nu4112 UCC

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Cancer
Group of diseases with uncontrolled cell growth and spread
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Tumour
Neoplasm or new abnormal cell growth
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Malignant
Tumors with invasive characteristics
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Benign
Non-invasive tumors with normal characteristics
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Proto-oncogenes
Genes promoting cell growth
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Tumour Suppressor Genes
Genes inhibiting cell division
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DNA Repair Genes
Genes maintaining DNA integrity
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Inflammatory Theory
Proposes infectious agents as primary cancer causes
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Anaplasia
Loss of cell differentiation in cancer
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Cancer Initiation
Starts with genetic mutation in a cell
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Cell Invasion
Abnormal cells infiltrate tissues
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Tumour Doubling Time
Varies from hours to months based on tumor type
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Cell Differentiation Loss
Cancer cells lose normal cell appearance and function
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Cancer Development Stages
Initiation
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Carcinoma
Cancer of epithelial origin
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Sarcoma
Cancer of supportive tissues like bones or muscles
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Lymphoma
Cancer of lymphatic system glands or nodes
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Cancer Mortality
Deaths attributed to cancer in a defined time and population
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Cancer Incidence
Newly diagnosed cancer cases in a specified population
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Cancer Prevalence
Measurement of all cancer cases at a specific time
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Cancer Epidemiology
Studies disease distribution
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Cancer Survival Analysis
Observes cancer patients' survival probabilities over time
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5-Year Relative Survival Rate
Percentage of cancer patients alive 5 years post-diagnosis
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Cancer Screening Initiatives
Linked to reduced cancer rates in the US
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Advancing age
Significant risk factor for cancer
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Immunosuppression
Increases cancer risk
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Alcohol and Cancer
Alcohol increases risk for cancers of mouth
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Chronic Inflammation
Can lead to DNA damage and cancer
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Tobacco Use
Linked to various cancers
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Diet and Obesity
Obesity increases cancer risks in various organs
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Cancer Risk Factors
Includes alcohol
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Ionizing Radiation
Includes radon
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Infections and UV Rays
Infections like HBV
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Genetics and Cancer
Genes control cell function
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Cancer Patterns
Different cancers prevail in regions due to various causative agents
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Cancer Screening
Early detection tests like mammograms
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Screening Benefits and Risks
Benefits include mortality reduction; risks include false positives and radiation exposure
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National Cancer Strategy
Aims to reduce cancer burden
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BreastCheck and CervicalCheck
National screening programs for breast and cervical cancers
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CervicalCheck
Program offering free smear tests every 3 years to women aged 25-44 in Ireland
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Colposcopy
Procedure to closely examine the lining of the cervix for abnormal cells
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BowelScreen
National Bowel Screening Programme providing free home FIT tests every 2 years
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FIT test
Faecal immunochemical test used in BowelScreen for home screening
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Tumour markers
Antigens indicating cancer presence
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PSA
Prostate-specific antigen; a tumour marker for prostate cancer
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TNM staging
Method to stage tumours based on size
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Grading of tumours
Microscopic examination to determine cancer cell differentiation and mitosis levels
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Metastasis
Spread of malignant cells from the primary tumour to distant sites
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Lymphatic spread
Transport of tumour cells via lymphatic circulation
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Hematogenous spread
Dissemination of cells through the bloodstream
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Angiogenesis
Malignant cells inducing growth of new capillaries
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Tumour grading
Determining cancer cell differentiation and mitosis levels
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Tumour staging
Assessing tumour size
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Chemotherapy
Drugs used to destroy tumor cells by interfering with cell function
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Chemotherapy Function
Kills enough cancer cells for the body's immune system to eliminate the rest
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Chemotherapy Facts
Affects normal rapidly dividing cells
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Chemotherapy History
Began early 1900s
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Chemotherapy Administration
Can be topical
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Chemotherapy Classification
Chemotherapeutic agents classified by cell cycle relationship and chemical groups
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Cell Cycle
Phases of cell division
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Combination Chemotherapy
Uses multiple drugs to kill more cancer cells and prevent resistance
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Chemotherapy
Regimens Specific drug combinations for breast
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Chemotherapy Safety
Risks to healthcare workers
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Chemotherapy Adverse Effects
Targets rapidly dividing cells
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Nadir Period
Lowest blood cell count post-chemotherapy
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Tumor Lysis Syndrome
An emergency condition due to rapid breakdown of cancer cells
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Chemotherapy Side Effects Severity
Classified as mild (grade 1) to life-threatening (grade 4) based on WHO scale
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Immediate Chemotherapy Side Effects
Quickly observable effects on skin
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Chronic Chemotherapy Side Effects
Includes drug resistance
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Chemotherapy Impact on Cognitive Function
Up to 75% of patients report cognitive changes during treatment
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Psychological Morbidity from Chemotherapy
Associated with high physical and psychiatric morbidity
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Chemotherapy-Induced Alopecia
Hair loss influenced by drug type
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Scalp Cooling for Alopecia Prevention
Effective method using cooled caps or 'Cryogel' bags to reduce hair loss
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Nursing Interventions for chemotherapy
Monitoring Heart Sounds Regular assessment of heart sounds for any abnormalities;assessing Kidney Function Evaluation of creatinine
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Radiotherapy
Use of ionizing radiation to treat malignant disease with minimal damage to healthy tissue
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Purpose of Radiotherapy
Eradicate disease
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Principles of Radiotherapy
Destroy cancer cells' ability to grow
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Radiation Measurement
Doses measured in gray (Gy)
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Radiosensitivity
Tumors destroyed by radiation
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Types of Radiotherapy
External-beam (Teletherapy)
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External Radiation Therapy
Delivered daily for 2-8 weeks
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Intensity Modulated Radiation Therapy (IMRT)
Precise radiation delivery to tumor while sparing healthy tissue
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Internal Radiotherapy - Brachytherapy
Implanting sealed radioactive source near cancerous area for localized treatment
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Radiotherapy Side Effects
Affect rapidly dividing cells
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Radiation Dermatitis
Injury to skin cells due to radiation
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Radiation Dermatitis Risk Factors
Treatment factors
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Acute Radiation Dermatitis
Immediate skin reactions to radiation
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Chronic Radiation Dermatitis
Long-term skin changes post-radiation
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Radiation Dermatitis Prevention
Gentle washing
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Management of Radiation Dermatitis
Varied approaches with conflicting evidence
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StrataXRT®
Silicone-based film-forming gel dressing effective in preventing grade 2 and 3 skin toxicity
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Topical Corticosteroids
Effective in managing acute radiation dermatitis
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RTOG Classification
Radiation Therapy Oncology Group classification system for radiation dermatitis severity
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Herbal Options for Radiation Dermatitis
Calendula
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Topical Vitamins for Radiation Dermatitis
Ascorbic acid (Vitamin C)
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Endogenous Agents for Radiation Dermatitis
Hyaluronic acid
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Pharmaceutical Management of Radiation Dermatitis
Topical corticosteroids
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Silver Nylon Dressings
Used daily during and post-radiotherapy to manage skin toxicity
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Daily Washing with Mild Soap
Recommended for all patients receiving radiation treatment to reduce itching
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Topical Management
Treatment applied directly to the skin surface
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Systematic Review
Comprehensive analysis of existing research studies on a specific topic
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Meta-Analysis
Statistical analysis combining results from multiple studies for increased power
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Risk Factors
Variables increasing the likelihood of developing a condition
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Treatment
Algorithm Step-by-step medical decision-making process for managing a condition
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Mepilex Lite Dressings
Specific type of dressing used for managing radiation dermatitis
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External-Beam Radiation Therapy
Delivery of radiation from outside the body to target cancer cells
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Implant
Device placed inside the body to deliver radiation directly to the tumor
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Systemic Radiation Therapy
Treatment where radioactive substances travel through the bloodstream to target cancer cells
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Cystitis
Inflammation of the bladder
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White et al. (2011)
Authors who studied treatment-induced female sexual difficulties after pelvic radiotherapy
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Linear Accelerators
Machines delivering high-energy radiation beams for cancer treatment
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Care to Drive
Programme Initiative providing transport assistance for cancer patients
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National Cancer Registry Ireland
Official database collecting cancer-related information in Ireland
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Centres of Excellence
Specialized facilities providing high-quality cancer treatment
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Safety Precautions
Measures taken to protect patients and visitors from radiation exposure
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Moist Desquamation
Skin peeling or shedding due to radiation therapy
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Radiotherapy-Related Clinical Toxicities
Adverse effects resulting from radiation treatment
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Global Quality of Life
Overall quality of life assessment encompassing various aspects
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Cancer Symptoms
New problems indicating progression and prognosis
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Psychological Symptoms
Includes depression
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Neurological Symptoms
Include weakness
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Respiratory Symptoms
Manifest as dyspnoea
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Dermatological Symptoms
Present as skin ulceration
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Urinary Symptoms
Include haematuria
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Gastrointestinal Symptoms
Manifest as oral mucositis
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Haematological Symptoms
Include haematuria
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Oral Symptoms
Present as halitosis
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Symptom Clusters
When patients experience multiple related symptoms concurrently
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Cancer Pain
Experienced by 20-50% of cancer patients
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Pain - Classification
Categorizing pain based on duration and cause
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Pain - Assessment
Utilizes tools like Visual Analog Scale and Verbal Description Scale
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Pain - Management
Involves non-pharmacological interventions and WHO ladder for opioids
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Cancer Related Fatigue
Subjective sense of tiredness not proportional to activity
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CRF - Classification
Distinguishes between acute and chronic cancer-related fatigue
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Fatigue - Causes
Factors like stress
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Fatigue - Causes: Treatments
Chemotherapy
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Fatigue - Management
Includes screening
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CRF
Cancer-related fatigue impacting daily living activities
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Bone Marrow Transplant
Procedure where stem cells are transplanted to treat cancer
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Hodgkin's Lymphoma
Cancer of the lymphatic system
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Psychological Distress
Emotional suffering affecting mental well-being
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Psychosocial Factors
Anxiety
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Nausea & Vomiting
Common side effects in cancer patients
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Chemotherapy
Treatment using drugs to kill cancer cells
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Radiotherapy
Treatment using high-energy radiation to kill cancer cells
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Anticipatory Nausea & Vomiting
Learned response to environmental triggers before treatment
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Antiemetics
Medications to prevent or treat nausea and vomiting
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Constipation
Difficulty in passing stools
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NCCN
National Comprehensive Cancer Network providing cancer care guidelines
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ESMO Guidelines
European Society for Medical Oncology's cancer treatment recommendations
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CRF Impact
CRF affects daily activities in cancer patients
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NV Causes
Factors like cancer
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NV Types
Acute
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Emesis Control Principles
Prevention and proper antiemetic selection for nausea and vomiting
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Constipation Consequences
Obstruction
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Neutropenia
Neutrophil count <1000-1500/μl; causes: drugs
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Neutropenia Management
Includes broad spectrum antibiotics
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Fever
May be the only sign of neutropenia; requires immediate medical attention
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Mucositis
Inflammation of mucosal tissue; common in chemo patients; causes pain and difficulty eating
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Mucositis Signs
Include red
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Mucositis Assessment
Process of evaluating the severity and impact of mucositis on the patient
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Mucositis Management
Involves analgesia
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Malnutrition
Present in 15-40% of cancer diagnoses; increases during treatment
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Cancer Cachexia
Progressive muscle loss in cancer patients; not reversible by normal nutrition
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Nutritional Consequences
Surgery and radiotherapy can lead to severe nutritional problems and complications
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Psychosocial Impact of mucositis
Mucositis can affect eating and communication
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Neutropenic Diet
Involves high-temperature cooked food; limited evidence of effectiveness
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Waste Management
Involves regular bin emptying
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Food Precautions
Wash fruit thoroughly
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Handwashing Importance
Critical in preventing infections in neutropenic patients
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Mucositis Impact on Quality of Life
Causes functional limitations
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Lean Body Mass Loss
Sarcopenia in cancer patients is a risk factor for poor outcomes
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Gene Expression Profiles
Distinct in tumours like lung and pancreas
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Inflammation in Malnutrition
Systemic inflammation plays a role in malnutrition in GI cancers
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Nutrient Absorption
Reduced in cancer patients due to treatment-induced damage
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Protein and Energy Intake
Must meet individual needs to prevent malnutrition in cancer patients
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Surgery Complications
Include anaemia
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Radiotherapy Effects
Can impact oral mucosa
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Stomatitis
Inflammation of the mouth and lips
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Candida
Fungal infection causing oral thrush
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Xerostomia
Dry mouth condition
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Mediastinum
Area between the lungs
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Anorexia
Loss of appetite
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Gastric Distension
Abdominal bloating due to gas or fluid accumulation
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Biotherapy
Treatment using substances to stimulate the immune system
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Deficiencies
Lack of essential nutrients like Vitamins B1
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Taste Alterations
Changes in taste perception
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Fatigue
Extreme tiredness
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Enteral Feeding
Nutritional support through the gastrointestinal tract
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Parenteral Feeding
Nutritional support through intravenous delivery
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Albumin
Protein in the blood
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Cholesterol
Fatty substance in the blood
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Cachexia
Severe muscle wasting and weight loss
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Oral Candidiasis
Fungal infection in the mouth
Wasting Progressive decline in health and muscle mass
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Self-Care Agency
Ability to care for oneself and manage symptoms
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Neuropathic Pain
Pain caused by nerve damage
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Cancer diagnosis challenges
Specific difficulties faced by individuals receiving a cancer diagnosis
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Psychosocial impact
Effects on emotional
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Common emotional responses
Includes denial
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Adjustment to Cancer
Initial emotional distress followed by seeking information and help
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Psychological distress
Fears of isolation
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Psychological disorders in cancer
Anxiety and depression present in a third of cancer patients
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Distress in cancer
Unpleasant emotional experience interfering with coping effectively
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Screening Tools
Instruments like Edinburgh Depression Scale used to assess mental health
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Anxiety Response
Manifests during screening
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Existential Crises in Cancer
Thoughts on mortality
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Model of Care of Psycho-Oncology
Levels of intervention based on the severity of distress in patients
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Depression and Cancer
Common yet overlooked source of suffering impacting quality of life
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Periods of Increased vulnerability for depression
Times during cancer journey where depression risk is heightened
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Risk Factors for Depression in People With Cancer
Includes psychiatric history
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Managing Depression and Anxiety in Cancer Care
Strategies to address mental health challenges in cancer patients
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Risk Factors for Depression in Cancer Patients
Includes previous psychiatric illness
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Survivorship in Cancer
As treatment improves
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Economic Impact on Cancer Survivorship
Emerging as a crucial dimension
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Psychological Distress in Family Members of Cancer Patients
Relatives
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Informal Carers in Cancer Treatment
Significantly contribute to patient support and self-management
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Impact on Children of Parents with Cancer
Exclusion or involvement affects psychological morbidity
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Role Adjustment in Cancer Patients
Roles may change dramatically
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Spiritual Distress in Cancer Crisis
Prompting questions of meaning and existence
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Body Image and Sexuality in Cancer Patients
Assaults to body image include surgery
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Quality of Life Issues in Cancer Patients
Involves decisional conflict
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Social Support in Cancer Care
Includes emotional
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Supportive Care for Cancer Patients
Dependent on support services
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Supportive Interventions in Cancer Care
Includes psychological interventions
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Irish Cancer Society Services
Provides various services like counseling
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Cancer Nurseline
Service providing telephone support for cancer-related queries
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Daffodil Centres
Physical locations offering cancer support services
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Survivor Support
Programs aiding individuals post-cancer treatment
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Hematopoietic Stem Cells
Cells in bone marrow capable of reproducing into blood cells
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Lymphoid Tissue
Includes lymph nodes
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Autologous Transplant
Patient's own stem cells used for transplant
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Allogeneic Transplant
Stem cells from a donor
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Umbilical Cord Blood Transplant
Stem cells from a newborn's umbilical cord used for transplant
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Graft Versus Host Disease (GVHD)
Immune cells from transplant attacking recipient's body
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Conditioning
High-dose chemoadiotherapy to prepare for transplant
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Engraftment
Transplanted stem cells start producing new blood cells
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HLA Typing
Checking compatibility through Human Leukocyte Antigen markers
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Total Body Irradiation (TBI)
Radiation therapy affecting the entire body
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Graft Failure
Transplanted cells fail to establish in recipient's body
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Acute Complications
Early post-transplant issues like myelosuppression and infections
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Late Complications
Long-term effects post-transplant like secondary malignancies
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Psychological Issues
Emotional challenges post-transplant affecting mental health
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Rehabilitation Services
Support services aiding recovery post-transplant
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Isolation Precautions
Protective measures to prevent infections in transplant patients
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Apheresis
Cell separation process during stem cell collection
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Myelosuppression
Decrease in bone marrow activity leading to low blood cell counts
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GVHD Drugs
Medications to manage graft-versus-host disease
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HEPA Filter
High Efficiency Particulate Arresting filter for air purification
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Graft Rejection
Recipient's immune system attacking transplanted cells
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Mobilization
Stimulating stem cell production before collection
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Graft
Transplanted tissue or organ
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Surgery Objectives
Goals include cancer elimination
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Principles of Surgical Oncology
Factors considered: Anatomic Location
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Role of Surgery in Cancer Care
Diagnostic
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Advances in Surgery
Include TNM Staging
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Sentinel Lymph Node Biopsy (SLNB)
Diagnostic test for regional lymph nodes status
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TNM Staging
System for cancer staging based on Tumour
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Role of Laparoscopic Surgery
Involves peritoneal cavity inspection and performing surgeries under visual control
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Nursing Management in cancer surgery
Includes pre-op support
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Post-Operative Rehabilitation
Involves pain management
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Hormonal Therapy Premise
Belief that body cells
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Hormone Therapy Definition
Cancer treatment inhibiting hormone-dependent cancer growth
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Hormone Therapy Role
Manipulating endocrine system through hormone administration
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Breast Cancer Hormone Receptors
Hormones like oestrogen and progesterone can stimulate breast cancer growth
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Hormone Receptor Status
Significant prognostic indicator in breast cancer
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Adjuvant Endocrine Therapy
Prescribed for hormone receptor-positive breast cancer to block oestrogen action
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Hormonal Therapy Categories in Breast Cancer
Selective oestrogen receptor modulators and Aromatase inhibitors
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Tamoxifen
Principal anti-oestrogen used in breast cancer management
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Prostate Cancer Hormone Therapy
Primary treatment strategy due to hormone-responsive nature of prostate cancer
270
Androgens in Prostate Cancer
Male hormones promoting prostate cell growth
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Side Effects of Hormonal Treatment in prostate cancer
Include erectile dysfunction
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Assessment of Symptoms in cancer
Nurses evaluate depression
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Non-Adherence to Therapy
Ranges from 25%-96%
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Liaison in Therapy Management
Collaboration between nurses and pharmacists to manage side effects and improve adherence
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Chronic Diseases
Long-term conditions lasting over 1 year
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Multimorbidity
Existence of two or more chronic conditions in the same individual.
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Unhealthy Lifestyle Behaviours
Factors like smoking
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Global Chronic Disease Deaths
41 million deaths annually
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Premature Deaths
17 million die before 70 years
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Chronic Disease Impact in Ireland
38% over 50 have one condition
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Preventable Deaths in chronic disease
80% of heart disease
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Determinants of Health
Factors like birth circumstances
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Modifiable Risk Factors
Behaviors like tobacco use
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Metabolic Risk Factors
Key changes like high blood pressure
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Socio-Economic Impacts
Poverty linked to chronic diseases
286
Focus of Health Budget
Historically on acute medical needs rather than prevention
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Chronic Disease
Non-fixable
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Prevention
Reducing risk factors to avoid chronic diseases
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Comprehensive Approach
Involving multiple sectors to collaborate on risk reduction
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Screening
Process of detecting diseases early through tests
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Early Detection
Identifying diseases in their initial stages
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Timely Treatment
Providing appropriate care promptly
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Health Insurance Coverage
Extent to which medical expenses are covered
294
Sustainable Development Goals (SDGs)
Global goals for a better future for all
295
Global Action Plan
WHO's strategy to prevent and control NCDs
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Voluntary Targets
Goals that countries are not obligated to achieve
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Structured Chronic Disease Management Programme
Population-based approach to prevent and manage chronic diseases
298
Opportunistic Case Finding Programme
Identifying patients with chronic diseases during routine care
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MECC Framework
Empowering people to make healthier choices through supportive conversations; Framework for supporting healthier lifestyle choices
Healthier Lifestyle Choices Actions that promote better health and well-being
300
Chronic disease and poverty
Close association between poverty and increased risk of chronic diseases

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