General Overview of Cancer

Definition: Malignant neoplasia marked by the uncontrolled growth of cells, often with invasion of healthy tissues locally or throughout the body (metastasis).
Incidence: Second leading cause of death in the U.S., after cardiovascular (CV) disease.

Onset: Varies with different types of cancer.

Etiology: Varies with different types of cancer. Risk factors include tobacco use, sun exposure, environmental/occupational exposure to carcinogens, poor nutrition, decreased level of physical activity, and infectious diseases.

Clinical Findings: Vary with different types of cancer. For a general overview of symptoms suggestive of cancer, refer to CAUTION 7 Warning Signs of Cancer in this section.

Types of Treatments
■ Surgery: Removing cancerous tissue surgically or by means of cryosurgery (a technique for freezing and destroying abnormal cells).
■ Chemotherapy:Treatment of cancer with drugs (“anticancer” drugs) that destroy cancer cells, or stop them from growing or multiplying. Because some drugs work better together than alone, two or more drugs are often given concurrently (combination therapy).
■ Radiation Therapy: Ionizing radiation (x-rays, gamma rays, or radioactive implants) deposits energy that injures or destroys the cells in the target tissue by damaging their genetic material, making it impossible for them to continue to grow.

Nursing Focus
■ Nausea/vomiting: Administer antiemetics as needed and before chemotherapy is initiated. Withhold foods and fluids 4–6 hours prior to chemotherapy. Provide small portions of bland foods after each treatment.
■ Diarrhea: Administer antidiarrheals. Monitor electrolytes. Give clear liquids as tolerated. Maintain good perineal care.
■ Stomatitis: Avoid commercial mouthwash containing alcohol. Encourage good oral hygiene. Help Pt rinse with viscous Lidocaine prior to eating to reduce discomfort, and again after meals. Apply water-soluble lubricant to cracked lips. Popsicles provide a good source of moisture.
■ Itching: Keep Pt’s skin free of foreign substances. Avoid soap: wash with plain water and pat dry. Use cornstarch or olive oil to relieve itching, and avoid talcum powder and powder with zinc oxide.

Patient Teaching
■ Provide literature for specific type of cancer to Pt and family.
■ Prepare the Pt and family for what to expect with chemotherapy and radiation therapy.
■ If surgery is to be performed, provide preoperative teaching to prepare the Pt and family for the procedure and postoperative care. Provide discharge instructions.
■ Explain the actions, dosages, side effects, and adverse reactions of meds.

Cancer Facts
■ Benign tumors: Noncancerous. They can often be removed and, in most cases, they do not come back. Cells from benign tumors do not spread to other parts of the body. Most importantly, benign tumors are rarely a threat to life.
■ Malignant tumors: Cancerous. Cells in these tumors are abnormal and divide without control or order. They can invade and damage nearby tissues and organs.
■ Metastasis: Process by which cancer cells break away from a malignant tumor and enter the bloodstream or the lymphatic system, thereby spreading from the original cancer site to form new tumors in other organs.

TNM—Staging of Cancer
T—Tumor Size	N—Nodes Involved	M—Metastasis
T—1 small	N—0 no involvement	M—0 none
T—2–3 medium	N—1–3 moderate	M—1 metastasis
T—4 large	N—4 extensive

CAUTION 7 Warning Signs of Cancer

C - change in bowel or bladder habits

A - any sore that does not heal

U - unusual bleeding or discharge

T  - thickening or lump in breast or elsewhere

I  - indigestion or dysphagia

O - obvious change in wart or mole

N - nagging cough or hoarseness

ABCDs of Melanoma

A—Asymmetry one side of lesion different from the other

B—Border edges are irregular, ragged, notched, or blurred

C—Color color is not uniform throughout lesion

D—Diameter diameter > 6 mm or an increase in size