Particular Cancer Power Point

PARTICULAR CANCERPARTICULAR CANCER

BREAST CANCERBREAST CANCER

is a malignant ( cancerous) tumor that starts from is a malignant ( cancerous) tumor that starts from cells of the breast. The disease occurs mostly in cells of the breast. The disease occurs mostly in women, but in men can get breast cancer as wellwomen, but in men can get breast cancer as well

most breast cancers begin in the ducts ( ductal most breast cancers begin in the ducts ( ductal carcinoma), some begin in the lobules ( lobular carcinoma), some begin in the lobules ( lobular carcinoma), and rest in other tissuescarcinoma), and rest in other tissues

if breast cancer cells reach the underarm lymph if breast cancer cells reach the underarm lymph nodes and continue to grow, they cause the nodes to nodes and continue to grow, they cause the nodes to swell. Once cancer cells have reached these nodes swell. Once cancer cells have reached these nodes they are more likely to spread to other organs of the they are more likely to spread to other organs of the body as wellbody as well

BREAST CANCERBREAST CANCER

ETIOLOGYETIOLOGY

- - Unknown, but areas under Unknown, but areas under investigation includes:investigation includes:

SmokingSmoking Age Age Family historyFamily history Early menarcheEarly menarche Late menopauseLate menopause Nulliparous or first child after age 34Nulliparous or first child after age 34 High fatHigh fat Use of oral contraceptiveUse of oral contraceptive

CLINICAL CLINICAL MANIFESTATIONMANIFESTATION

Non tender lump, usually in Non tender lump, usually in upper quadrant pain (late) upper quadrant pain (late)

Axillary Lymphadenopathy (late)Axillary Lymphadenopathy (late) Fixed nodular breast mass (late)Fixed nodular breast mass (late)

PROTECTIVE FACTORSPROTECTIVE FACTORS

ExerciseExercise Breast feedingBreast feeding Pregnancy before 30 years oldPregnancy before 30 years old

ASSESSMENT FINDINGSASSESSMENT FINDINGS

Mass – the most common Mass – the most common location is the upper outer location is the upper outer quadrant (UOQ)quadrant (UOQ)

Mass is NON-tender. Fixed, hard Mass is NON-tender. Fixed, hard with irregular borderswith irregular borders

Skin dimplingSkin dimpling Nipple retractionNipple retraction Peau d’ orangePeau d’ orange

LABORATORY FINDINGSLABORATORY FINDINGS

Biopsy procedureBiopsy procedure MammographyMammography

BREAST CANCER BREAST CANCER STAGINGSTAGING

- TNM staging- TNM staging I - < 2cmI - < 2cm II – 2 to 5 cm, ( + ) LNII – 2 to 5 cm, ( + ) LN III - > 5cm, ( + )LNIII - > 5cm, ( + )LN IV – metastasisIV – metastasis

MEDICAL MANAGEMENT MEDICAL MANAGEMENT

ChemotherapyChemotherapy Tamoxifen therapy – blocks Tamoxifen therapy – blocks

estrogen receptor sitesestrogen receptor sites Radiation therapyRadiation therapy

SURGICAL MANAGEMENTSURGICAL MANAGEMENT

Radical Mastectomy – removal of Radical Mastectomy – removal of tumor, pect. Major, pect. Minor + LNtumor, pect. Major, pect. Minor + LN

Modified Radical Mastectomy –pect. Modified Radical Mastectomy –pect. Minor remains, removal of tumor, Minor remains, removal of tumor, pect. major + LN ( most commonly pect. major + LN ( most commonly donedone

LumpectomyLumpectomy QuadrantectomyQuadrantectomy

Radical MastectomyRadical Mastectomy

NURSING INTERVENTION NURSING INTERVENTION

PRE-OPPRE-OP Explain breast cancer and treatment Explain breast cancer and treatment

optionsoptions Reduce fear and anxiety and improve Reduce fear and anxiety and improve

coping abilitiescoping abilities Promote decision making abilitiesPromote decision making abilities Provide routine pre-op care:Provide routine pre-op care: Consent, NPO, meds, teaching about Consent, NPO, meds, teaching about

breathing exercisebreathing exercise

NURSING NURSING INTERVENTIONINTERVENTION

POST-OPPOST-OP Position patientPosition patient SupineSupine Affected extremity elevated to reduce edemaAffected extremity elevated to reduce edema Relieve pain and discomfortRelieve pain and discomfort Moderate elevation of extremityModerate elevation of extremity IM/IV injection medsIM/IV injection meds Warm shower on 2nd post-opWarm shower on 2nd post-op Maintain skin integrityMaintain skin integrity Immediate post-op, snug dressing with drainageImmediate post-op, snug dressing with drainage Maintain patency of drainMaintain patency of drain Monitor for hematoma with in 12 hour and apply bandage and Monitor for hematoma with in 12 hour and apply bandage and

ice refer to surgeonice refer to surgeon Drainage is removed when the discharge is ledd than 30 ml in Drainage is removed when the discharge is ledd than 30 ml in

24 hour, inform the doctor to remove JP24 hour, inform the doctor to remove JP Lotions, creams are applied only when the incision is healed in Lotions, creams are applied only when the incision is healed in

4-6 weeks4-6 weeks

NURSING NURSING INTERVENTIONINTERVENTION

Promote activityPromote activity Support operative site when movingSupport operative site when moving Hand, shoulder exercise done on 2nd dayHand, shoulder exercise done on 2nd day Post-op mastectomy exercise 20 minutes TIDPost-op mastectomy exercise 20 minutes TID No BP or Iv procedure on the operative siteNo BP or Iv procedure on the operative site Heavy lifting is avoidedHeavy lifting is avoided Elevate the arm at the level of the heartElevate the arm at the level of the heart On a pillow for 45 minutes TID to relieve transient On a pillow for 45 minutes TID to relieve transient

edemaedema Gardening is prohibitedGardening is prohibited Arm > elbowArm > elbow Elbow > shoulderElbow > shoulder

LUNG CANCERLUNG CANCER

rapid growth of abnormal cells in rapid growth of abnormal cells in the lungsthe lungs

caused by smoking, second caused by smoking, second smoke, exposure to harmful smoke, exposure to harmful substance such as arsenic, substance such as arsenic, asbestos, radioactive dust, or asbestos, radioactive dust, or radon radon



TYPESTYPES

a. Small cell lung cancera. Small cell lung cancer less common but they grow more quickly less common but they grow more quickly

and are more likely to metastasizeand are more likely to metastasize

b. Non-small cell lung cancerb. Non-small cell lung cancer1. adenocarcinoma1. adenocarcinoma most common type of lung cancermost common type of lung cancer2. squamous cell carcinoma2. squamous cell carcinoma -second most common type of lung cancer-second most common type of lung cancer

MEDICAL MANAGEMENTMEDICAL MANAGEMENT

Radiation therapyRadiation therapy ChemotherapyChemotherapy SurgerySurgery

Surgical ProceduresSurgical Procedures

Surgical ProceduresSurgical Procedures

ASSESSMENT FINDINGSASSESSMENT FINDINGS

1.Persistent cough ( may be productive of blood tinged )1.Persistent cough ( may be productive of blood tinged )2.Chest pain2.Chest pain3.Dyspnea3.Dyspnea4.Unilateral wheezing4.Unilateral wheezing5.Friction rub 5.Friction rub 6.Possible paralysis of the diaphragm6.Possible paralysis of the diaphragm7.Fatigue7.Fatigue8.Anorexia8.Anorexia9.Nausea and vomiting9.Nausea and vomiting10.Pallor10.Pallor11. Diagnostic tests : 11. Diagnostic tests : - Chest X-ray may show presence of tumor or evidence of - Chest X-ray may show presence of tumor or evidence of

metastasis to surrounding structuresmetastasis to surrounding structures- Sputum or cytology reveals malignant cell- Sputum or cytology reveals malignant cell- Bronchoscopy: biopsy reveals malignancy- Bronchoscopy: biopsy reveals malignancy- Thoracentesis: pleural fluid contains malignant cells- Thoracentesis: pleural fluid contains malignant cells

NURSING NURSING INTERVENTIONSINTERVENTIONS

Provide support and guidance to the client as Provide support and guidance to the client as neededneeded

Provide relief/control painProvide relief/control pain Administer medications as ordered and monitor Administer medications as ordered and monitor

effects/side effectseffects/side effects Control nausea: administer medications as Control nausea: administer medications as

ordered, provide oral hygiene, provide small and ordered, provide oral hygiene, provide small and more frequent feedingsmore frequent feedings

Provide nursing care for a client with thoracotomyProvide nursing care for a client with thoracotomy Provide client teaching and discharge planning Provide client teaching and discharge planning

concerningconcerning Disease process, diagnostic and therapeutic Disease process, diagnostic and therapeutic

interventionsinterventions Side effects of radiation and chemotherapySide effects of radiation and chemotherapy Realistic information about prognosisRealistic information about prognosis

OVARIAN CANCEROVARIAN CANCER

The ovary is common site of primary as well The ovary is common site of primary as well as metastatic lesions from other cancers. as metastatic lesions from other cancers. Most cases affect women ages 50 to 59. Most cases affect women ages 50 to 59. Hereditary plays part and many physician Hereditary plays part and many physician advocate pelvic examination every 6 advocate pelvic examination every 6 months for women who have one or two months for women who have one or two relatives with ovarian cancer. Transvaginal relatives with ovarian cancer. Transvaginal ultrasound and Ca-15 antigen testing are ultrasound and Ca-15 antigen testing are helpful in those at high risk for this helpful in those at high risk for this condition.condition.

OVARIAN CANCEROVARIAN CANCER

Clinical ManifestationClinical Manifestation

Increased abdominal girthIncreased abdominal girth Pelvic pressurePelvic pressure BloatingBloating Indigestion, flatulence, increased Indigestion, flatulence, increased

waist sizewaist size Leg pain and pelvic painLeg pain and pelvic pain Slight anorexiaSlight anorexia

Medical ManagementMedical Management

Total hysterectomyTotal hysterectomy Bilateral salpingo-oophorectomyBilateral salpingo-oophorectomy ChemotherapyChemotherapy Radiation therapyRadiation therapy PharmacologicPharmacologic

cyclophosphamidecyclophosphamide doxubricindoxubricin CisplastinCisplastin CaboplastinCaboplastin

Nursing InterventionNursing Intervention

Administer intravenous therapy to Administer intravenous therapy to alleviate fluid and electrolyte imbalancesalleviate fluid and electrolyte imbalances

Provide adequate nutritionProvide adequate nutrition Provide post-operative care after intestinal Provide post-operative care after intestinal

bypass to alleviate obstructionbypass to alleviate obstruction Provide pain relief and managing drainage Provide pain relief and managing drainage

tubestubes Provide small frequent mealsProvide small frequent meals Decrease fluid intakeDecrease fluid intake Administer diuretic agentsAdminister diuretic agents Provide quite environmentProvide quite environment

ComplicationsComplications

spread of the cancer to other organs spread of the cancer to other organs progressive function loss various progressive function loss various

organsorgans ascites ( fluid in the abdomen)ascites ( fluid in the abdomen) blockage of the intestinesblockage of the intestines

Diagnostic ExamsDiagnostic Exams

Pelvic ExamPelvic Exam UltrasoundUltrasound CA-125 assayCA-125 assay Lower GI series or Barium enemaLower GI series or Barium enema CT ScanCT Scan BiopsyBiopsy

CT ScanCT Scan

UTERINE CANCERUTERINE CANCER

Most uterine cancers are endemetriod. It is Most uterine cancers are endemetriod. It is fourth most common cancer in the world. fourth most common cancer in the world. Cumulative exposure to estrogen is Cumulative exposure to estrogen is considered the major risk factors. It is a considered the major risk factors. It is a shaped like an upside down pear and sits shaped like an upside down pear and sits inside the pelvis. it is also known as cancer inside the pelvis. it is also known as cancer of the womb, endometrial cancer, cancer of of the womb, endometrial cancer, cancer of the lining of the wombthe lining of the womb

UTERINE CANCERUTERINE CANCER

Risk FactorsRisk Factors

Age : at least 55 years; median Age : at least 55 years; median age 61 yearsage 61 years

Postmenopausal bleedingPostmenopausal bleeding ObesityObesity Unopposed estrogen therapyUnopposed estrogen therapy

Assessment Assessment

abnormal uterine bleedingabnormal uterine bleeding pre or post menopausepre or post menopause hyperplasiahyperplasia prolonged menstruationprolonged menstruation

DiagnosticDiagnostic

Physical examinationPhysical examination Dilatation and curettageDilatation and curettage X-raysX-rays Blood tests Blood tests

Dilatation and CurettageDilatation and Curettage

Medical ManagementsMedical Managements

Total hysterectomyTotal hysterectomy Bilateral salpingo-oophorectomyBilateral salpingo-oophorectomy Radiation therapyRadiation therapy ChemotherapyChemotherapy

Bilateral Salpingo-Bilateral Salpingo-OophorectomyOophorectomy

Nursing InterventionsNursing Interventions

Institute routine pre and post-op careInstitute routine pre and post-op care Assess for hemorrhage, infection or other post Assess for hemorrhage, infection or other post

surgical complicationssurgical complications Support woman and family through procedure Support woman and family through procedure

encourage expression of feelings and reactions to encourage expression of feelings and reactions to procedureprocedure

Allow woman to verbalize concerns about sexuality Allow woman to verbalize concerns about sexuality post surgerypost surgery

Maintain the patient on low residue diet to prevent Maintain the patient on low residue diet to prevent bowel movements which might dislodge apparatusbowel movements which might dislodge apparatus

Observe for symptoms of radiation sickness – Observe for symptoms of radiation sickness – nausea, vomiting and elevated temperaturenausea, vomiting and elevated temperature

Observe for any symptoms that might suggest Observe for any symptoms that might suggest radiation injury to the intestine diarrhea, report radiation injury to the intestine diarrhea, report these if they occurthese if they occur

Tell the patient the importance of monthly follow up Tell the patient the importance of monthly follow up visits to her physician for the first 6 months to visits to her physician for the first 6 months to assess effects of radiation on tumorassess effects of radiation on tumor

OROPHARYNGEAL CANCEROROPHARYNGEAL CANCER

Is a disease in which cancer cells Is a disease in which cancer cells are found within the anatomical are found within the anatomical borders of the oropharynx. The borders of the oropharynx. The majority of oropharyngeal majority of oropharyngeal cancers are squamous cancers are squamous carcinomas.carcinomas.

OROPHARYNGEAL CANCEROROPHARYNGEAL CANCER

EtiologyEtiology

Use of alcoholUse of alcohol Use of TabaccoUse of Tabacco Being infected with the human Being infected with the human

papilloma virus (HPV)papilloma virus (HPV)


A sore throat that persistA sore throat that persist Pain of difficulty with swallowingPain of difficulty with swallowing Unexplained weight lossUnexplained weight loss Voice changesVoice changes Ear painEar pain A lump in the back of the throat of A lump in the back of the throat of

mouthmouth A lump in the neckA lump in the neck

TreatmentTreatment

Radiation therapyRadiation therapy A clinical trial of chemotherapy that is A clinical trial of chemotherapy that is

followed by surgery or radiation followed by surgery or radiation therapytherapy

A clinical trial of chemotherapy A clinical trial of chemotherapy combined with radiation therapycombined with radiation therapy

A clinical trial of new ways to provide A clinical trial of new ways to provide radiation therapyradiation therapy

Radiation TherapyRadiation Therapy

CANCER OF THE LARYNXCANCER OF THE LARYNX

Is a malignant tumor in the larynx (voice Is a malignant tumor in the larynx (voice box ), potentially curable if detected earlybox ), potentially curable if detected early

Less than 1% of all cancers, common in men Less than 1% of all cancers, common in men than in women ages 50-70 years of age.than in women ages 50-70 years of age.

Occurs in : glottic area ( vocal cords ), Occurs in : glottic area ( vocal cords ), supraglottic area, subglottis areasupraglottic area, subglottis area

CANCER OF THE CANCER OF THE LARYNXLARYNX

Risk Factors for laryngeal cancerRisk Factors for laryngeal cancer

Carcinogens :Carcinogens :

- tobacco- tobacco

- asbestos - asbestos

- paint fumes- paint fumes

- wood dust- wood dust

- chemicals- chemicals

Risk Factors for laryngeal Risk Factors for laryngeal cancercancer

OthersOthers- straining the voice- straining the voice- chronic laryngitis- chronic laryngitis- nutritional deficiencies- nutritional deficiencies- history of alcohol abuse - history of alcohol abuse - age- age- gender- gender- race- race- weakened immune system - weakened immune system

Clinical Manifestations Clinical Manifestations

Hoarseness of more than 2 weeksHoarseness of more than 2 weeks Cough or sore throat Cough or sore throat A lump felt on the neckA lump felt on the neck Dysphagia, dyspnea, unilateral nasal Dysphagia, dyspnea, unilateral nasal

obstructionobstruction Pain radiating to the earPain radiating to the ear

Assessment and Diagnostic Assessment and Diagnostic

FindingsFindings

History, Physical AssessmentHistory, Physical Assessment Indirect laryngoscopyIndirect laryngoscopy BiopsyBiopsy CTCT MRIMRI PETPET

Indirect LaryngoscopyIndirect Laryngoscopy

Medical Management Medical Management

SurgerySurgery Radiation therapyRadiation therapy ChemotherapyChemotherapy Speech therapySpeech therapy

Surgical ManagementSurgical Management

Laryngectomy- surgical removal Laryngectomy- surgical removal of part of all of the larynx and of part of all of the larynx and surrounding structuressurrounding structures Partial laryngectomyPartial laryngectomy HemilaryngectomyHemilaryngectomy Total laryngectomyTotal laryngectomy

Surgical ProcedureSurgical Procedure

Nursing Diagnosis Nursing Diagnosis

Ineffective airway clearance related to Ineffective airway clearance related to excess mucus production secondary to excess mucus production secondary to surgical alterations in the airwaysurgical alterations in the airway

Imbalance nutrition less than body Imbalance nutrition less than body requirement related to inability to ingest requirement related to inability to ingest foodfood

Self care deficit related to pain, weakness, Self care deficit related to pain, weakness, fatigue, musculoskeletal impairementfatigue, musculoskeletal impairement

Complications Complications

Respiratory distress Respiratory distress HemorrhageHemorrhage InfectionInfection Wound breakdownWound breakdown

Nursing Interventions Nursing Interventions

Teaching the patient preoperatively Teaching the patient preoperatively Reducing anxiety and depressionReducing anxiety and depression Maintaining a patent airwayMaintaining a patent airway Promoting alternative communication Promoting alternative communication

methodsmethods Adequate nutritionAdequate nutrition Promoting positive body image and self-Promoting positive body image and self-

esteem esteem Monitoring and managing potential Monitoring and managing potential

complicationscomplications

COLORECTAL CANCERCOLORECTAL CANCER

The colon and rectum are part of the The colon and rectum are part of the digestive tract. Together, they comprise the digestive tract. Together, they comprise the large intestine, or large vowel, which is large intestine, or large vowel, which is located in the abdomen between the small located in the abdomen between the small intestine and the anus. Cancer that intestine and the anus. Cancer that originate in the colon or rectum may be originate in the colon or rectum may be called colon cancer, rectal cancer or called colon cancer, rectal cancer or colorectal cancer. Colon cancer is the term colorectal cancer. Colon cancer is the term most commonly used to refer to this type of most commonly used to refer to this type of cancer.cancer.

COLORECTAL CANCERCOLORECTAL CANCER

EtiologyEtiology

Family historyFamily history Chronic inflammatory bowel Chronic inflammatory bowel

diseasedisease PolypsPolyps Low fiber dietLow fiber diet


Change in bowel habitsChange in bowel habits Passage of blood in stoolsPassage of blood in stools Unexplained anemiaUnexplained anemia Anorexia, Anorexia, Weight lossWeight loss FatigueFatigue Right side abdominal painRight side abdominal pain Left side abdominal pain, cramping, Left side abdominal pain, cramping,

narrowing stools, constipation and narrowing stools, constipation and distentiondistention

DiagnosisDiagnosis

Digital rectal examinationDigital rectal examination Fecal occult blood testFecal occult blood test Fiber optic sigmoidoscopyFiber optic sigmoidoscopy BiopsyBiopsy ColonoscopyColonoscopy

ColonoscopyColonoscopy

TreatmentTreatment

ChemotherapyChemotherapy Radiation therapyRadiation therapy Segmental resection with Segmental resection with

anastomosisanastomosis Abdomino perineal traction with Abdomino perineal traction with

sigmoid colostomysigmoid colostomy IleostomyIleostomy

CANCER OF THE STOMACHCANCER OF THE STOMACH

Most often develops the distal third and Most often develops the distal third and may spread thru the walls of the stomach may spread thru the walls of the stomach into adjacent tissues, lymphatics and into adjacent tissues, lymphatics and abdominal organsabdominal organs

Most death occur in 40 years of age but Most death occur in 40 years of age but occasionally occur in younger peopleoccasionally occur in younger people

Men have higher incidence of gastric Men have higher incidence of gastric cancer than women cancer than women

CANCER OF THE CANCER OF THE STOMACHSTOMACH

SymptomsSymptoms

EarlyEarly Indigestion or burning sensation Indigestion or burning sensation

( heartburn)( heartburn) Loss of appetite specially meatLoss of appetite specially meatLateLate Abdominal painAbdominal pain Nausea and vomitingNausea and vomiting Diarrhea or constipationDiarrhea or constipation Bloating of the stomach after mealsBloating of the stomach after meals Weight lossWeight loss Weakness and fatigueWeakness and fatigue Bleeding which can lead to anemiaBleeding which can lead to anemia


Pain relieved by antacidsPain relieved by antacids AnorexiaAnorexia DyspepsiaDyspepsia Weight lossWeight loss ConstipationConstipation


ChemotherapyChemotherapy Radiation therapyRadiation therapy Pharmacologic drugsPharmacologic drugs

cisplastincisplastin IrrinotecanIrrinotecan Doxorubicin Doxorubicin


Encourage the family to support the Encourage the family to support the patientpatient

Offer reassurance and support coping Offer reassurance and support coping measuresmeasures

Explain the procedures and treatmentExplain the procedures and treatment Encourage the patient to eat small Encourage the patient to eat small

frequent portion of non irritating foodsfrequent portion of non irritating foods Monitor IV therapyMonitor IV therapy Record intake and outputRecord intake and output Monitor daily weightsMonitor daily weights Assess for signs of dehydrationAssess for signs of dehydration

LIVER CANCERLIVER CANCER

Hepatic tumors may be malignant or Hepatic tumors may be malignant or benign. Benign liver tumors were the benign. Benign liver tumors were the uncommon until the wide spread use uncommon until the wide spread use of oral contraceptives. Primary liver of oral contraceptives. Primary liver tumors are associated with chronic tumors are associated with chronic liver diseases Hepatitis B and C liver diseases Hepatitis B and C infection and Cirrhosis.infection and Cirrhosis.




WeaknessWeakness Anorexia Anorexia Nausea and vomitingNausea and vomiting Right upper quadrant discomfortRight upper quadrant discomfort Blood tinged ascitesBlood tinged ascites Friction rub over liverFriction rub over liver

Diagnostic FindingsDiagnostic Findings

Increase serum levels of bilirubinIncrease serum levels of bilirubin Alkaline phosphatesAlkaline phosphates Lactic dehydrogenaseLactic dehydrogenase


ChemotherapyChemotherapy Percutaneous biliary drainagePercutaneous biliary drainage LobectomyLobectomy Radiation therapyRadiation therapy


Provide emotional support to the Provide emotional support to the clientclient

Provide care of the client receiving Provide care of the client receiving radiation therapyradiation therapy

Provide care with abdominal surgeryProvide care with abdominal surgery Provide nutritional statusProvide nutritional status

WILM’S TUMORWILM’S TUMOR

is a malignant tumor that rises from is a malignant tumor that rises from the metanephric mesoderm cell of the the metanephric mesoderm cell of the upper role of the kidney.upper role of the kidney.

It occurs in association with It occurs in association with congenital anomalies such aniridia congenital anomalies such aniridia ( lack of the color in the iris )( lack of the color in the iris )

Also known as “ Also known as “ NephroblastomaNephroblastoma ””

Wilm’s tumorWilm’s tumor

Assessment Assessment

nephroblastoma is usually nephroblastoma is usually discovered early in life (6 mos to 5 discovered early in life (6 mos to 5 yr; peak at 3 to 4yr)yr; peak at 3 to 4yr)

Although it apparently arises from Although it apparently arises from an embryonic structure present in an embryonic structure present in child before birth. Nephroblastoma child before birth. Nephroblastoma may manifest w/ hematoria and may manifest w/ hematoria and low grade fever occurs between of low grade fever occurs between of rennin production rennin production

DiagnosisDiagnosis

CT- scanCT- scan Glomerular filtration rateGlomerular filtration rate Blood urea nitrogenBlood urea nitrogen

Therapeutic Therapeutic ManagementManagement

Nephrectomy ( excision of Nephrectomy ( excision of affected kidney)affected kidney)

Chemotherapy w/ dactinomycinChemotherapy w/ dactinomycin

NephrectomyNephrectomy

STAGING STAGING NEPHROBLASTOMANEPHROBLASTOMA

II - tumor confined to the kidney and - tumor confined to the kidney and completely removes surgically.completely removes surgically.

IIII - tumor extending beyond the kidney - tumor extending beyond the kidney but completely removes surgically.but completely removes surgically.

IIIIII - Regional spread of the diseases - Regional spread of the diseases beyond the kidney w/ residual abdominal beyond the kidney w/ residual abdominal dse.dse.

Post operative.Post operative. IVIV - metastases to lung, liver, bone - metastases to lung, liver, bone

distance lymph nodes or other distance distance lymph nodes or other distance sitessites

VV - Bilateral diseases.- Bilateral diseases.

ComplicationComplication

small bowel Obstructionsmall bowel Obstruction Fibrotic scarringFibrotic scarring Hepatic damage from radiation to Hepatic damage from radiation to

the lesion can occursthe lesion can occurs NephritisNephritis In girls, radiation related damage to In girls, radiation related damage to

the ovaries may result sterilitythe ovaries may result sterility Interstitial pneumoniaInterstitial pneumonia Scoliosis Scoliosis

PROSTATE CANCERPROSTATE CANCER

is the most common cancer in the men other than is the most common cancer in the men other than non melanoma skin cancernon melanoma skin cancer

the second most common cause of cancer death in the second most common cause of cancer death in American men older than 55 y/o American men older than 55 y/o

It is estimated that 189,000 new cases of prostate It is estimated that 189,000 new cases of prostate cancer and 30,200 death occurs annuallycancer and 30,200 death occurs annually

Increase risk prostate cancer only 47 % of the men in Increase risk prostate cancer only 47 % of the men in sample who were 40 y/o or Older had prostate sample who were 40 y/o or Older had prostate cancer screening as part of annual physical cancer screening as part of annual physical examination.examination.




Risk FactorsRisk Factors

Increasing age rapidly with the age Increasing age rapidly with the age of 50 years.of 50 years.

Prostate cancer is common in the Prostate cancer is common in the United states and northwestern United states and northwestern Europe but is rare in Asia, Africa, Europe but is rare in Asia, Africa, Central America and South America.Central America and South America.

Familial predispositionFamilial predisposition Diet high in red meat and fat Diet high in red meat and fat

increase.increase.

Sign and SymptomsSign and Symptoms

Difficulty and frequency of urinationDifficulty and frequency of urination Urinary retentionUrinary retention Decrease size and force of urinary Decrease size and force of urinary

streamstream Blood in the urine or semenBlood in the urine or semen Painful ejaculationPainful ejaculation HematoriaHematoria

Symptoms related to Symptoms related to metastasesmetastases

backache backache hip painhip pain perineal and rectal discomfortperineal and rectal discomfort anemiaanemia weight lossweight loss weaknessweakness nauseanausea oligoriaoligoria

DiagnosisDiagnosis

every man older than 40 y/o should have every man older than 40 y/o should have DRE as part of the regular health checkupDRE as part of the regular health checkup

Rectal palpitation of the glandRectal palpitation of the gland Transurethral sectionTransurethral section Open ProstatectomyOpen Prostatectomy Transrectal needle biopsyTransrectal needle biopsy Transrectal Ultrasound ( TRUS)Transrectal Ultrasound ( TRUS) X- ray ( to identify bone metastasisX- ray ( to identify bone metastasis CT- scanCT- scan


1. 1. Surgical managementSurgical management - Radical prostatectomy (removal of - Radical prostatectomy (removal of

the prostate and seminal vesicle)the prostate and seminal vesicle)2. Radiation therapy2. Radiation therapy - teletherapy w/ linear accelator or - teletherapy w/ linear accelator or

interstitial irradiation ( implantation interstitial irradiation ( implantation of radioactive seeds of iodine or of radioactive seeds of iodine or palladium)palladium)


33.. Hormonal therapy- used to control rather than Hormonal therapy- used to control rather than cure prostate cancer.cure prostate cancer.

A. TURPA. TURP – the most common procedure used, can – the most common procedure used, can be carried out through endoscopy.be carried out through endoscopy.

B.B. SUPRAPUBIC PROSTATECTOMYSUPRAPUBIC PROSTATECTOMY - Is one method of removing the gland - Is one method of removing the gland

through an abdominal incisionthrough an abdominal incisionC.PERINEAL PROSTATECTOMYC.PERINEAL PROSTATECTOMY - Removing the gland through an incision in - Removing the gland through an incision in

the perineumthe perineumD. RETROPUBIC PROSTATECTOMYD. RETROPUBIC PROSTATECTOMY - is more common then the supra pubic - is more common then the supra pubic

approach. This procedure is suitable approach. This procedure is suitable For large gland located high in the pelvis.For large gland located high in the pelvis.

NURSING INTERVENTION NURSING INTERVENTION

Reducing anxietyReducing anxiety Relieving discomfort Relieving discomfort Providing instructionProviding instruction Preparing patientPreparing patient Maintaining fluid balanceMaintaining fluid balance Relieving painRelieving pain Monitoring for hemorrhage and Monitoring for hemorrhage and

infection infection

From the looks of the expression From the looks of the expression on the dog's face, he is really into on the dog's face, he is really into

saying his prayers saying his prayers

http://us.rd.yahoo.com/mail_us/taglines/postman8/*http:/us.rd.yahoo.com/evt=39663/*http:/voice.yahoo.com

The End!!!The End!!!

GOD BLESS !!!GOD BLESS !!!

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Particular Cancer Power Point