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 What do you know about Cancer?

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تاريخ التسجيل : 02/04/2008

مُساهمةموضوع: What do you know about Cancer?   الثلاثاء 08 أبريل 2008, 19:09

What is Cancer?:
Cancer is a group of more than 100 different diseases characterized by the uncontrolled, abnormal growth of cells. These cells form a lump or mass called a tumor. Cancer can spread to other parts of the body.
Cancer is a disease process where by cells proliferates abnormally, ignoring growth regulating signals in the environment surrounding the cells.

Terminology of terms :-

Biopsy: - a diagnostic procedures to remove a small sample of tissue to be examined microscopically to detect malignant cells .

Carcinogenesis: - process of transforming normal cells into malignant cells.

Chemotherapy: - use of the drugs to like tumor cells by interfering with cellular functions and reproduction.

Metastasis: - spread of cancer cells from the primary tumor to distant sit .by ( lymphatic, hematogenous)

Radiation therapy:-use of ionizing radiation to interrupt the growth of malignant cells.

Incidence of epidemiology :-
Although cancers affects every age group, most cancer occur in people older than 65 years of age,

The incidence of cancer is higher in man than in women and higher in industrialized sector and nation.

More than 1.2 million Americans are diagnosed each year with a cancer affecting one of various body sites; cancer is second only to cardiovascular disease as a leading cause of death in the United States.

Path physiology of the cancer :-

Cancer is a disease process that begin when an abnormal cell is transformed by the genetic mutation of the cellular DNA, this abnormal cells is transformed cell forms a clone and begin to proliferate abnormally, ignoring growth-regulating signal in the environment surrounding the cell.

The cells acquire invasive characteristics, and change occur in surrounding tissue .

The cells infiltrate this tissue and gain access to lymph and blood vessels, which carry the cell to other area of the body.

This phenomenon is called metastasis (cancer spread to other parts of the body).

Cancer is not a single disease with a single cause; rather, it is a group of distinct disease with different causes, manifestations, treatment, and prognoses .

What is the risk factors?
1. age
2. race
3. family history
4. lifestyle factors
5. radiation exposure
Type of the cancer:-
1-bening
2-malignant
Characteristics of benign and malignant tumor:-
characteristics benign malignant
Cell characteristics Well-differentiated cells that resemble normal cells of the tissue from which the tumor originated. Cells are undifferentiated and often bear little resemblance to the normal cells of the tissue from which they arose
Mode of growth Tumor grows by expansion and does not infiltrate the surrounding tissues; usually encapsulated Grows at the periphery and sends put processes that infiltrate and destroy the surrounding tissue
Rate of growth slow Variable and depends on level of differentiated; the more anaplastic the tumor, the faster its growth
General effect It usually a localized phenomenon that does not cause generalized effects unless its location interferes with vital functions Often cause generalized effects; such as anemia weakness, and weight loss
Ability to cause to death Does not usually cause of death unless its location interferes with vital function Usually causes death unless growth can be controlled




Mechanisim of metastasis:

Lymph and blood are key mechanism by which cancer cell spread. Angiogenesis, a mechanism by which the tumor cells are ensured a blood supply, is another important process.

• Metastasis = development of secondary tumor implants in distant tissue.

• Half of all pt with malignancies have Mets at the time of diagnosis.


• Metastasis depended on :-
1-type of tumor
2-size of tumor
3-degree of differentiation of tumor

• Three ways tumors Metastasis :-
1-seeding
2-lymphatic spread
3-hematogenous spread

• Three ways tumors Metastasis :-
• 1-seeding :-
a- Tumor invades body cavity
b- Bits break off and implant on peritoneal surfaces
c- Ovarian cancer

• 2- lymphatic spread :-
A-Tumor spread to local lymph nodes
B-Sentinel lymph node first
C-Moves through thoracic ducts
D-Empties into subclavian vein
E-Carcinomas like to spread this way

• 3-hematogenous spread :-
A-Vein are easier to invade than arteries
B-Liver and lunge are most common met static destinations

c-Some tumor like other sites better:-
• prostate --- bone
• most lung cancers --- adrenal, brain
D-sarcomas like to spread this way (but so do carcinomas)

Etiology :-
Certain categories of factors implicated in carcinogenesis include:-
1- viruses and bacteria
2- Physical agents: - physical factors associated with carcinogenesis include exposure to sunlight or radiation, chronic irritation or inflammations, and tobacco use.
3- chemical agents :- (smoking, tobacco)

4- genetic and familial factor ( environmental; cultural; lifestyle; Hx; abnormal chromosomal )
5- Dietary factor (fat; alcohols salt-cured; smoked meats; food containing nitrates and high caloric dietary intake.
6- Hormonal agents ( endogenous /estrogen progesterone )
Prevention strategies:
1: increase consumption of fresh vegetables.
2: increase fiber intake.
3: increase intake vitamin A.
4: Increase intake of vitamin C.
5: body weight control, because obesity is linked to cancer.
6: reduce intake if fatty diets.
7: reduce intake of: salt-cured, smoked, and nitrate-cured foods
8: stop smoking cigarettes, as its carcinogens
9: reduce alcohol intake.
10: avoid exposure to the sun, wear protective clothing, and use sunscreen to prevent skin damage from ultraviolet rays, which increase risk of skin cancer.
Warning signs of cancer

• A change in bowel or bladder habits.
• A sore that does not heal.
• Unusual bleeding or discharge from any place.
• A lump in the breast or other parts of the body.
• Chronic indigestion or difficulty in swallowing.
• Obvious changes in a wart or mole.
• Persistent coughing or hoarseness.


Diagnosis of cancer

1- Screening

2- Ultrasound ((abdominal and pelvic cancer))

3- Biopsy


4- Blood test ((Brest, colon, lung, ovaries, testicular, prostate cancer))

5- X-rays

6- CT scans
7-endoscopy ((bronchial, gastrointestinal cancer))

8-MRI ((neurology, pelvic, abdominal, thoracic cancer))







Treatment

Treatment depends on stage of cancer

More than one treatment can be used includes:

Surgery, radiation therapy, chemotherapy:

Surgery: it’s removal of tumor
* It may be primary method of treatment or may be prophylactic, or palliative, or reconstructive.


Radiation therapy

• The us e of high-energy x-rays to destroy cancer cells
• Usually used after cancer surgery
• External-beam: outside the body
• Internal: uses implants inside the body
• Side effect may include fatigue, swelling and skin changes


Chemotherapy

• Drugs used to kill cancer cells
• May be given before surgery to shrink a large tumor or after surgery to reduce the risk of recurrence.
• A combination of medications is often used.

• Side effect may include: damage in body structure like skin, bone marrow, hair, sperms, and follicles. As a result of toxicity.

Nursing care plan for patient with cancer

Nursing diagnosis: imbalance nutrition, less than body requirements, related to nausea and vomiting.

Goal: fewer episodes of nausea and vomiting before, during, and after chemotherapy.

Nursing intervention: 1: asses the patient’s previous experiences and expectations of nausea and vomiting, including causes and interventions used.

2: adjust diet before and after drug administration according to patient preference and tolerance.

3: administer prescribed antiemetics, before and after chemotherapy as needed
Rationale: 1: identifies patient concern, misinformation, and potential strategies for intervention.

2: each patient response differently to food after chemotherapy. A diet containing food that relives the patient’s nausea or vomiting is most helpful.

3: administration of antiemetic regimen before onset of nausea and vomiting limits the adverse experience and facilitate control



Expected outcomes:
1: Identifies the previous triggers of nausea and vomiting.
2: exhibit decrease apprehension and anxiety.

3: identifies previously used successful intervention for nausea and vomiting.

4: reports decrease in nausea.
5: reports decrease in vomiting.

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What do you know about Cancer?
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