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Nursing Care of the Child With Cancer

Nursing Care of the Child With Cancer. Neoplasia Cell growth in cancerous tissue proliferates in disorderly and chaotic ways Neoplasm- literally “new growth,” but usually refers to abnormal new growth. ASSESSING CHILDREN WITH CANCERS. History Physical and laboratory examination Biopsy

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Nursing Care of the Child With Cancer

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  1. Nursing Care of the Child With Cancer

  2. Neoplasia • Cell growth in cancerous tissue proliferates in disorderly and chaotic ways • Neoplasm- literally “new growth,” but usually refers to abnormal new growth

  3. ASSESSING CHILDREN WITH CANCERS • History • Physical and laboratory examination • Biopsy • Bone marrow aspiration

  4. OVERVIEW OF CANCER TREATMENT MEASURES USED WITH CHILDREN • Radiation therapy • Immediate side effects • Long term side effects

  5. OVERVIEW OF CANCER TREATMENT MEASURES USED WITH CHILDREN • Chemotherapy • Chemotherapy protocols…no ASA, no live viruses, no folic acid • Side effects & toxic reactions • Hair loss and N&V are common • Also malnutrition, stomatitis, constipation, and diarrhea

  6. OVERVIEW OF CANCER TREATMENT MEASURES USED WITH CHILDREN • Bone Marrow transplantation • Can be autologous or allogenic • Hematopoitic Stem Cell transplant • Autologous, peripheral • Stored umbilical cord blood • Embryonic?

  7. THE LEUKEMIAS • Leukemia-uncontrolled proliferation ofWBCs and the most common childhood cancer • Acute Lymphocytic Leukemia • 75% of leukemias fall into this category • Overproliferation of lymphocytes • S/S • Pallor, low-grade fever, lethargy • Goal • Total cure, 95% of children will have a first remission but if they experience a relapse, the prognosis is less favorable

  8. THE LEUKEMIAS • Acute Myelogenous Leukemia • Accounts for 20% of leukemias • Overproliferation of granulocytes • S/S are the same as with ALL but may also have had recent URIs • Goal • Remission is harder to achieve than in ALL and tends to be shorter

  9. THE LYMPHOMAS • Malignancies of the lymph or reticuloendothelial system • Hodgkin’s Disease • Reed-Sternberg cells • S/S • One painless, enlarged, rubbery-feeling lymph node, usually cervical • Therapeutic Management • Chemo and radiation • 90% 5-year survival rate and relapses respond well the further therapy

  10. THE LYMPHOMAS • Non-Hodgkin’s Lymphoma • Proliferation of lymphocytes • Spread through the bloodstream rather than by lymph flow • S/S • Enlargement of lymph nodes of neck and chest • Therapeutic Management • Chemo and autologous bone marrow transfusion • 80-90% of those with minimal symptoms will achieve remission

  11. Non-Hodgkin’s Lymphoma • Burkitt’s lymphoma • Rare form of Non-Hodgkins • Associated with the Epstein-Barr virus that causes mononucleosis • S/S • Enlarged lymph node in the neck or abdomen • Therapeutic Management • Surgery, then chemo

  12. NEOPLASMS OF THE BRAIN • Types of Brain Tumors • Astrocytomas • Medulloblastomas • Brain stem tumors • S/S • Symptoms of increased ICP • Headache, vomiting, vision changes, enlarging head circumference • Therapeutic management • Surgery, then chemo and radiation

  13. BONE TUMORS • Osteogenic Sarcoma-malignant tumor of thelong bone • S/S • Pain and swelling, esp. around the knee • Therapeutic Management • Surgery, usually amputation, then chemo • 60-65% of those rigorously treated can be cured • Ewing’s Sarcoma-occurs most often in the bone marrow of long bones • S/S is pain • Therapeutic Management is surgery, radiation, and chemo

  14. OTHER CHILDHOOD NEOPLASMS • Neuroblastoma • Tumors that arise from the cells of the sympathetic nervous system • The most common abdominal tumor in childhood • S/S • Palpable abdominal mass • Therapeutic Management • Depends on staging • Surgery, chemo, bone marrow transplant • Overall survival rate is 70-90%

  15. OTHER CHILDHOOD NEOPLASMS • Rhabdomyosarcoma • Tumor of striated muscle • S/S depend on site • Therapeutic Management • Surgery, then chemo • Prognosis depends on size and location of tumor

  16. OTHER CHILDHOOD NEOPLASMS • Wilm’s tumor- malignant tumor that rises from the metanephric mesoderm cells of the upper pole of the kidney • Accounts for 20% of solid tumors in childhood • Associated with aniridia, cryptorchidism, hypospadias • S/S • Firm, nontender, abdominal mass • Therapeutic Management • Abdominal palpation seems to increase metastasis • Surgery, radiation, chemo

  17. OTHER CHILDHOOD NEOPLASMS • Retinoblastoma-malignant tumor of the retina of the eye • Accounts for only 1-3% of childhood malignancies • Associated with an alteration of chromosome 13 and also an inherited autosomal dominant pattern • S/S • Absence of red reflex in the pupil then later, strabismus • Therapeutic Management • Cryosurgery for small tumors, enucleation for large ones

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