Upload
yucef-bahian-abang
View
257
Download
0
Tags:
Embed Size (px)
DESCRIPTION
nursing
Citation preview
Neoplasia
Oncology definedBranch of medicine that deals with the study, detection, treatment and management of cancer and neoplasia
Root wordsNeo- newPlasia- growth
NeoplasiaUncontrolled growth of Abnormal cells1. Benign2. Malignant3. Borderline
Characteristics of NeoplasiaBENIGNWell-differentiatedSlow growthEncapsulated Non-invasiveDoes NOT metastasize
Characteristics of NeoplasiaMALIGNANTUndifferentiatedErratic and Uncontrolled GrowthExpansive and InvasiveSecretes abnormal proteinsMETASTASIZES
leiomyomas
adenoma
adenocarcinoma
carcinoma
Nomenclature of NeoplasiaTumor is named according to:1. Parenchyma, Organ or CellHepatoma- liverOsteoma- boneMyoma- muscle
Nomenclature of NeoplasiaTumor is named according to:2. Pattern and Structure, either GROSS or MICROSCOPICFluid-filled CYSTGlandular ADENOFinger-like PAPILLOStalk POLYP
BENIGN TUMORSSuffix- OMA is usedAdipose tissue- LipOMABone- osteOMAMuscle- myOMABlood vessels- angiOMAFibrous tissue- fibrOMA
MALIGNANT TUMOR-nomenclature Glandular, EpithelialUse the suffix- CARCINOMAPancreatic AdenoCarcinomaSquamos cell Carcinoma
MALIGNANT TUMOR2. connective tissue originUse the suffix SARCOMAFibroSarcomaMyosarcomaAngioSarcoma
OMA but MalignantHepatOMA, lymphOMA, gliOMA, melanOMA
dysplasiadenotes a loss of architectural organization and a loss of cell uniformity in epitheliummild to moderate dysplasia is potentially reversible
dysplasia
normal epithelium
dysplasia
Dysplasia is a non-neoplastic proliferation.Dysplasia may or may not progress to cancer.
differentiationWell-differentiated tumors contain cells that resemble the normal cells of originpoorly-differentiated or undifferentiated tumors contain cells that do not resemble their normal counterparts (ancillary studies may be needed to determine the cell of origin)
well-differentiated
poorly-differentiated
Benign tumors are composed of well-differentiated cells.Malignant tumors are characterized by a wide range of cellular differentiation.
rate of growth In general, well-differentiated malignant tumors have a slower rate of growth than poorly-differentiated malignant tumors.There are exceptions. Blood supply, site, and hormonal stimulation are factors that can affect the growth rate of tumors.
meningioma
basal cell carcinoma
melanoma
metastasisDistant spread of the tumorMethods of metastasis include: lymphatic spread, and hematogenous spread.
metastatic ovarian carcinoma
MRI: metastatic adenocarcinoma
metastatic adenocarcinoma
Spread of Cancer1. LYMPHATICMost common2. HEMATOGENOUSBlood-borne, commonly to Liver and Lungs3. DIRECT SPREADSurrounding organs
Spread of cancer Cancers commonly spread t bone,lungs liver and brain(secondary deposits)
Cancer Diagnosis1. BIOPSY The most definitive2. CT, MRI3. Tumor Markers
grading and stagingGrading is based on the microscopic features of the cells which compose a tumor and is specific for the tumor type.Staging is based on clinical, radiological, and surgical criteria, such as, tumor size, involvement of regional lymph nodes, and presence of metastases. Staging usually has prognostic value.
Cancer GradingThe degree of DIFFERENTIATIONGrade 1- Low gradeGrade 4- high grade
Cancer Staging1. Uses the T-N-M staging systemT- tumorN- NodeM- Metastasis
GENERAL MEDICAL MANAGEMENT
1. Surgery- cure, control, palliate2. Chemotherapy3. Radiation therapy4. Immunotherapy5. Bone Marrow Transplant
GENERAL Promotive and Preventive1. Lifestyle Modification2. Nutritional management3. Screening4. Early detection
SCREENING1. Male and female- Occult Blood, CXR, and DRE2. Female-, Mammography and Paps Smear3. Male- DRE for prostate, Testicular self-exam
Cancer causes
Etiology of cancer1. PHYSICAL AGENTSRadiationExposure to irritantsExposure to sunlightAltitude, humidity
Etiology of cancer2. CHEMICAL AGENTSSmokingDietary ingredientsDrugs
Etiology of cancer3. Genetics and Family HistoryColon CancerPremenopausal breast cancer
Etiology of cancer4. Dietary HabitsLow-FiberHigh-fatProcessed foodsalcohol
Etiology of cancer5. Viruses and BacteriaDNA viruses- Hep, Herpes, EBV, CMV, Papilloma VirusRNA Viruses- HIV, Bacterium- H. pylori
Etiology of cancer6. Hormonal agentsOCP especially estrogen
Etiology of cancer7. Immune DiseaseAIDS
Proposed Molecular cause of CANCER:
Change in the DNA structure altered DNA function Cellular aberration neoplastic change
CARCINOGENSISMalignant transformationIPPInitiationPromotionProgression
CARCINOGENSISINITIATIONCarcinogens alter the DNA of the cellCell will either die or repair
CARCINOGENSISPROMOTIONRepeated exposure to carcinogensAbnormal gene will expressLatent period
CARCINOGENSISPROGRESSIONIrreversible periodCells undergo NEOPLASTIC transformation then malignancy
Colon cancer
COLON CANCERRisk factors1. Increasing age2. Family history3. Previous colon CA or polyps4. History of IBD5. High fat, High protein, LOW fiber6. Breast Ca and Genital Ca
COLON CANCERSigmoid colon is the most common sitePredominantly adenocarcinomaIf early 90% survival
COLON CANCERPATHOPHYSIOLOGYBenign neoplasm DNA alteration malignant transformation malignant neoplasm cancer growth and invasion metastasis (liver)
COLON CANCERASSESSMENT FINDINGS 1. Change in bowel habits- Most common2. Blood in the stool3. Anemia4. Anorexia and weight loss5. Fatigue6. Rectal lesions- tenesmus, alternating D and C
Colon cancerDiagnostic findings1. Fecal occult blood2. Sigmoidoscopy and colonoscopy3. BIOPSY4. CEA- carcino-embryonic antigen
Colon cancerComplications of colorectal CA1. Obstruction2. Hemorrhage3. Peritonitis4. Sepsis
Colon cancerMEDICAL MANAGEMENT1. Chemotherapy- 5-FU2. Radiation therapy
Colon cancerSURGICAL MANAGEMENTSurgery is the primary treatmentBased on location and tumor sizeResection, anastomosis, and colostomy (temporary or permanent)
Colon cancerNURSING INTERVENTIONPre-Operative care1. Provide HIGH protein, HIGH calorie and LOW residue diet2.Provide information about post-op care and stoma care3. Administer antibiotics 1 day prior
Breast CancerThe most common cancer in FEMALESNumerous etiologies implicated
Breast CancerRISK FACTORS1. Genetics- BRCA1 And BRCA 22. Increasing age ( > 50yo)3. Family History of breast cancer4. Early menarche and late menopause5. Nulliparity6. Late age at pregnancy
Breast CancerRISK FACTORS7. Obesity8. Hormonal replacement9. Alcohol10. Exposure to radiation
Breast CancerPROTECTIVE FACTORS1. Exercise2. Breast feeding3. Pregnancy before 30 yo
Breast CancerASSESSMENT FINDINGS1. MASS- the most common location is the upper outer quadrant2. Mass is NON-tender. Fixed, hard with irregular borders3. Skin dimpling4. Nipple retraction5. Peau d orange
Breast CancerLABORATORY FINDINGS1. Biopsy procedures2. Mammography
Breast CancerBreast cancer StagingTNM stagingI - < 2cmII - 2 to 5 cm, (+) LNIII - > 5 cm, (+) LNIV- metastasis
Breast CancerMEDICAL MANAGEMENT1. Chemotherapy2. Tamoxifen therapy3. Radiation therapy
Breast CancerSURGICAL MANAGEMENT 1. Radical mastectomy2. Modified radical mastectomy3. Lumpectomy4. Quadrantectomy
Thank you