Oncology

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 Presentation outline

Objectives
Definition
Pathophysiology of cancer
Risk factor of cancer
Clinical manifestation of cancer
Diagnosis method of cancer
Management of Cancer
References

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 Objectives
At the end of this presentation you will be able to:
 Define Oncology, cancer
 Describe types of cancer.
 Identify risk factors, cause, clinical manifestation,
 Discuss nursing and medical managements of
common types of cancer.

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 We are made up of cells,
which contain genes

Cells grow and divide (copy themselves) to form

new cells

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 Cont…
When cells grow old or become
damaged, they die and new cells take
their place

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 Dention of terms
─ Anaplasia: cells that lack normal cellular characteristics
and differ in shape and organization with respect to their
cells of origin; usually malignant
─ Metaplasia: conversion of one type of mature cell into
another type of cell
─ Neoplasia: uncontrolled cell growth that follows no
physiologic demand
─ Apoptosis: programmed cell death

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 Cont…
─ Benign: not cancerous; may
grow but are unable to spread to
other areas
─ Malignant: having cells or
processes that are characteristic
of cancer
─ Carcinogenesis: process of
transforming normal cells into
malignant cells

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 Cont..
─ Hyperplasia: increase in the number of
cells of a tissue; most often associated with
periods of rapid body growth
─ Metastasis: spread of cancer cells from
the primary tumor to distant sites
─ Tumor-specific antigen (TSA): protein on
the membrane of cancer cells that
distinguishes the malignant cell from a
benign cell of the same tissue type
─ Tumor:- A growth of neoplastic cells clustered
together to form a mass.
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 Tumor
Can be Benign or Malignant
MALIGNANT
BENIGN
 Undifferentiated
 Well-differentiated
 Erratic and Uncontrolled
 Slow growth Growth

 Encapsulated  Expansive and Invasive

 Secretes abnormal
 Non-invasive
proteins
 Does NOT
 METASTASIZES

metastasize 12/08/2024 kid 9

Cont…

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 Introduction
Oncology
 Oncology is branch of medicine that deals with
the study, detection, treatment and
management of cancer.

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 Cont…
Cancer is a group of diseases characterized by
uncontrolled growth and spread of abnormal cells.

It is a disorder of altered cell differentiation and

growth.

Cancer is not a single disease with a single cause;

 It is a group of distinct diseases

 has different causes, manifestations, treatments,

and prognoses
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Cont…

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The common pathophysiologic processes with neoplastic disease are:

Proliferation

Invasions

Metastasis

Carcinogenesis

Angiogenesis

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Proliferation
 Cell proliferation is the process of increasing cell
numbers by mitotic cell division.

Angiogenesis
 A mechanism by which the tumor cells are
ensured a blood supply by its ability to induce
the growth of new capillaries from the host tissue
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Invasion and Metastasis
 Allows spread or transfer of cancerous cells from one organ
or body part to another

Invasion:-
 refers to the growth of the primary tumor in to the
surrounding host tissues

Metastasis :-
 is the dissemination or spread of malignant cells from the
primary tumor to distant sites through lymphatic and blood
circulation.
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 Carcinogenesis/ Oncogenesis
 Oncogenesis refers to genetic mechanisms where by

proto-oncogene and anti-oncogens transforms normal cell

into cancer cells
 Carcinogenic agent is a multi step process that can be

divided into three stages.

Initiation-primary exposure

promotion and –transformation

progression –cancer growth

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Pathophysiology of
malignant

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 Risk Factor Of Cancer Development
1. PHYSICAL AGENTS
 Radiation
 Exposure to irritants
 Exposure to sunlight
 Altitude, humidity

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Risk Factor Of Cancer Development
2. Chemical Agents 4. Dietary Habits
 Low-Fibere
 Smoking
 High-fat
 Dietary ingredients  Processed foods
 Drugs  alcohol

3. Genetics and Family

History
 Colon Cancer
 Breast cancer

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 Cont.…….
5. Other risk factors.
 Genetic or familial factors
 Hormonal agents: Oral contraceptives especially
prolonged estrogen therapy
 increased risk of hepatocellular, endometrial, and
breast cancers,
 but decrease the risk of ovarian cancer

 Physical inactivity

 Immunosuppression :- HIV
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
 Clinical manifestation of cancer

Presence of persistent change in bowel or bladder habits

Unusual bleeding or discharge from any body opening

Anemia

Unexpected weight loss, night sweat, fever

Persistent cough or hoarseness

Presence of a thickening or lumps any where in the body

Sore throat doesn’t heal

Sever pain

Fatigue
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7 Warning sign of cancer

CAUTION
 C- Change in bowel/bladder habits
 A- A sore that does not heal
 U- Unusual bleeding
 T- Thickening or lump in the breast
 I- Indigestion
 O- Obvious change in warts
 N- Nagging cough and hoarseness
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Types of cancer

Bladder cancer Oral &

Breast cancer Oropharnyangeal
Prostate cancer Pancreatic cancer
Kidney cancer Uterine cancer
Lung cancer
Colorectal cancer
Lymphoma
melanoma
Thyroid cancer
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 Complication of cancer
Acute complication  Chronic complication
 Hemorrhage  Renal artery stenosis
 Intestinal obstruction  Hypertension
 Biliary obstruction  Congestive heart failure
 Intracranial hypertension  Cardiomyopathy
 Cord compression syndrome  Hepatotoxicity
 Pulmonary  Infertility
thromboembolism  Rickets bone tumors

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Diagnostic evaluation of cancer
History collection  Positron emission
Physical examination
Blood examination
tomography

Sputum cytology  ABG analysis

X-ray  Pulmonary angiography
Bronchoscopy
 Mammography
CT scan
MRI  Endoscope

Fine needle aspiration  Fluoroscopy

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Diagnostic aids used to detect cancer

 Tumor marker identification:-

 some times called cancer marker, in the blood, urine,

or body tissues,
 Tumor markers are substances made by cancer cells or
by normal cells in response to cancer in the body.

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Bronchoscopy may be done to diagnose and
treat lung problems such as: Tumors or
bronchial cancer.

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Cont.…..
 Fine needle aspiration
 In fine needle aspiration, a thin needle is inserted into
an area of abnormal-appearing tissue or body fluid.
 can help make a diagnosis or rule out cancer

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Positron emission tomography (PET)
 Scan uses a mildly radioactive drug to show up areas of
your body where cells are more active than normal.
 It's used for cancer diagnosis.

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CT scans:- can MRI :- is a tool used to
show a tumor's find and locate certain
shape, size, and cancers. It is used to look for
location signs that cancer has spread
elsewhere in the body and
plan cancer treatment.

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A Fluoroscopy -To visually
mammogram examine the gastrointestinal
is an x-ray of the tract if a gastrointestinal
breast used to cancer is suspected. To guide a
detect breast liver biopsy if liver cancer is
cancer in women. suspected.

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Ultrasonograph Endoscope
y-  Allows tissue biopsy,
 Helps to look for fluid aspiration, and
tumors in certain areas excision of small tumors
of the body that don't  Used for diagnostic and
show up well on x- therapeutic purposes
rays.
 Use them to guide a
needle during a biopsy

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General promotive care of cancer
Lifestyle Modification
Nutritional management
Screening

Early detection
Diagnosis

Rehabilitation follow up
care
Palliative care

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Nursing management for patient with cancer

 Educate patient
 Maintain tissue integrity
 Promoting nutrition
 Relieving pain
 Decreasing fatigue
 Improved body image & self esteem
 Monitoring & managing potential complication
 Promoting home & community based care
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Medical management of
cancer
Chemotherapy

Immunotherapy

Surgery

Bone marrow transplant.

Radiation therapy

Targeted therapy

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 Cont.……….
Chemotherapy :- Is a drug treatment that uses powerful
chemicals to kill fast-growing cells in your body.

Immunotherapy :-Is treatment that uses certain parts of a

person's immune system to fight diseases such as cancer.

Surgery :-is the primary purpose of cancer surgery is to

cure your cancer by removing all of it from your body.

Radiation therapy :-is a type of cancer treatment that uses

beams of intense energy to kill cancer cells by using x-ray

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 Cont.……
Targeted therapy:-
 Is a type of cancer treatment that uses drugs or other
substances to precisely identify and attack certain types of
cancer cells.

A bone marrow transplant:-

 Replaces your damaged stem cells with healthy cells.
 This helps your body make enough white blood cells,
platelets, or red blood cells to avoid infections, bleeding
disorders, or anemia.
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 Cont…
Reality

death is inevitable but

it does not need to be,
painful or premature

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Cont…

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 Palliative care
WHO Definition
Palliative care is an approach that
improves the quality of life of patients
and their families facing the problem
associated with life-threatening illness,
through the prevention and relief of
suffering by means of early identification
and assessment and treatment of pain
and other problems; physical,
psychosocial and spiritual.
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 Palliative CARE
 AIDS, Cancer, Neurological
degenerative diseases, Diabetes,
and Peripheral Vascular Disease
(PVD)

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Principles of Palliative CARE

1. Affirms life and regards dying as a normal

process
2. Neither hastens nor postpones death
3. Provides relief from pain and other
distressing symptoms
4. Integrates the psychological and spiritual
aspects of care
5. Offers a support system to help patients live
as actively as possible until death
6. Offers a support system to help the family
7. cope during the patients illness and
bereavement
8. Will enhance quality of life
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Components of Palliative
Care
Relief of symptoms
Psychosocial support
End-of-life care
Caring for caregivers

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Pain

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 pain
◦ Is n unpleasant sensory
and emotional experience
resulting from actual or
potential tissue damage.

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 Physical Psychological
Functional Ability Fear
Strength/Fatigue Anxiety
Sleep and Rest Depression
Nausea Enjoyment/Leisure
Appetite Pain Distress
Constipation Happiness
Pain Cognition/Attention
mensions of Pain Quality of Life
Social Spiritual
Financial Burden Hope
Caregiver Burden Suffering Adapted
Roles and Relationships Meaning of Pain from
Affection/Sexual Function Religiosity Ferrell,
Appearance Transcendence(metke)et al.
1991

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 Pain Assessment
 Systematic evaluation of pain involves the
following:
 Taking a detailed history of pain, including
an assessment of its severity/intensity and
character
 Evaluate the psychological state of the
patient, including an assessment of mood
and coping responses
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 Cont…
◦The initial evaluation of
pain should include a
description of the pain using
the OPQRSTUV
characteristics:
◦O – Onset: ’When did it
start? How long does it last?
How often does it occur?’
◦P – Palliative or provocative
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Quality

 Steady
 Throbbing  Localized
 Pervasive
 Chronic
 Stabbing (persisten
 Dull t)
 Aching  Acute (in
 Pinching the
moment)

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 Cont…
◦R – Radiation: ‘Does it spread anywhere else?’
◦S – Severity: ‘How severe is it?’
◦T – Temporal factors: ‘Is it there all the time, or
does it come and go?’
◦U – Understanding impact
 What do you believe is causing this symptom?
 How is this symptom affecting you and/or your
family?
◦V – Values
 What is your comfort goal or acceptable level for
this symptom (on a scale of 0–10 with 0–being
none and 10– being the worst possible)?
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 Pain Assessment Scales

Assessing pain intensity

◦There are several rating scales
available to assess pain
1. Verbal Rating Scale (VRS)

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 Cont…
 Numeric Rating Scale (NRS)

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face pain rating scal

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Pain Treatment

◦Options for treating pain:

 Non-Pharmacological Pain
Management
 Pharmacological Pain
Management

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Cont…
Non-Pharmacological Pain
Management
◦Acupuncture
◦TENS (Transcutaneous electrical
nerve stimulation)
◦Meditation (relaxation)
◦Therapeutic massage
◦Guided imagery
◦Cognitive (behavioral) therapy
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WHO analgesic ladder

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Reference
Brunner and Suddarth’s Textbook of Medical Surgical
Nursing twelfth edition Lippincott, Williams and Wilkins
Company

Global Cancer Facts & Figures 2nd Edition

Harrison’s principle of internal medicine 18th edition

Brunner and Suddarth’s textbook of medical surgical

nursing 12th edition

Robbins basic pathology 8th edition

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