WHAT IS CANCER?

Effects of Cancer MED-SURG

TUTOR || September 16, 2022
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Outline Cancer signs: CAUTION US!

Legend:
Remember Previous
➢ Change in bowel or bladder habits
(Exams)
Lecturer Book
Trans ➢ A sore that does not heal
    ➢ Unusual bleeding or discharge
➢ Thickenings or lumps
Heading 1 ➢ Indigestion or difficulty in swallowing
 Heading 2 ➢ Obvious change in a wart or mole
• The quick brown fox jumps over the lazy dog ➢ Nagging or persistent cough or hoarseness
 The quick brown fox jumps over the lazy dog
➢ Unexplained anemia
▪ The quick brown fox jumps over the lazy dog
➢ Sudden unexplained weight loss
• The quick brown fox jumps over the lazy dog
Subheading
Warning Signs of Cancer
EFFECTS OF CANCER ▪ C – change in bowel, bladder habits
 Disruption of Function- can be due to - Changes in color; consistency
obstruction or pressure - Size or shape of stools
 Hematologic Alterations: can impair function - Blood present in urine or stool
of blood cells - Alternating constipation and
 Hemorrhage: tumor erosion, bleeding, severe - diarrhea – most characteristic
anemia - manifestation of colon cancer
 Anorexia- Cachexia Syndrome: wasted
appearance of client Discussions:
 A person with colon cancer may have
Effects of Cancer diarrhea or constipation, or he may notice that
 Paraneoplastic Syndromes: ectopic sites with the stool has become smaller in diameter
excess hormone production  A person with bladder or kidney cancer may
- ↑ Parathyroid hormone→ hypercalcemia have urinary frequency and urgency
- ↑ secretion of insulin→ hypoglycemia
- ↑ Antidiuretic hormone (ADH) → fluid ▪ A – a sore that does not heal
retention, HTN & peripheral edema Sores that:
 ↑ Adrenocorticotropic hormone (ACTH): - Don’t seem to be getting better over time
cause excessive secretion of cortisone (ie: - Are getting bigger
fluid retention, ↑ glucose levels) - Getting more painful
 Pain: major concern of clients and families - Are starting to bleed
associated with cancer
 Physical Stress: body tries to respond and Discussions:
destroy neoplasm  Because tumor causes impaired circulation
 Psychological Stress and oxygenation in the area.
 Small, scaly patches on the skin that bleed or
ASSESSMENT do not heal may be a sign of skin cancer
 Nursing History  A sore in the mouth that does not heal can
- Health History – chief complaint and indicate oral cancer
history of present illness (onset, course,
duration, location, precipitating and ▪ U – unusual bleeding or discharge
alleviating factors) - Blood in the urine and stool
- Discharge from any parts of the body*

Page 1 of 4
[SUB] 1.01 TITLE OF LECTURE – Dr. Professor
Discussions:
 Blood in the stool is often the first sign of
colon cancer
 Similarly, blood in the urine is usually the first
sign of bladder or kidney cancer
 Postmenopausal bleeding (bleeding after
menopause) may be a sign of uterine cancer
▪ T – thickening or lump in the breast or
elsewhere
- Any lumps found in the breast when doing
BSE
- Any lump in the scrotum when doing self-
exam
- Other lumps found in the body
Discussions:
 Enlargement of the lymph nodes or glands
(such as the thyroid gland) can be an early
sign of cancer
 Breast and testicular cancers may also
present as a lump
▪ I – indigestion or difficulty in swallowing
- Feeling pressure in throat or chest which
makes swallowing uncomfortable
- Feeling full without food or with a small
amount of food
Discussions:
 Cancers of the digestive system, including
those of the esophagus, stomach, and
pancreas, may cause indigestion, heartburn,
or difficulty swallowing
▪ O – obvious change in wart or mole
Use the ABCD Rule:
- A – asymmetry
- B – Border
- C – Color
- D - Diameter
Discussions:
 A - are mole looks the same or different
 B- sharp or ragged
 C-colors seen in the mole
 D-is mole bigger than a pencil eraser
 Moles or other skin lesions that change in
shape, size, or color should be reported
Page 2 of 4
▪ N – nagging cough or hoarseness
- Change in voice or hoarseness
- Cough that does not go away
- Sputum with blood
Discussions:
 Cancers of the respiratory tract, including
lung cancer and laryngeal cancer, may
cause a cough that does not go away or a
hoarse (rough) voice
▪ U – Unexplained anemia
Discussions:
 In EACH CASE, fewer RBC means there
is less hgb to carry O2 throughout the
body
▪ S – Sudden weight loss
 Tumor use your blood and nutrients and
release your waste product inside your
body
 Sometimes tumor release chemicals that
can increase the body’s metabolism which
can lead to unexplained weight loss
Physical Assessment
• Inspection – skin and mucus membranes for
lesions, bleeding, petechiae, and irritation
- Assess stools, urine, sputum, vomitus for
acute or occult bleeding
- Scalp noting hair texture and hair loss
• Palpation
- Abdomen for any masses, bulges or
abnormalities
Lymph nodes for enlargement
• Auscultation – of lung sounds, heart sounds
and bowel sounds
Laboratory & Diagnostic Tests
▪ Cancer detection examination
▪ Laboratory tests
- Complete blood cell count (CBC)
[SUB] 1.01 TITLE OF LECTURE – Dr. Professor
- Tumor markers – identify substance
(specific proteins) in the blood that are made
by the tumor
➢ PSA (Prostatic-specific antigen): prostate
cancer
➢ CEA (Carcinoembryonic antigen): colon
cancer
➢ Alkaline Phosphatase: bone metastasis
- Biopsy
Diagnostic Tests
➢ Determine location of cancer:
➢ X-rays
➢ Computed tomography
➢ Ultrasounds
➢ Magnetic resonance imaging
➢ Nuclear imaging
➢ Angiography
Diagnosis of cell type:
- Tissue samples: from biopsies, shedded cells
(e.g. Papanicolaou (PAP) smear), & washings
- Cytologic Examination: tissue examined
under microscope
Direct Visualization:
▪ Sigmoidoscopy
▪ Cystoscopy
▪ Endoscopy
▪ Bronchoscopy
▪ Exploratory surgery; lymph node biopsies to
determine metastases
Cancer Detection and Diagnosis
Discussions:
 Detecting cancer early can affect the outcome
of the disease for some cancers. When
cancer is found, a doctor will determine what
type it is and how fast it is growing.
 He or she will also determine whether cancer
cells have invaded nearby healthy tissue or
spread (metastasized) to other parts of the
body.
 In some cases, finding cancer early may
decrease a person’s risk of dying from the
cancer. For this reason, improving our
methods for early detection is currently a high
priority for cancer researchers.
Page 3 of 4
Early Cancer May Not Have Any Symptoms
Discussions:
 Some people visit the doctor only when they
feel pain or when they notice changes like a
lump in the breast or unusual bleeding or
discharge. But don’t wait until then to be
checked because early cancer may not have
any symptoms.
 That is why screening for some cancers is
important, particularly as you get older.
Screening methods are designed to check
for cancer in people with no symptoms.
Cervical Cancer Screening
Discussions:
 A screening
technique
called the Pap
test (or Pap
smear) allows
early detection
of cancer of the
cervix, the
narrow portion
of the uterus
that extends
down into the
upper part of
the vagina.
 In this
procedure, a doctor uses a small brush or
wooden scraper to remove a sample of cells
from the cervix and upper vagina. The cells
are placed on a slide and sent to a laboratory,
where a microscope is used to check for
abnormalities.
 Since the 1930s, early detection using the
Pap test has helped lower the death rate from
cervical cancer more than 75 percent.
 Should abnormalities be found, an additional
test may be necessary. There are now 13
high-risk types of human papillomaviruses
(HPV) recognized as the major causes of
cervical cancer.
 The U.S. Food and Drug Administration has
approved an HPV test that can identify their
presence in a tissue sample. This test can
detect the viruses even before there are any
conclusive visible changes to the cervical
cells.
[SUB] 1.01 TITLE OF LECTURE – Dr. Professor
Breast Cancer Screening
Discussions:
 Breast cancer can sometimes be detected in
its early stages using a mammogram, an X-
ray of the breast.
 Mammography is most beneficial for women
as they age and undergo menopause.
Mammography is a screening tool that can
detect the possible presence of an abnormal
tissue mass.
 By itself, it is not accurate enough to provide
definitive proof of either the presence or the
absence of breast cancer. If a mammogram
indicates the presence of an abnormality,
further tests must be done to determine
whether breast cancer actually is present.
Prostate and Ovarian Cancer Screening
Discussions:
 The U.S. Food and Drug Administration has
approved the PSA test along with a digital
rectal exam to help detect prostate cancer in
men age 50 and older. Doctors often use the
PSA test and DRE as prostate cancer
screening tests; together, these tests can
help doctors detect prostate cancer in men
who have no symptoms of the disease.
 Most men with an elevated PSA test, though,
turn out not to have cancer; only 25 to 30
percent of men who have a biopsy due to
elevated PSA levels actually have prostate
cancer, so researchers are working hard to
find new clues.
 Experts are trying to develop better blood
tests that might alert people to malignancies
while the cancers are still in their early stages.
For example, several new blood tests for
ovarian or prostate cancer are under
development.
Colon Cancer Screening
Discussions:
 A procedure called a fecal occult blood test
(FOBT) detects invisible amounts of blood in
the feces, a possible sign of several
disorders, including colon cancer.
 The test is painless and can be done at home
or in the doctor’s office along with a rectal
exam. With an application stick, a dab of a
stool specimen is smeared on a chemically
treated card, which is tested in a laboratory
for evidence of blood. If blood is confirmed in
the stool, more elaborate tests may be
performed to find the source of the bleeding.
Page 4 of 4
 Some other options include sigmoidoscopy
and colonoscopy. The former exam uses a
lighted instrument called a sigmoidoscope to
find precancerous or cancerous growths in
the rectum and lower colon. The latter exam
uses a lighted instrument called a
colonoscope to find precancerous or
cancerous growths throughout the colon,
including the upper part.
Biopsy
Discussions:
 To diagnose the presence of cancer, a doctor
must look at a sample of the affected tissue
under the microscope. Hence, when
preliminary symptoms, Pap test,
mammogram, PSA test, FOBT, or
colonoscopy indicate the possible existence
of cancer, a doctor must then perform a
biopsy, which is the surgical removal of a
small piece of tissue for microscopic
examination. (For leukemias, a small blood
sample serves the same purpose.)
 This microscopic examination will tell the
doctor whether a tumor is actually present
and, if so, whether it is malignant (i.e., cancer)
or benign.
 In addition, microarrays may be used to
determine which genes are turned on or off in
the sample, or proteomic profiles may be
collected for an analysis of protein activity.
This information will help doctors to make a
more accurate diagnosis and may even help
to inform treatment planning.
Microscopic Appearance of Cancer Cells
Back
Discussions:
 Cancer
tissue has a
distinctive
appearance
under the
microscope.
Among the
traits the
doctor looks
for are a
large number of irregularly shaped dividing
cells, variation in nuclear size and shape,
variation in cell size and shape, loss of
specialized cell features, loss of normal tissue
organization, and a poorly defined tumor
boundary.