Table Differniation Between Tumor and Benign

Definition of Cancer
is a genetic disease. Every phase of carcinogenesis is affected by multiple genetic

mutations. Its abnormal profilaration of cells.
Mitosis (cell division) occurs more frequently in malignant cells than in normal cells.
As the cells grow and divide, more glucose and oxygen are needed. If glucose and
oxygen are unavailable, malignant cells use anaerobic metabolic channels to produce
energy, which makes the cells less dependent on the availability of a constant
oxygen supply
Table differniation between tumor and benign
Page 391
Metastatic Mechanisms
LYMPHATIC SPREAD
The most common mechanism of metastasis is lymphatic spread which is transport
of tumor cells through the lymphatic circulation. Tumor emboli enter the lymph
.channels by way of the interstitial fluid that communicates with lymphatic fluid
HEMATOGENOUS SPREAD
Another metastatic mechanism is hematogenous spread, by which
malignant cells are disseminated through the bloodstream. Hematogenous spread is

directly related to the vascularity of the tumor
ANGIOGENESIS
Malignant cells also have the ability to induce the growth of new
capillaries from the host tissue to meet their needs for nutrients and
oxygen. This process is referred to as angiogenesis. It is through this
vascular network that tumor emboli can enter the systemic circulation and travel to
distant sites.
1
Carcinogenesis
Malignant transformation, or carcinogenesis, is thought to be
at least a three-step cellular process: initiation, promotion, and
.progression
Ininitiation, the first step, initiators (carcinogens), such as
chemicals, physical factors, and biologic agents, escape normal
enzymatic mechanisms and alter the genetic structure of the
cellular DNA. Normally, these alterations are reversed by DNA
repair mechanisms, or the changes initiate programmed cellular suicide (apoptosis
ETIOLOGY
Certain categories of agents or factors implicated in carcinogenesis include viruses

and bacteria, physical agents, chemical
agents, genetic or familial factors, dietary factors, and hormonal
agents.
Risks factors steps to reduce the risks factors
When teaching individual patients or groups, nurses can recom-mend the following
cancer prevention strategies:
1. Increase consumption of fresh vegetables (especially those of the cabbage family)

because studies indicate that roughage and vitamin-rich foods help to prevent
certain kinds of cancer.
2. Increase fiber intake because high-fiber diets may reduce the risk for certain
cancers (eg, breast, prostate, and colon).
3. Increase intake of vitamin A, which reduces the risk for esophageal, laryngeal, and
lung cancers.
4. Increase intake of foods rich in vitamin C, such as citrus fruits and broccoli, which
are thought to protect against stomach and esophageal cancers.
2
5. Practice weight control because obesity is linked to cancers of the uterus,
gallbladder, breast, and colon.
6. Reduce intake of dietary fat because a high-fat diet in-creases the risk for breast,
colon, and prostate cancers.
7. Practice moderation in consumption of salt-cured,
smoked, and nitrate-cured foods; these have been linked to
esophageal and gastric cancers.
8. Stop smoking cigarettes and cigars, which are carcinogens.
9. Reduce alcohol intake because drinking large amounts of alcohol increases the risk
of liver cancer. (Note: People who drink heavily and smoke are at greater risk for
cancers of the mouth, throat, larynx, and esophagus.
10. Avoid overexposure to the sun, wear protective clothing, and use a sunscreen to
prevent skin damage from ultra-violet rays that increase the risk of skin cancer.
Early detection and diagnosis for cancer table page 324
Prophylactic Surgery
Prophylactic surgery involves removing nonvital tissues or organs
that are likely to develop cancer. The following factors are con-sidered when electing
prophylactic surgery:
•Family history and genetic predisposition
•Presence or absence of symptoms
•Potential risks and benefits
•Ability to detect cancer at an early stage
•Patient’s acceptance of the postoperative outcome
Colectomy, mastectomy, and oophorectomy are examples of
prophylactic operations. Recent developments in the ability to
3
identify genetic markers indicative of a predisposition to develop some types of
cancer may play a role in decisions concerning pro-phylactic surgeries. breast,
abnormal mammography findings, and abnormal biopsy results may be fac-tors
Because the long-term physiologic and psychological effects are unknown,

prophylactic surgery is offered selectively to patients and discussed thoroughly with
the patient and family. Preoperative teaching and counseling, as well as long-term
follow-up, are provided.
Palliative Surgery
When cure is not possible, the goals of treatment are to make the
Patient as comfortable as possible and to promote a satisfying and
Productive life for as long as possible. Whether the period is ex-tremely brief or
lengthy, the major goal is a high quality of life—with quality defined by the patient
and family. Honest and informative communication with the patient and family
about the goal of surgery is essential to avoid false hope and disappointment.
Palliative surgery is performed in an attempt to relieve complications of cancer, such

as ulcerations, obstructions, hemorrhage, pain, and malignant effusions .
Reconstructive Surgery
Reconstructive surgery may follow curative or radical surgery and
is carried out in an attempt to improve function or obtain a more
desirable cosmetic effect. It may be performed in one operation
or in stages. Patients are instructed about possible reconstructive
surgical options before the primary surgery by the surgeon who
will perform the reconstruction. Reconstructive surgery may be
.indicated for breast, head and neck, and skin cancers
The nurse must recognize the patient’s needs and the impact
that altered functioning and altered body image may have on
quality of life. Providing the patient and family with opportuni-ties to discuss these
issues is imperative. The needs of the indi-vidual must be accurately assessed and
validated in each situationfor any type of reconstructive surgery
4
.
Nursing Management in Cancer Surgery

The patient undergoing surgery for cancer requires general perioperative nursing
,care
care related to the patient’s age, organ impairment, nutritional
deficits, disorders of coagulation, and altered immunity
RADIATION THERAPY
In radiation therapy, ionizing radiation is used to interrupt cellular growth. More

than half of patients with cancer receive a form of radiation therapy at some point
during treatment. Radiation may be used to cure the cancer, as in Hodgkin’s disease,
testicular seminomas, thyroid carcinomas, localized cancers of the head and neck,
and cancers of the uterine cervix
External Radiation
If external radiation therapy is used, one of several delivery
methods may be chosen, depending on the depth of the tumor.
Depending on the amount of energy they contain, x-rays can
be used to destroy cancerous cells at the skin surface or deeper
in the body. The higher the energy, the deeper the penetration
into the body.
Internal Radiation
Internal radiation implantation, or brachytherapy, delivers a
high dose of radiation to a localized area. The specific radio-isotope for implantation
is selected on the basis of its half-life,
CHEMOTHERAPY
In chemotherapy, antineoplastic agents are used in an attempt
to destroy tumor cells by interfering with cellular functions and
5
reproduction. Chemotherapy is used primarily to treat systemic
disease rather than lesions that are localized and amenable to
Cell Kill and the Cell Cycle
Each time a tumor is exposed to a chemotherapeutic agent, a per-centage of tumor

cells (20% to 99%, depending on dosage) is destroyed. Repeated doses of
chemotherapy are necessary over a
prolonged period to achieve regression of the tumor. Eradication
of 100% of the tumor is nearly impossible, but a goal of treat-ment is to eradicate

enough of the tumor so that the remaining
.tumor cells can be destroyed by the body’s immune system
Actively proliferating cells within a tumor (growth fraction) are
the most sensitive to chemotherapeutic agents.
Responsibilities of the nurse in caring of patient with cancer

Support the idea that cancer is a chronic illness that has acute exacerbations rather than one
that is synonymous with death and suffering.
• Assess own level of knowledge relative to the pathophysiology of the disease process.
• Make use of current research findings and practices in the care of the patient with cancer
and his or her family.
• Identify patients at high risk for cancer.
• Participate in primary and secondary prevention efforts.
• Assess the nursing care needs of the patient with cancer.
• Assess the learning needs, desires, and capabilities of the patient with cancer.
• Identify nursing problems of the patient and the family.
• Assess the social support networks available to the patient.
• Plan appropriate interventions with the patient and the family.
• Assist the patient to identify strengths and limitations.
6
• Assist the patient to design short-term and long-term goals for care.
• Implement a nursing care plan that interfaces with the medicalcare regimen and that is
consistent with the established goals.
• Collaborate with members of a multidisciplinary team to foster continuity of care.
• Evaluate the goals and resultant outcomes of care with the patient, the family, and
members of the multidisciplinary team.
• Reassess and redesign the direction of the c

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Definition of Cancer

is a genetic disease. Every phase of carcinogenesis is affected by multiple genetic

Table differniation between tumor and benign

Another metastatic mechanism is hematogenous spread, by which

malignant cells are disseminated through the bloodstream. Hematogenous spread is

oxygen. This process is referred to as angiogenesis. It is through this

Malignant transformation, or carcinogenesis, is thought to be

at least a three-step cellular process: initiation, promotion, and

Ininitiation, the first step, initiators (carcinogens), such as

chemicals, physical factors, and biologic agents, escape normal

enzymatic mechanisms and alter the genetic structure of the

cellular DNA. Normally, these alterations are reversed by DNA

repair mechanisms, or the changes initiate programmed cellular suicide (apoptosis

Certain categories of agents or factors implicated in carcinogenesis include viruses

agents, genetic or familial factors, dietary factors, and hormonal

Risks factors steps to reduce the risks factors

1. Increase consumption of fresh vegetables (especially those of the cabbage family)

7. Practice moderation in consumption of salt-cured,

smoked, and nitrate-cured foods; these have been linked to

esophageal and gastric cancers.

8. Stop smoking cigarettes and cigars, which are carcinogens.

Early detection and diagnosis for cancer table page 324

•Family history and genetic predisposition

•Presence or absence of symptoms

•Potential risks and benefits

•Ability to detect cancer at an early stage

•Patient’s acceptance of the postoperative outcome

Colectomy, mastectomy, and oophorectomy are examples of

prophylactic operations. Recent developments in the ability to

Because the long-term physiologic and psychological effects are unknown,

Patient as comfortable as possible and to promote a satisfying and

Palliative surgery is performed in an attempt to relieve complications of cancer, such

is carried out in an attempt to improve function or obtain a more

desirable cosmetic effect. It may be performed in one operation

or in stages. Patients are instructed about possible reconstructive

surgical options before the primary surgery by the surgeon who

will perform the reconstruction. Reconstructive surgery may be

.indicated for breast, head and neck, and skin cancers

that altered functioning and altered body image may have on

Nursing Management in Cancer Surgery

care related to the patient’s age, organ impairment, nutritional

deficits, disorders of coagulation, and altered immunity

In radiation therapy, ionizing radiation is used to interrupt cellular growth. More

If external radiation therapy is used, one of several delivery

methods may be chosen, depending on the depth of the tumor.

Depending on the amount of energy they contain, x-rays can

be used to destroy cancerous cells at the skin surface or deeper

into the body.

Internal radiation implantation, or brachytherapy, delivers a

In chemotherapy, antineoplastic agents are used in an attempt

to destroy tumor cells by interfering with cellular functions and

disease rather than lesions that are localized and amenable to

Cell Kill and the Cell Cycle

Each time a tumor is exposed to a chemotherapeutic agent, a per-centage of tumor

prolonged period to achieve regression of the tumor. Eradication

of 100% of the tumor is nearly impossible, but a goal of treat-ment is to eradicate

.tumor cells can be destroyed by the body’s immune system

Actively proliferating cells within a tumor (growth fraction) are