1. Chapter 28 Cancer

2. Introduction
Second leading cause of death in persons aged 65 years and older
Probability of developing cancer increases with age
Incidence/prevalence
Role of the gerontological nurse:
Prevention
Diagnosis
Treatment

3. Question The single most important risk factor for cancer is
Environment
Age
Poverty
Carcinogens

4. Answer
B. Age
Rationale: The National Cancer Institute (NCI) acknowledges that age is the single most important risk factor for cancer.

5. Aging and Cancer Unique challenges for older persons with cancer:
Advanced stage when initially diagnosed
Multiple health conditions
Increased risk of complications, disability, and death
Treatment challenges

6. Question Is the following statement true or false?
Older adults have the highest rate for any age group of receiving early detection tests for cancer.

7. Answer
False
Rationale: Despite having the highest rate of most cancers, older adults have the lowest rate of receiving early detection tests for cancer; thus, their disease may be in an advanced stage when diagnosed.

8. Aging and Cancer (cont.)
Explanations for increased incidence of cancer in older adults:
Two major theories:
Biological age-related changes that impair the ability to resist diseases
Prolonged exposure to carcinogens over the years
Reduction of risk factors is beneficial

9. Risk Factors, Prevention, and Screening
Many cancers can be prevented by healthy lifestyle practices that minimize risks
Avoid the use of and exposure to tobacco products
Limit exposure to the sun
Eat a diet rich in fiber, fruits, and vegetables
Maintain weight within an ideal range
Protect against exposure to known carcinogens

10. Risk Factors, Prevention, and Screening (cont.)
Many cancers can be prevented by healthy lifestyle practices that minimize risks (cont.)
Limit alcohol consumption
Discuss chemoprevention with your physician if family history increases the risk of cancer
Women
Increased age
Genetic factors
Ovarian and breast cancer
Other risk factors

11. Gerontological Nurses
Promote positive health habits
Understand evidence-based risk factors
Preventive measures
Educate individuals regarding appropriate cancer screening
Early detection can improve prognosis

12. Treatment Conventional treatment:
Plan of treatment depends on the specific cancer
Surgery, radiation, chemotherapy, and biologic therapy
Unique risks for older adults
Impact of advanced age

13. Treatment (cont.) Complementary and alternative medicine (CAM):
Prevalence
Special diets, psychotherapy, spiritual practices, vitamin supplements, and herbal remedies
Healing philosophies and approaches
Treatment of not just the disease, but caring for the whole person

14. Treatment (cont.) CAM practitioners offer: Relationship-centered care
Support
Healing partnerships
Comfort
Hope
Need to weigh risks and benefits

15. Question
Which of the following roles provided by a CAM practitioner best describes the healing partnership?
Empowerment, facilitation, and support
Options to offer hope
Acceptance and understanding
High touch to relieve stress and discomfort

16. Answer A. Empowerment, facilitation, and support
Rationale: Healing partnerships allow CAM practitioners to honor patients’ rights to control their care and their lives, while seeing their role as empowering, facilitating, and supporting patients in the healing process.

17. Nursing Considerations for Older Adults with Cancer
Providing patient education
Increase awareness of measures that can prevent cancer
Understanding of warning signs of cancer
CAUTION mnemonic
Self-examination instruction
Cancer screening tests

18. Question
Warning signs of cancer are identified in the mnemonic CAUTION, in which the U is a reminder of which sign of cancer?
Swallowing difficulty
Nonhealing sores
Lumps in the body
Bleeding or drainage that is abnormal

19. Answer D. Bleeding or drainage that is abnormal Rationale:
C: Change in bowel or bladder habits
A: A sore that does not heal
U: Unusual bleeding or drainage
T: Thickening or lump in the breast or elsewhere
I: Indigestion or swallowing difficulty
O: Obvious change in a wart or mole
N: Nagging persistent cough or hoarseness

20. Nursing Considerations for Older Adults with Cancer (cont.)
Promoting optimum care
Choice of treatment facility
Clinical trials through the NCI
Care after radiation and chemotherapy with knowledge of the increased risks related to age- related changes
Knowledge of common age-related risk factors that increase likelihood for certain conditions

21. Nursing Considerations for Older Adults with Cancer (cont.)
Prevention of complications
Knowledge of certain types of cancer
Assure patients that pain can be managed
Regularly assess for pain and develop plans for prevention/management

22. Nursing Considerations for Older Adults with Cancer (cont.)
Providing support to patients and families
Diagnosis may be overwhelming and stressful
Fear
Cost of treatment
Change in plans and future pursuits

23. Nursing Considerations for Older Adults with Cancer (cont.)
Assess patient and family understanding:
Clarify misconceptions
Offer explanations
Allow expression of feelings
Consult with a physician