1. Cancer Unit 47 Adonis K. Lomibao, R.N.

3. Objectives Spell & define terms List methods of reducing the risk of cancer Explain the importance of good nutrition in cancer prevention and treatment List 7 S&S of cancer Describe 2 types of cancer treatment Describe nursing assistant responsibilities when caring for patients with cancer

4. Introduction Cancer: a disease in which the normal mechanisms of cell growth are disturbed. Benign: stays in one place and does not spread Metastasis: spread to other parts of the body through the blood & lymphatic system Malignant:cancers that are spread to other parts of the body Carcinogen: substance that causes cancer

5. Risk Factors Age-most occur over 55 Lifestyle & habits -smoking -alcohol -diet Family history, genetics Environmental pollution

6. Risk Factors Cont. Harmful Substances in environment: -asbestos -benzene Chemicals Radiation Prolonged sun exposure Infections & some viruses

8. Nutrition & Cancer Direct relationship between certain foods and certain cancers Obesity: gallbladder, uterus, colon, & breast CA Prevention: -30% or less calories from fat -<300mg cholesterol/Daily -55% of calories from complex carbs -no more than 1 tsp. salt

9. Cancer Prevention & Detection Preventative measures: -not smoking -limit alcohol -food pyramid -regular exercise -healthy weight -avoid sun exposure between 10a-3p Genetic testing if at risk

11. S&S of Cancer CAUTION C-change in bowel or bladder habits A-a sore that doesn't heal U-unusual bleeding or discharge T-thickening or lump I-indigestion or difficulty swallowing O-obvious changes in a wart, mole, skin cond. N-nagging cough or hoarseness

12. Screening Regular screening for early detection Screening based on risk factors Monthly personal screening: -breast self-examination -testicular self-examination

14. Treatment Treatment is determined by: -type of cancer -location -benign/malignant -the stage (how advanced) -general pt. condition

15. Surgery Biopsy: minor surgery used to diagnose a cancer If cancerous, surgical procedure done to try to completely remove cancerous tissue May be part or all of an organ, & lymph tissue Reconstructive surgery Preventative surgery: done with strong genetic link to CA

16. Chemotherapy Uses medications or drugs to destroy the CA Healthy cells may also be destroyed Goals: -eliminate, -control & slow growth-prolong life -reduce size-eliminate pain n improve quality of life Drugs can be oral, I.V., etc. Drugs very potent & irritating-require special handling and disposal

17. Side Effects of Chemotherapy Targets rapidly regenerating cells Also affects: blood cells, hair/nail cells,GI Cells Side Effects: -Alopecia-within 2 weeks after therapy -N&V -Anorexia, loss of appetite—taste,nausea -Anemia,Fatigue -Low WBC -low platelets -Destruction of mouth mucous membranes

18. Disposal of Body Fluids & Wastes May excrete drugs in waste & body fluids Special PPE instructions & policies for discarding Discard in leak-proof container Biohazard! Gloves! Standard Precautions

19. Special Care of the Chemo Pt. Observe for side effects & report to nurse Nursing comfort measures, mouthcare & bath Prevent injuries & infection Encourage deep breathing, Vitals Report S&S of infection (p.842) Prevent bleeding Promote good nutrition & hydration(p.842) Report IV infilitration, change in mental status, change in VS Emotional support with body image!

20. Radiation Therapy High-energy, ionizing beams at the cancer site Destroys cancerous tissue without damaging healthy tissue Side effects: -fatigue -N & V -loss of appetite -p.843

21. Special Care of RT Pt. Radiation may be irritating to the skin Do not wash markings on skin off Skin care!!: -wash with lukewarm water & mild or no soap -avoid rubbing on skin -avoid shaving near treatment -avoid tape near area -p.843

22. Brachytherapy Tiny radioactive seeds or pellets implanted inside the body Fewer side effects Used for localized cancers such as breast, prostate, lung, cervical CA Seeds implanted-dosage depends on area & type of CA May be used in combination with radiation

23. Brachytherapy Pt. Care Special precautions to reduce radiation exposure Private room Visitors restricted on time & distance Pregnant women & below 18 not permitted Dosimeter-measures radiation dose

24. Immunotherapy Treatment alters immune response to eliminate the cancer Biological agents change normal immune response Care involves: -monitor VS Q4 or more -monitor cap refill -Bedrest if systolic below 100 or as instructed -weigh pt. & report weight gain

25. Immunotherapy Cont. Notify nurse: -fever/chills -rapid pulse/ respirations -cyanosis -SOB -restless/apprehensive -diarrhea, N&V -itching

26. Pain Most common symptom May be caused by cancer or treatment Extended pain reduces quality of life WHO Analgesic ladder-model for pain management Pain evaluated regularly Narcs may be necessary-low incidence of addiction Notify nurse

27. Mental & Emotional Needs CA Pts.Fear dying, anxious, depressed, grieving process. PCT Care: -time to talk -allow to talk about feelings/fears -ADL's -anticipate needs -respect beliefs & wishes -respect privacy -make pt. Feel respected & valued as person

28. Palliative Care Care designed to treat symptoms of discomfort, but not the disease Advanced directive & DNR order Comfort care till death-Hospice may be involved Maintain quality of life as long as possible PCT care-hygiene & comfort Emotional support Report pain,SOB, anxiety