3. Tertiary Prevention – focuses on management of long term care for clients undergoing complex cancer treatments. Examples: support groups and rehab programs E. Diagnosis 1. Signs / Symptoms CAUTION: C hange in bowel/bladder habits A sore that does not heal U nusual bleeding / discharge T hickening or lump in breast or elsewhere I ndigestion or difficulty swallowing O bvious change in wart or mole N agging cough or hoarseness Cancer may invade the bone marrow which may lead to anemia, leukopenia, and _infection_____________. Unexplained __weight____________ loss
Cachcexia= extreme malnutrition and muscle wasting Fever The #1 symptom a client complains of with a diagnosis of cancer is _fatigue___________. Other general s/sx is: _pain_________ 2. Laboratory Tests Abnormal CBC & differential on white blood count with the most concerning in cancer being _neutrophils_____________ Elevated liver enzymes: AST and ALT Tumor markers (biomarkers) 3. Diagnostic Studies a. CXR b. CT scan c. MRI d. PET scan e. Bone marrow _biopsies__________ f. Tissue biopsy (biopsy provides the definitive diagnosis for cancer and results are ALWAYS reported to patient by the Dr., not nurse) g. Diagnostic / imaging studies (ex. Bronchoscopy, EGD, colonoscopy) 4. Staging of Cancer a. TNM System: This type of staging classifies the cancer according to 3 characteristics 1. __T____ describes the size of the T umor 2. __N____ describes if lymph N odes 3. __M____ is the presence of M etastasis 5. Grading of Cancer Grading compares the cancers cells with the cell they originated from (i.e. the parent cell) The less the cancer cells look like the tissue they originated from (the original cell), the more aggressive the cancer is Grading is on a scale from 1-4 The higher the grade the more _malignant______ the cancer is F. Treatment of Cancer 1. The goals of treatment – MUST ALWAYS consider quality of life during and after treatment a. Cure b. Control c. Palliation__________________ Adjuvant means 2 therapies are used together Neoadjuvant means time-specific therapies or sequencing one treatment before the next
Always involve client in choices 2. Types of Treatment a. Surgery: may be used for prevention, _diagnosis__, treatment, or reconstruction (ex. See post-op mastectomy care from last week). Palliative care is surgery to improve the client’s quality of life when there is no cure (ex. Debulking a tumor that is causing pain) Successful surgery is dependent on 3 things: #1 question after surgery? “Did they get it all?” Had the cancer spread at the time of surgery? Was the surgeon able to get adequate _margins__? Amount of normal tissue around the cancerous tissue that was also able to be removed. Risk of micro-metastasis: impact on what kind of treatment is needed, so even after removal of tissue there is chance of metastasis, radiation can be used. b. Radiation Therapy 1. Internal radiation (brachytherapy) Brachytherapy is used to get the radiation close to the cancer or _target__ tissue It is internal radiation which means it is inside the _body________.
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- Spring '17
- Oncology, Chemotherapy