steroids (may have increase wt. gain*)
 CLL
 chemotherapy
 Targeted therapy
 Monoclonal antibodies
 Stem cell transplant
(American Cancer Society, 2015)

VARIOUS TYPES OF CANCER/TREATMENTS
Laryngeal cancer
 Causes: smoking cigarettes and consuming
large amounts of ETOH, among other reasons
 TX: laryngectomy, radiation on neck-side effect
of this is dry desquamation of the skin*
 Monitor for xerostomia, stomatitis, dysgeusia
(altered sense of taste)

VARIOUS TYPES OF CANCER/TREATMENTS
Thyroid cancer
 Causes: smoking, family history/heredity,
gender (women)
 TX-surgery, chemo, radiation, targeted therapy
 Radioactive iodine
Teach that the urine and saliva will be
radioactive for a short period of time*

VARIOUS TYPES OF CANCER/TREATMENTS

Lung cancer
 One
possible treatment is pneumonectomy
 Others
 Chest
include radiation and chemo
tube may be inserted on the side of the
pneumonectomy to aid in blood removal (blood can
ooze into empty space where lung was)
VARIOUS TYPES OF CANCER/TREATMENTS

Colon cancer
 Removal
of part of the colon (colostomy)
 Tx: surgery, chemo (5-FU), radiation. Side effects
may need to be tolerated**
**Patient teaching:
1. TCDB
2. Leg ROM, early ambulation
3. Arrange for enterostomal therapist (ET) to assist
with colostomy care
4. Encourage expression of feelings about changes
in body image