Cancer
Pathophysiology: Malignant
neoplasia marked by uncontrolled growth of cells, often with invasion of healthy tissue locally or throughtout the body. DNA
mutations cause 1. Conversion of protooncogenes to oncogenes 2. Inhibition of tumor suppressor genes & 3. Inhibition of
DNA repair genes. In step 1 the protooncogenes which were regulared are now oncogenes which continuously produce growth related
proteins. Step 2 turns off the genes that would normally suppress oncogenes. Step 3 turns off the genes that encode proteins
to fix DNA so the cells cannot regain control. After a cell becomes cancerous it multiplies rapidly in one place but untreated
it will spread through the circulatory system.
Symptoms: pain, malnutrition,
weakness, fatigue, bone fractures, stroke-like syndrome, malaise; change in bowel or bladder habits, a sore that does not
heal, unusual bleeding & discharge; thickening or mass in breast or other body part, indigestion or difficulty swallowing;
obvious change in wart or mole; nagging cough or horseness
Causes: Cigarette smoking, second-hand smoke, occupational exposure to carcinogens such as asbestos, uranium, nickel,
and chromate; ionizing radiation, UV light, some viruses, drugs that damage nucleic acids may initiate genetic lesions that
result in cancer; heredity
Diagnostic Tests: endoscopy, radiography (x-ray, CT, MRI, untrasound, mammography), examination
of cytological specimen, review of biopsy specimen; Screening: Pap smear, mammography, PSA, occult blood test
Medical Treatments: surgery, chemotherapy, radiation
Nursing Implications:
Assessment: VS, I/O, psychosocial/emotional status, perception of Dx,
knowledge level, status of other body systems, body weight, skin turgor, mucous membrane condition; assess support network,
impact of illness on family, employment, lifestyle, sexuality; assess perceived life stress & usual coping patterns, $
status/worries; current medications (Rx & OTC)
Care: Monitor and record VS and I/O, maintain diet, maintain IV fluids and IV site integrity if applicable, assist
with personal and oral hygiene, provide for patient comfort, explain all procedures and obtain written informed consent, monitor
and record the above assessment, encourage adherence to medication regiment, document pt pain patterns & response to interventions,
individualize home care instructions; encourage active participation in all decision making; provide pt w/ relevant reading
material/information on support groups.
Corwin – Handbook of Pathophysiology
Phipps – Med-Surg Nursing
Taber’s Cyclopedic Medical Dictionary
www.webmd.com
www.merck.com
www.cancer.gov
