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Care of the Client Undergoing Surgery for Bone/Skin Cancer

Care of the Client Undergoing Surgery for Bone/Skin Cancer. Objective. The learner will be able to identify the primary oncologic bone and skin conditions and their appropriate surgical interventions. Bone Cancer. Can occur in any type of bone tissue: Osteosarcoma (osteoid tissue)

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Care of the Client Undergoing Surgery for Bone/Skin Cancer

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  1. Care of the Client Undergoing Surgery for Bone/Skin Cancer

  2. Objective The learner will be able to identify the primary oncologic bone and skin conditions and their appropriate surgical interventions.

  3. Bone Cancer • Can occur in any type of bone tissue: • Osteosarcoma (osteoid tissue) • Chondrosarcoma (cartilaginous tissue) • Ewing sarcomas (a number of types) • Risk factors: • High-dose radiation therapy • Some chemotherapy agents • History of hereditary retinoblastoma • History of hereditary defects in bone

  4. Bone Cancer Symptoms: • Pain is the most common symptom. • Decreased mobility or fracture may occur. Treatment options: • Surgery is standard treatment. • Most patients will avoid amputation due to newer surgical techniques. • Chemotherapy: Adjuvant combination therapy • Radiation therapy: Adjuvant

  5. Bone Cancer:Postoperative Nursing Management Acute postoperative priorities: • Vital sign management/pulse oximetry • Airway management in immediate postop period • Pain management Ongoing concerns: • Risk of infection • Activity intolerance • Alterations in body image/ineffective coping • Preparation for reconstructive surgery or functional disability

  6. Skin Cancer Skin cancer is: • The most common cancer in the U.S. • Classified according to cell from which it arises. • Squamous cell: Epidermal layer of skin • Basal cell: Below squamous cells • Melanoma: Melanocytes, in the deepest part of epidermis, along with basal cells Risk factors: • Sunlight exposure • Severe blistering sunburns • Tanning (including tanning beds) • Some family histories; fair, freckled skin, light eyes and hair

  7. Skin Cancer: Symptoms • Squamous or basal cell: • New growth • Sore that does not heal • Change in an old growth • Typically not painful • Melanoma: • Change in mole, or new mole

  8. Skin Cancer: Treatment • Surgery is typically the first treatment. • Cancerous growth and normal margins • Lymph node dissection may be included. • Skin graft may be necessary if large area of tissue is removed. • Chemotherapy or biotherapy: Topical or systemic • Photodynamic therapy (drug plus light source) • Radiation therapy

  9. Skin Cancer:Postoperative Nursing Management Acute postoperative priorities: • Pain management • Infection risk Ongoing concerns: • Patient education regarding sun/tanning exposure; lifelong surveillance • Preparation for skin graft/reconstructive surgery

  10. References National Cancer Institute. (2012a). Osteosarcoma. Retrieved from http://cancer.gov/cancertopics/pdq/treatment/osteosarcoma/HealthProfessional National Cancer Institute. (2012b). Skin cancer. Retrieved from http://www.cancer.gov/cancertopics/types/skin National Comprehensive Cancer Network. (2012a). NCCN Clinical Practice Guidelines in Oncology: Bone cancer [v.2.2012].Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/bone.pdf National Comprehensive Cancer Network. (2012b). NCCN Clinical Practice Guidelines in Oncology: Melanoma [v.3.2012].Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/melanoma.pdf

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