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Diagnosis, Staging &Chemotherapy for Cancer

This informative guide covers the differences between benign and malignant tumors, the process of carcinogenesis, genetic influences, family history assessment, carcinogenic factors, diagnosis and staging, and chemotherapy treatment for cancer patients. It also outlines common side effects such as myelosuppression, nausea, fatigue, and alopecia.

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Diagnosis, Staging &Chemotherapy for Cancer

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  1. Diagnosis, Staging &Chemotherapy for Cancer Cheryl A. Yarde RN, MSN Clinical Assistant Professor

  2. Benign Vs. Malignant What is the difference between a benign tumor and a malignant t tumor? • Malignant tumors are ambitious. • They have two goals in life: • To survive • To conquer new territory

  3. Benign vs. Malignant Benign Malignant Undifferentiated Invades and infiltrates Rate of growth is variable Spreads to other areas of the body- metastasizes • Well differentiated • Tumor does not infiltrate surrounding tissue • Growth is slow • Does not spread

  4. Benign vs. Malignant Benign Malignant Can Cause anemia, weakness, Systemic inflammation, weight loss Causes extensive tissue damage Eventually causes death unless growth can be controlled • Does not cause generalized effects Cause localized effects • Does not usually cause tissue damage • Does not usually cause death unless location interferes with vital function

  5. CANCER/MALIGNANCY • Metastasize (Mets)

  6. Carcinogenesis • Process of transforming normal cells into cancer cells • Every phase of this process is affected by multiple gene mutations • Some gene mutations- inherited • 90% acquired mutations in specific cells

  7. Genetics Examples of some Cancers influenced by genetics: • Breast • Ovarian • Colorectal • Prostate Ca • Retinoblastoma • Familial melanoma syndrome

  8. Family History Family history assessment for specific Oncology disorders: • H/O of maternal and paternal sides • Three generations- parent, sibling, child • Clusters of Ca that occur at young ages • Multiple cancers in one individual • Two or more close relatives with the same cancer

  9. Family history • Referral for genetic testing • Need support if genetic testing is positive • Need to know options • Support groups

  10. Factors inducing carcinogenesis • Viruses: HPV, HepB, Epstein Barr • Bacteria: H. plylori • Physical agents: sunlight, radiation, tobacco, asbestos • Hazardous Chemicals: Alter DNA structure • Tobacco smoke, passive smoke, cigars, pipes, chewing tobacco • Workplace chemicals • Asbestos

  11. Carcinogens • Tobacco smoke – single most lethal chemical carcinogen • Accounts for 1/3 of all cancer deaths • Lung • Head and neck • Esophagus • Stomach • Pancreas • Kidney • AML • Second hand smoke- • Non - smokers who live with smokers have a 20%-30% greater risk of developing lung cancer

  12. Factors inducing carcinogenesis Lifestyle factors: • Diet - long term ingestion of carcinogens: • Fats, alcohol, salt cured or smoked meats, nitrate containing foods, red and processed meats • Obesity • Insufficient physical activity

  13. Diagnosis and Staging

  14. Diagnosis of Cancer • Determining presence/Type of malignancy • Obtain tissue, cells for analysis: • Biopsy • Fine needle aspiration **The only way to confirm whether a tumor is cancerous or benign is with a biopsy/ fine needle aspiration

  15. Diagnosis of Cancer Staging: • Size of tumor • local invasion • Lymph node involvement • Distant mets

  16. *Staging • Done prior to treatment • Provides baseline data • Treatment options and prognosis are based on staging

  17. Staging • Stage I-IV • stage 1 is localized cancer, • further local spread will take it to stage 2; stage 2 also usually includes spread to the nearest lymph nodes; • stage 3 usually indicates more extensive lymph node involvement and • stage4 always indicates distant spread.

  18. Grading • Determine the type of tumor the tissue originated from • Differentiation does the tumor cells retain the function and histologic characteristics of the tissue of origin- differentiation • Helps with prognosis • Grade l: • well differentiated • Resembles the tissue of origin • Grade lV • Poorly differentiated • More aggressive, less responsive to treatment

  19. Chemotherapy

  20. Treatment • Chemotherapy

  21. Chemotherapy • What is chemotherapy? • Drugs used for cancer treatment • Used to kill tumor cells by interfering w/cellular functions and reproduction • Kills rapidly dividing cells • Administration of chemotherapy

  22. Extravasation

  23. Side Effects of Chemotherapy

  24. Side Effects • Myelosuppression • Neutropenia • Thrombocytopenia • Anemia

  25. GI Effects Nausea & Vomiting (N/V): Most common side effect

  26. GI Effects 5-14 days Stomatitis: • Mouth Mucositis • Oral cavity & • GI tract *

  27. Thrush

  28. Fatigue • Cancer fatigue is distressing • Rest helps but does not make it go away • A little activity may be exhausting • Interferes w/family, work, recreation, and social life

  29. Psychosocial distress • Actual/potential losses • Fear • Symptoms • Changes in family and social roles • Financial issues • Loss of control

  30. Grieving

  31. Alopecia • Destruction of hair follicles by chemotherapy or radiation to head and neck • Hair loss usually temporary w/chemotherapy • usually permanent in response to radiation

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