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 of WBCs 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 the long 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