ADDITIONAL NOTES ON ONCOLOGY MS 2 * The location of cancer with the highest mortality rate is the lung. * In males, the two locations with the highest incidence of cancer are the lung and the prostate. * In females, the two locations with the highest incidence of cancer are the breast and the colon/rectum. * Three general signs and symptoms of cancer include anemia, weakness, and weight loss. * A carcinogen is a substance that can cause changes in a cell that can lead to cancer. * The number one risk factor for developing lung cancer is smoking. * A diet high in fat and low in fiber places an individual at increased risk of colon cancer. * Infection with the human immunodeficiency virus (HIV) increases the risk of developing two types of cancer : Kaposi’s sarcoma and lymphoma * Three host factors that increase the risk of developing cancer that cannot be controlled include age over 40, being male, and race. * When a tumor spreads from its primary site it is called a metastasis. * The five most common sites of tumor migration: lymph system, lungs, bone, liver, and brain.

Cancer names based on its origin of involvement: * surface epithelium – Squamous cell sarcoma * glandular epithelium – Adenosarcoma * fibrous connective tissue – Fibrosarcoma * adipose tissue – Liposarcoma * cartilage – Chondrosarcoma * bone – Osteosarcoma * blood vessels – Hemangiosarcoma * lymph vessels – Lymphangiosarcoma * smooth muscle – Leiomyosarcoma * striated muscle – Rhabdomyosarcoma * glial tissue – Glioma * nerve sheath – Glioma * blood – Leukemia

TUMOR STAGING

The TNM system of classification for breast cancer is based on evaluating the spread of disease. T = tumors size. The range is T0 to T4, with T0 being no evidence of tumor and T4 being an extensive tumor that extends into the chest wall or skin. N = Lymph node involvement. The range is from N0-N3. N0 indicates that no nodes are involved; N3 indicates that there is extensive involvement in the ipsilateral internal mammary nodes. M= metastasis; M0 = no metastasis; M1 signifies that metastases are present.

* When a tumor is staged by the TNM system as T2 N0 M0 it means: localized lesion with deep penetration into adjacent structures; no lymph node involvement; and no metastasis

TUMOR MARKERS

Tumor markers are monitored for decreases or increases that may correlate closely with responses to treatment and reoccurrence or spread of disease. -fetoprotein is a fetal antigen normally not expressed during adulthood. It can often be detected in the blood of clients with liver cancer and germ cell tumors of the ovary and testes. Carcinoembryonic antigen (CEA) is an embryonic antigen present in 75 percent of clients with colorectal cancer. It can be monitored through simple blood wok. A recently popularized tumor marker to follow in men over 40 years old is the prostatic acid phosphatase enzyme. It is usually elevated with prostate enlargement either from cancer or benign prostatic hypertrophy.

* If a 48-year-old male has a routine prostate-specific antigen ( PSA) screening test and there is a significant increase from last year’s value, what type of cancer would it most likely indicate? Prostate

NURSING CARE OF THE CLIENT RECEIVING RADIATION

Approximately 50 percent of client with cancer receive some form of radiation, especially those with carcinoma, Hodgkin’s disease, or cancer of the larynx and cervix.

The therapeutic goals of radiation include: * Cure * Tumor reduction for comfort * Maintenance of tumor size during chemotherapy or preparation for surgery

Radiation can immediately kill cells or interrupt cell replication by directly hitting the target cells or by interacting with critical cell components. Since DNA synthesis is