Leukemia: Also known as Blood Cancer.

It is the malignant disease of the blood-forming cells especially the neoplastic proliferation of immature leukocytes. 
It is a group of malignant disorders affecting the blood and blood-forming tissues of bone marrow, lymph system a spleen. Leukemia is a malignancy ( cancer ) of blood cells. In leukemia abnormal blood cells are produced in the bone marrow usually leukemia involves the production of abnormal WBC. 

Introduction | Definition | Classification | Myeloid Leukemia | Lymphoid Leukemia | Risk factor | Sign Symptoms | Diagnosis | Management |

Introduction:-

It is a group of malignant disorders affecting the blood and blood-forming tissues of bone marrow, lymph system a spleen. Leukemia is a malignancy ( cancer ) of blood cells. In leukemia abnormal blood cells are produced in the bone marrow usually leukemia involves the production of abnormal WBC.

Definition:-

It is the malignant disease of the blood-forming cells especially the neoplastic proliferation of immature leukocytes.

Classification:-

Classification according to time duration –

  1. Acute Leukemia:- In acute leukemia the abnormal cell production is quick. A large number of leukemia cells accumulate very quickly in the blood and bone marrow. Acute leukemia requires fast and immediate treatment.
  2. Chronic Leukemia:– It develops slowly over time. This leukemia may not cause specific symptoms at the beginning of their cause. If it left untested the cells make eventually grow to a high number.

Classification Based on Cells:-

(1.) Myeloid Leukemia:-

Myeloid Leukemia further divided into two types:-

  • Acute Myeloid Leukemia:- It is also called Acute Myelogenous Leukemia. It involves the rapid growth of myeloid cells. It occi=ur in both adults and children.
  • Chronic Myeloid Leukemia:- It is also called Chronic Myelogenous Leukemia. It develops slowly and mainly affects adults.

(2.) Lymphoid Leukemia:- 

It also further divided into two types:-

  • Acute Lymphoid Leukemia:- It is also known as Lymphocytic Leukemia or Lymphoblastic Leukemia. It is the most common type of leukemia in young children, but it can also affect adults.
  • Chronic Lymphoid Leukemia:– It is a slow-growing cancer of lymphoid cells. That usually affects people of 55 years of age.

Etiology And Risk Factor:-

The exact cause of leukemia is unknown:-

Risk factors:-

  • Radiation.
  • Chemical Exposure.
  • Cigarette Smoking.
  • Heredity ( Down Syndrome ).
  • Drugs and Dyes.

Sign And Symptoms:-

  • The most symptoms in children are easy bruising, pale skin, fever, and enlarge spleen or liver.
  • Excessive frequent infections.
  • Dyspnoea.
  • Feeling of fatigue and tiredness.
  • Night sweats.
  • Unintentional weight loss.
  • Abdominal pain and swelling.

If leukemia cells have infiltrated the brain, symptoms such as headache, confusion, seizures, and loss of muscle tone.

Diagnosis:-

  • Medical history.
  • Physical examination.
  • Blood test.
  • Bone marrow aspiration.
  • Lumbar Puncture.
  • Chest x-ray.

Management:-

  • Chemotherapy.
  • Radiation therapy.
  • Biological Therapy.
  • Target therapy.
  • Stemcells Transplantation.

Nursing Management:-

  • Risk of infection or ineffective protection related to leukemia ( Leukemia 2nd degree).
  • Imbalance nutrition is less than body requirements related to anorexia, pain, or fatigue.
  • Disturb body image resulting from alopecia, weight loss related to chemotherapy.

Related Post:-

Cancer

Breast Cancer

Lung Cancer

Hodgkin Lymphoma

Oral Cancer

Cancer Causes, Types, Symptoms and Signs

Cancer: Everything you want to know!
Cancer is a disease of cell in which normal mechanisms of control of growth and proliferation are disturbed. Cancer is a group of cells that grows out of control, taking over the function of affected organs or it is a group of diseases characterized by uncontrolled cellular growth with local tissue invasion at systemic metastasis. It is a disease process that begins when abnormal cells are transformed by a genetic mutation of cellular DNA.

Introduction | Incidence | Etiology or Causes | Risk Factor | Pathophysiology | Difference Between Benign and Malignant | Classification of Cancer | General Effects | Tumor Markers | General Symptoms | Psychological Changes | Warning sign of Cancer | Prevention of Cancer | Investigation |

Cancer: Everything you want to know!

Cancer Introduction:-

why cancer is called cancer?

Cancer is a disease of cell in which normal mechanisms of control of growth and proliferation are disturbed. Cancer is a group of cells that grows out of control, taking over the function of affected organs or it is a group of diseases characterized by uncontrolled cellular growth with local tissue invasion at systemic metastasis.

It is a disease process that begins when abnormal cells are transformed by a genetic mutation of cellular DNA.

Incidence Of Occurrence:-

Cancer affects millions of people around the world. It affects a large group but higher in very young and old age. The incidence rate is greater in men than in women.

Some of the percentages are:-

how many cancer are there?

In Male:-

  • Prostate cancer (32%)
  • Colorectal cancer(12%)
  • Urinary Tract including Urinary Bladder(9%)
  • Leukemia Cancer(7%)
  • Skin and Renal cancer(4%)
  • Pancreatic cancer(2%)

In Female:-

  • Cervical Cancer(26%)
  • Colorectal cancer(13%)
  • Uterine cancer(8%)
  • Leukemia (6%)
  • Skin cancer(4%)
  • Ovarian, Kidney’s, Thyroid Cancer(3%)

Cancer Etiology or Cancer Causes:-

 
The exact causes of the development of cancer are unknown.
Various theories are suggested which are the following:-

(a). Virus and Bacteria:-

Viruses and bacteria are thought to be in co-operative themselves in the genetic structure of the cells. Thus altering the future generation of that cell population leading to cancer.

For example- Herpes Simplex Virus (HSP) causes Nasopharyngeal cancer. Cytomegalovirus (CMV) and Papillomavirus can cause Cervical and vaginal cancer.

(b). Radiation:-

There is an increased incidence of cancer in persons who exposed to prolong or large amounts of radiation. Ionizing radiation involving x-ray, alpha, beta, gamma rays, and UV rays present in sunlight. It also plays a major role in promoting leukemia, melanomas, or Skin cancer. The UV rays have ionizing indications which change in DNA structure that can be lead to malignant transformation.

(c). Chemical Agents:-

It includes dyes, pesticides or fertilizers, cosmetics, tar, fuel, oil, etc. These agents can cause cancer only after closed and prolong contact. The persons affected are usually workers of industry, labors, persons working in the laboratory, and farmers. In which these chemicals are used or produced.

(d). Genetic Factor:-

Genetic factors play a large role in cancer formation. Certain types of cancer are linked to specific gene mutations.
for example- Breast cancer, Colorectal cancer, Skin cancer, Prostate cancer have a genetic tendency.

(e). Diet:-

DIet is also a major factor for the cause of malignancy. People who eat or take high fat or low fiber diet, are more prone to develop colorectal cancer and a high-fat diet is linked to breast cancer in women and prostate cancer in men.
The conception of a large number of pickles, spicy foods, smoked food, has been linked with esophageal and gastric or stomach cancer.

(f). Hormonal Factor:-

Hormonal agent that disturb the hormonal balance of the may also cause or promote cancer. For example Long term use of female hormone therapy (estrogen and progesterone), use of regular or prolong contraceptives are associated with cancer of breast, uterus, cervix, ovaries, vagina, etc. The hormonal changes during the time of puberty and reproduction are also associated with cancer. Example: DES (Diethylstilbestrol ).

(g). Immune Factor:-

A healthy immune system destroys mutant cells. Individual with altered or weak immunity and more exposed to the system fails to identify and stop the growth of malignant cells clinically cancer develops.

Cancer Risk Factor:-

  • Age:- Increased incidence is seen in very young and older persons. Example: Acute leukemia in children, Prostate cancer seen in older persons.
  • Gender:- Women have a risk for developing certain types of cancer and men also have a risk for developing certain types of cancer. Example: In older males Testicular, Prostate cancer is common. In women breast cancer, cervical cancer is common.
  • Environmental / Geographical area/ location:- The environmental factor such as climate excessive hot, cold, air, water, soil, pollution, humidity, etc. The environmental factor also plays an important role in developing cancer. The people living in urban areas are more prone to cancer than the rural areas.
  • LifeStyle / Habits:- Lifestyle/habit include lack of physical activity or exercise, poor personal hygiene, improper sleeping or rest, smoking use of tobacco or betel nuts, use of drugs, and excessive conception of alcohol, or beverage.
  • Stress:- Hypothalamus regulates hormones or the immune system increased stress causes hormonal or immunological changes that affect the growth and proliferation of the cell.
  • Other factors: It includes occupation, exposure to radio-isotopes.

Cancer Pathophysiology [Carcinogenesis, Oncogenesis]:-

 
Carcinogen:- Factor that associated with cancer conversion or production. for example: Maybe radiation, chemical, virus, bacteria, and other agents, in addition, hormones and stress play a significant role in the development of cancer.
Cancer is caused by a serious mutation.
 
Proliferation: Rapid multiplication of cells may occur in malignant growth or during wound healing.
 
Infiltration:- The entrance and diffusion of some substances, had usually form those, either fluid or solids into the cells, tissues, or membrane.
 
It is the transformation of normal cells into the cancer cells also called Oncogenesis. The process through which normal cells are transformed into the malignant or cancer cells called Carcinogenesis.
Carcinogenesis also called Oncogenesis or Tumorogenesis. It is the formation of cancer were by normal cells are transformed into cancer cells. The process is characterized by changes at the cellular, genetic and epigenetic levels, and abnormal cell division.
 
There are four broadly identified stages or processes of carcinogenesis which are:-
  1. Initiation
  2. Promotion
  3. Malignant conversion
  4. Progression
  • Initiation or Cancer 1st stage:- Initiation occurs when carcinogens damage DNA. Carcinogens cause a change in the structure and function of the cells at the genetic or molecular level. This damage may be reversible or maybe lead to a genetic mutation that is not repaired. However, the mutation may not lead immediately to cancer.
  • Promotion or Cancer 2nd stage: Promotion occurs with additional assault ( sudden attack or destroy)to the self resulting in further genetic damage.
  • Malignant Conversion or Cancer 3rd stage:- At some point, these genetic events result in management conversion.
  • Progression or Cancer 4th stage:- With progression cells are increasing malignant in appearance and invasive development with active cancer with metastasis to distant body parts or area.

Difference between Benign Tumour and Malignant Tumour:-

Classification of Cancer:-

  1. Anatomical Classification
  2. Histological Classification [ Grade ]
  3. The extent of Disease [ Stage, Metastasis ]
  4. T.N.M. Classification [ Tumour Nodes Metastasis ]

1. Anatomical Classification:-

2. Histological Classification [ Grading ]:-

It defines types of tissues from which the tumor is originated and the degree to which the tumor cells retain the functions and histological characteristics of tissue of tissues of their origin [growth].
Grade 1st:- cells differ slightly from normal cells and well-differentiated (mild or slight dysplasia).
Grade 2nd:- More abnormal cells with moderate differentiation (moderate dysplasia).
Grade 3rd:- Cells are very abnormal and poor differentiation (Severe Dysplasia).
Grade 4th:- Cells are immature, primitive, and undifferentiated (anaplasia).
 

3. The extent of Disease [ staging, metastasis]:-

Stage 1st:- Tumour in situ. Tumour is limited to the tissue of origin or localized.
Stage 2nd:– Increase in tumor size with local metastasis.
Stage 3rd:- Metastasis to regional lymph nodes.
Stage 4th:- Distant metastasis.
 

4. T.N.M. classification:-

T – [primary tumor]
T (x) – Tumor cannot adequately be assessed.
T (o) – No evidence of primary tumor.
T (is) – Tumor in situ or localized.
T (1-4) – progressive increase in tumor size or extent of the primary tumor.
 
N – [ Regional Lymph nodes ]
N (o) – Regional lymph nodes cannot be assessed.
N (x) – No evidence of lymph nodes involvement.
N (1-4) – Increase in the degree of lymph nodes involvement.
 
M – [ Metastasis ]
M (x) – The presence of metastasis cannot be assessed.
M (o) – No evidence of metastasis or distant metastasis.
M (1-4) – Distant metastasis.

Cancer General Effects:-

Tumor in the bowel:-

  • Bowel obstruction
  • Constipation
  • diarrhea
  • G.I. Disturbance
  • Bleeding

Tumor in Prostate:-

  • Urinary problems
  • Urinary Bladder distension
  • Incontinence
  • Urinary retention
  • Sexual disfunction
  • Decreased libido

Tumor in the Liver:-

Fat, lipid, carbohydrate, protein metabolism will be disturbed.

Tumor in the Lungs:-

Respiratory distress, dyspnea.

Tumor in Mouth:-

Difficulty in mastication, Dysphagia.

Hematological Effects:-

  • Hematocrit decreases
  • WBC count (increase or decrease)
  • Hemoglobin Decreases.

Tumor Markers:-

  1. Cancer Antigen 125:- Increases in ovarian and pancreatic cancer.
  2. Prostatic Specific Antigen (PSA):- Increased in prostate cancer.
  3. Prostate Acid Phosphate:- Increased in metastatic prostate cancer.
  4. Carcinoembryonic antigen (CEA):- Increase in colorectal, breast, lungs, pancreatic, stomach, etc.

Cancer General symptoms:-

  • Anorexia
  • Weight loss
  • Anemia
  • Extreme fatigue
  • Pain
  • Headache
  • Nausea, Vomiting.

Cancer Psychological changes/Responses:-

  • Malaise
  • Grief
  • Hopelessness
  • Guilt
  • ANger
  • Anxiety
  • Fear of Death
  • Body image disturbance
  • Lack of confidence
  • Disfunction in sexual desire
  • Isolation or withdrawal.

can cancer be prevented?

Prevention of Cancer:-

What are cancer 7 warning signs?

cancer 7 warning signs:-

C – Change in bowel and bladder habits.
A – A sore that doesn’t heal.
U – Unusual bleeding or discharge.
T – Thickening of lumps ( breast or lymph nodes ).
I – Indigestion and dysphagia.
O – Obvious changes in moles.
N – Nagging cough/harshness.
 
The prevention of cancer is classified into three stages. These three interrelated activities involved in cancer prevention and control. These are:-
  1. Primary Prevention
  2. Early Detection
  3. Screening
Primary Prevention Involves measures to avoid or reduce exposure to carcinogenesis.
Early detection involves finding the pre-cancer lesions (warning sign) or cancer detect in the earliest and most treatable stage.
Seven process helps to identify high-risk population or individuals.

Primary Prevention:-

Primary prevention activity is in at intervention before pathology change has begun. They can help to reduce cancer risk through alteration of lifestyle, behavior, habits to eliminate and reduce exposure to carcinogens.
Many cancers are associated with smoking, dietary habits, and alcohol consumption. Some of cancer caused by combined tobacco or alcohol consumption should be avoided.
Adopting a more healthy diet, limiting exposure to sun and other sources like radiation or UV rays, modifying sexual practices, and increasing exposure to environmental and occupational carcinogens would lead to further reduction of cancer incidence.

Early Detection:-

Secondary prevention also referred to as early detection. Provides the opportunity to detect pre-cancers lesions or early-stage cancer before manifestation becomes readily apparent to the client to treat them promptly.
Screening efforts anticipate early detection, method of early detection are inception, palpation, and the uses of tests or procedures.
Inspection is useful in identifying lesions of the skin, lips, mouth, extragenital area, lumps, and nodules in the breast, salivary glands, mouth, subcutaneous tissues in the prostate, testis as well as enlarged lymph nodes can be detected through palpation.
Mammography, smear, blood test, and endoscopy examination and radiologic imaging studies are some of the test investigations or procedures that can be used.
As a result of the early detection pre-malignant lesion may be attested, removed, reversed, or cancer treatment can be started either often by the cancer is in a stage more enable to treatment.

Screening:-

Screening identifies a high risk of a group of people more likely to have cancer or pre-cancer lesions. It is estimated that some of the cancer can be cured in all available screening tests and self-examination methods worthy practiced routinely.
Criteria for Screening:-
  • The population to be screen as a high incidence of disease.
  • The disease is detectable in its pre-symptomatic stages.
  • Prognosis is poor if diagnosis delayed and manifestation is appearing and effective treatment is available for a disease that is diagnosed early.
  • The potential benefits of screening outweigh its potential risk and cost.

Approaches to Prevent Cancer:-

Education:- It beliefs that influence the effectiveness of education consist of client perception of susceptibility to developing cancer, about the harmful and beneficial consequences of lifestyle, behavior, and perception about the benefits of prevention and early detection.
Regulation:- Method of regulation utilized on the contrary includes prohibiting the selling of tobacco and alcohol to minors, limiting or restricting smoking in a public place, imposing excise taxes, regulating the use of manifested carcinogens, and prohibiting carcinogenesis in packed food.
Host modification:- Its aims to alter the body’s internal environment to decrease the risk of cancer or to reverse the carcinogenic.
Other Prevention:-
  • Educate the community or family about cancer and to avoid carcinogenesis.
  • Increase fiber-rich diet intake to decrease the risk of gastric and colorectal cancer.
  • Decrease intake of fats to decrease the risk of prostate and breast cancer.
  • Stop cigarette smoking (active and passive).
  • Avoid tobacco and betel nut.
  • Avoid overexposure to sunlight and radiation.
  • Advice to participate in regular exercise programs and self-examination.
  • Take adequate rest and sleep (6-8 hours/day) eliminate and reduce physical and mental stress.
  • Tell the people or community about the warning sign of cancer.

Investigation:-

The investigation is generally divided into two categories:-

  1. Cytological Study
  2. Radiological Study

1. Cytological Studies:-

Cytology is the study of anatomy, physiology, pathology, and chemistry of the cells. One of the most common cytological studies are:-

Staining technique developed by George M. Papanicolaou [ PAP test ], which is used to detect malignant cells. This test is used to study of vaginal and cervical cells, sometimes it may be used for other tissues obtained easily by smearing or scraping such as oral, bronchial, genital tract and tissues not available for scraping must be obtained by biopsy, which the removal of tissues for diagnostic studies.

Many times a fixative or refrigeration is used to prevent tissues decomposition by section method [ Frozen or Freezing technique ].

Biopsy:-

It is the surgical removal of tissues or cells. It helps in accurate identification of nature or type of cancer cells [ Benign or Malignant ]. The biopsy procedure is divided either open or closed.

1. Open Biopsy:-

A surgical incision is needed for open biopsy. There are two types of open biopsy.

  • Incisional Open Biopsy:- In this type of biopsy, a selected part or portion of lesion or tumor is removed. This type of biopsy is commonly completed during endoscopic examination.
  • Excisional Open Biopsy:- In this type of biopsy, the entire lesion or tumor and a margin of surrounding normal tissues are removed. This is the procedure of choice in most cases [ to prevent infiltration ]. There are procedures usually performed in an i=operative room or minor OT with the use of local anesthesia or IV sedation. After the procedure, the incision is closed with the sutures, and dressing is placed over the site.

2. Closed Biopsy:- 

In a closed biopsy, no open surgical incision is used. The closed biopsy includes:-

  • Needle Aspiration Biopsy:- A needle aspiration biopsy is inserted into the tissues or tumor, the aspirated cells or tissues are then examined under the microscope. This technique is common for the biopsy of the breast or prostate masses or tumors.
  • Core Needle Aspiration Biopsy:- A special needle cuts specimen from tissues or tumors which not in view. This technique is common for biopsy of kidneys, liver, prostate, etc.
  • Stereotactic Biopsy or Imaging Biopsy:- A 3D view of abnormal tissues is created on the basis of imaging research, then the needle is inserted into the mass or tumor. The client must be motionless for about 20-30 minutes while the procedure. This technique is used for biopsy of certain lungs tumor or lesions.

Breast cancer: Types, Pathophysiology, Cancer Stages, Symptoms, Investigation, Management

Breast cancer is cancer that forms in the cells of the breast.
After skin cancer breast cancer is the most common cancer diagnosed in women. Breast cancer is a disease that occurs when cells in breast tissue change or mutate and keep reproducing, these abnormal cells usually cluster together to form a tumor. A tumor is cancerous or malignant when these abnormal cells invade other parts of the breast.

Definition | Types |Causes | Risk Factors | Incidence | Pathophysiology | Breast cancer Stages | Sign and Symptoms | Diagnostic Evaluation | Surgical Management | Medical Management | Nursing Management |

Introduction:-

  • Breast cancer is cancer that forms in the cells of the breast.
  • After skin cancer breast cancer is the most common cancer diagnosed in women.

*What is the definition of breast cancer?

Breast cancer Definition:-

  • “Breast cancer is a disease that occurs when cells in breast tissue change or mutate and keep reproducing, these abnormal cells usually cluster together to form a tumor.”
  • A tumor is cancerous or malignant when these abnormal cells invade other parts of the breast.

*Enlist the breast cancer types ? Give a brief explanation of breast cancer types?

Breast Cancer Types:-

four breast cancer types are as follows:-

  1. Ductal carcinoma in situ:- DCTS is a non-invasive condition. The cancer cells are confined to the ducts in the breast have not invaded.
  2. Lobular carcinoma in situ:– Lobular carcinoma in situ is cancer that grows in the milk-producing glands of the breast, has not invaded.
  3. Invasive ductal carcinoma:- IDC is the most common type. This type of breast cancer begins in the breast milk duct and then invade nearby tissue in the breast.
  4. Invasive Lobular carcinoma:– ILC first develops in breast lobules then invade nearby tissue.

*What are the breast cancer causes? Or What are the breast cancer causes and risk factors of breast cancer?

Etiology or breast cancer causes:

  • Breast cancer is caused by a genetic mutation in the DNA of breast cells.
  • Inherited mutated genes known are breast cancer Gene 1 (BRCA 1), Breast cancer gene 2 (BRCA 2).

Breast Cancer Risk Factors:-

  • Gender and Age:- the risk begin after 40 years in women.
  • family history.
  • Inherited genes:- the most well-known gene mutation -BRCA 1, BRCA 2.
  • Radiation therapy.
  • Obesity.
  • The beginning period at a younger age (before age 12).
  • Beginning menopause at an older age.
  • Have never been pregnant.
  • Postmenopausal hormone therapy (estrogen and progesterone).
  • Alcohol Consumption.

*What is the incidence rate of breast cancer?

Incidence of Breast cancer:-

  1. Most common malignancy in women.
  2. Only 1% of breast cancer occurs in men.
  3. 1/8 postmenopausal women or at rest.
  4. The occurrence of breast cancer according to the location.

*Explain the pathophysiology of breast cancer?

Breast cancer Pathophysiology:-

  • Majority of breast cancer are adenocarcinomas. They are classified as ductal or lobular.
  1. Intraductal.
  2. Intralobular ( lobe or part or portion of an organ).
  3. Invasive ductal.
  4. Invasive lobular.

*Enlist and describe the stages of breast cancer?

Breast cancer Stages:-

  • Breast cancer Stage 1:-
  1. tumor less than 2 cm.
  2. Confined to the breast.
  3. No positive symptoms.
  4. No metastasis present.
  • Breast cancer Stage 2:- Tumors less than 2 cm with positive lymph-node.No metastasis evident. or tumor 2-5 cm with or without positive lymph node, not metastasis evident or tumor greater than 5 cm with lymph nodes, not metastasis evident.
  • Breast cancer Stage 3:- Tumor >5 cm with a positive lymph node, no metastasis present.
  • Breast cancer stage 4:- Any distend metastasis to brain, lung, liver, or bone with or without positive lymph node.

*What are the sign and symptoms of breast cancer?

Breast cancer sign and symptoms:-

  • A breast lumps or tissue thickening that feel different than surrounding tissue.
  • Breast pain.
  • Red, pitted skin over the entire breast.
  • Swelling in all or part of the breast.
  • Nipple discharge other than breast milk.
  • Bloody discharge from the nipple.
  • A sudden change in the shape and size of the breast.
  • Inverted nipple.
  • A lump or swelling in the arm.
  • Peeling, scaling, or blacking of skin on the nipple.

*Describe the diagnostic evaluation of breast cancer?

Breast cancer Diagnostic evaluation:-

  • Mammography:- It is the process of using low energy X-ray to examine the breast for diagnosis.during the procedure the breast is compressed using a dedicated mammography unit. Parallel plate compression evens out the thickness of breast tissue to increase image quality by reducing the thickness of tissue that X-ray penetrates.
  • Breast biopsy:-During this test doctor will remove a tissue sample from the suspicious area to have it tested. The doctor uses a needle to take the tissue sample. then send it to the laboratory to test the sample.
  • Ultrasound:- A breast ultrasound uses sound waves to create a picture of the tissue deep in the breast. An ultrasound distinguishes between a solid mass or a tumor.
  • Breast self-examination:- Breast self-exam or regularly examining your breast on your own.there are following steps :-(done before warm bath)
  1. Step 1:-Begin by looking at your breast in the mirror with your shoulders straight an arm on your hips. (breast that is their usual size, shape, and color) (Dimpling, bulging of skin, redness, rashes or swelling, a nipple that has changed position or an inverted nipple)
  2. Step 2:-Now raise your arm and look for the same changes.
  3. Step 3:- While you are at the mirror look for any sign of fluid come out of one or both nipples. (this could be a watery, milky or yellow fluid or blood).
  4. Step 4:- Next fell your breast while lying down using your right hand to feel your left breast and then left-hand feels right breast.use a firm, smooth touch with the first few fingers pads of your hand, keeping the fingers flat and together. Use a circular motion about the size of a quarter.
  5. Finally, feel breast while you are standing or sitting.

*Describe the management or surgical, medical, and Nursing management?

Breast cancer Management:-

Breast cancer Surgical management:-

  • Lumpectomy:-This procedure remove the tumor and surrounding tissue.
  • Mastectomy:- In this procedure, a surgeon removes an entire breast.
  • Sentinel node biopsy:- This surgery remove a few of the lymph node.
  • Contralateral prophylactic mastectomy:- Even though breast cancer may be present in only one breast this surgery remove healthy breast to reduce the risk of developing breast cancer again.

Breast cancer Medical management:-

  • Medication used after and in addition to surgery are adjuvant therapy.
  • Hormone blocking therapy:- some breast cancers require estrogen to continue growing. they can be identified by the presence of estrogen receptors (ER+) and progesterone receptors (PR+) on their surface. this ER+ cancer can be treated with drugs that either block the receptors. Example:- Tamoxifen, Toremifene (Prevent estrogen from binding to estrogen receptors), Aromatase Inhibitor (stop estrogen production).
  • Chemotherapy:- The chemotherapy medication is administered in combinations. Usually for periods of 3-6 months. Example:- Cyclophosphamide with Doxorubicin.
  • Radiation therapy:-Radiation is given after surgery to the region of the tumor bed and regional lymph node to destroy microscopic tumor cells. Radiation therapy can be delivered as external beam radiotherapy or as brachytherapy (internal radiotherapy).

*Write the pre and post-operative care of Nursing care or complete nursing management?

Breast cancer Nursing management:-

Pre-operative Nursing care:-

  1. Knowledge deficit about breast cancer and treatment.
  2. An anxiety-related cancer diagnosis.
  3. Fear related to a specific treatment, body images change, or possible death.
  4. Decisional conflict-related treatment option.
  5. The risk for ineffective coping related diagnosis of breast cancer.

Postoperative nursing diagnosis:-

  1. Pain-related to surgical incision and the manifestation of tissue.
  2. Impaired skin integrity due to surgical incision.
  3. The risk for the infection-related presence of surgical drain.
  4. Body image disturbance related loss or alteration of the breast-related surgical procedure.
  5. the risk for sexual dysfunction related loss of body part, changes in self-image.
  6. Self-care deficit related partial immobility of upper extremity on the operative side.

Related Post:-

Lung Cancer

Hodgkin’s lymphoma: Definition, Types, Stages, Causes, Symptoms, Management

Hodgkin’s lymphoma (HL) also known as Hodgkin’s disease is a cancer of the lymphatic system.
It was first discovered by Thomas Hodgkin in 1832.
HL is a type of lymphoma in which cancer originates from a specific type of WBC called Lymphocytes.
A lymphoma is a group of blood cancer that develop from lymphocytes.

Introduction | Definition | Types | Stages | Causes | Risk Factor | Sign and Symptoms | Diagnostic Evaluation | Management |

Introduction:-

  • Hodgkin’s lymphoma (HL) also known as Hodgkin’s disease is a cancer of the lymphatic system.
  • It was first discovered by Thomas Hodgkin in 1832.
  • HL is a type of lymphoma in which cancer originates from a specific type of WBC called Lymphocytes.
  • A lymphoma is a group of blood cancer that develop from lymphocytes.

Definition:-

  • “Hodgkin’s Lymphoma is also known as the cancer of the lymphatic system in which the lymphocytes (WBC cells)grow abnormally and spread beyond the lymphatic system.”
  • “Hodgkin’s lymphoma is a chronic disease the growth of tumor cells take place mainly in the lymphatic node.”
  • “Hodgkin’s lymphoma is a type of lymphoma in which cancer originates from a specific type of WBC called lymphocytes.”

Types of Hodgkin’s disease:-

  1. Classical Hodgkin’s lymphoma :-(more common type) In this lymphoma people is diagnosed with this disease have large, abnormal cells called Reed-Sternberg cells in their lymph node.
  2. Nodular lymphocyte-predominant Hodgkin’s lymphoma :-(have a better chance of cure) This much rare type of Hodgkin’s lymphoma involves large, abnormal cells that are sometimes called Popcorn cells lymphoma.

Stages of Hodgkin’s disease:-

Staging describes the extent and severity of the disease:-

  • Stage 1 (Early stage):- Means that cancer is found in one lymph node region on the cancer is found in only one area of a single organ.
  • Stage 2 (locally advanced disease):- Means that cancer is found in two lymph node region on one side of the diaphragm which is the muscle beneath your lung or that cancer was found in one lymph node region as well as in a nearby organ.
  • Stage 3 (Advanced disease):- Means that cancer is found in the lymph node region both above and below your diaphragm or that cancer was found in one lymph node area and in one organ on the opposite side of your diaphragm.
  • Stage 4 (widespread disease):- means that cancer was found outside the lymph node and has spread widely to other parts of your body, such as your bone marrow liver or lung.

Causes or etiology of Hodgkin’s disease:-

  • The main cause of HL is unknown.
  • The disease has been linked to DNA or genetic mutation. [ Mutation tells the cell to multiply rapidly, causing many diseased cells that continue multiplying.]

The risk factor of Disease:-

Factors that can increase the risk of HL:-

  • Age:– HL is most often diagnosed in people between 15 to 40 years and these over 55.
  • A family history of Lymphoma:- Having a blood relative with lymphoma, increase the risk of developing the disease.
  • Gender:- males are slightly more likely to develop Hodgkin’s lymphoma than are females.
  • Epstein Bar Infection:- People who have illness causes by Epstein bar virus such as mononucleosis are more likely to develop HL.
  • Weak Immune System.

Sign and Symptoms of Hodgkin’s disease:-

  • The most common symptoms -swelling of the lymph nodes.
  • Night sweats
  • Itchy skin
  • fever
  • fatigue
  • unintended weight loss
  • persistent cough, trouble breathing
  • chest pain
  • pain in lymph-node after consuming alcohol
  • Enlarged spleen
  • severe Dyspnoea

Diagnostic Evaluation or Investigation:-

  • Family history
  • physical examination
  • An imaging test such as x-ray or CT scan
  • Lymph node biopsy for abnormal cells
  • blood test (CBC) to measure RBC, WBC, and platelets
  • Bone marrow biopsy (to see cancer spread)
  • Immunophenotyping to determine the type of lymphoma cells are present.
  • lung function test (to determine how well your lungs are working)
  • Echocardiogram (to determine how well your heart are working)

Management:-

Hodgkin’s lymphoma treatment is right for you depends on the type and stage of your disease and health.

  • Chemotherapy:- Chemotherapy is a drug treatment that uses chemicals to kill lymphoma cells (bleomycin).Chemotherapy is often combined with radiation therapy in people with early-stage classical type Hodgkin’s lymphoma.
  • Radiation therapy:- Radiation therapy uses high-energy beams such as x-ray and protons to kill cancer cells.
  • Bone marrow transplantation:– also known as stem cell transplant is a treatment to replace with healthy stem cells.
  • Other drug therapy:- Drugs used to treat H.D. such as immunotherapy that works to activate your immune system to kill lymphoma cells.

Nursing Diagnosis:-

  1. Risk of infection related to immunodeficiency.
  2. Ineffective therapeutic regimen management related to insufficient knowledge.
  3. Imbalance nutrition is less than body requirement related to malabsorption or pain.
  4. Activity intolerance related to weakness.
  5. Disturbed body image due to swelling of lymph node or disease condition.
  6. The risk of impaired skin integrity due to weakness or immunodeficiency.

Oral cancer: Common sites, Incidence, Clinical Manifestation, Investigation, Palliative care, Management

Oral cancer is also known as mouth cancer.
Oral cancer is cancer that develops in the tissue of the mouth or throat. It belongs to a large group of cancer called head and neck cancer. Most develop in squamous cells found in your mouth, tongue, and lips. It can be fatal if not diagnosed in the early stages.
“Oral cancer is defined as uncontrolled growth or sore in mouth.that does not go away. “

Introduction | Definition | Common Sites of Oral Cancer | Incidence | Clinical Manifestation | Diagnostic Evaluation | Management | Palliative care |

Introduction:-

  • Oral cancer is also known as mouth cancer.
  • Oral cancer is cancer that develops in the tissue of the mouth or throat. It belongs to a large group of cancer called head and neck cancer. Most develop in squamous cells found in your mouth, tongue, and lips. It can be fatal if not diagnosed in the early stages.

*What is the definition of oral cancer?

Definition:-

  • “Oral cancer is defined as uncontrolled growth or sore in mouth.that does not go away. “
  • Oral cancer and high include cancer of lips, tongue, cheeks, the floor of mouth hard and soft palate, sinuses, and pharynx (throat).
  • Oral cancer is a type of head and neck cancer is any tissue growth located in the oral cavity.
  • It may arise as from distant sites of the origin or by extrusion from neighboring anatomic sites such as a nasal cavity.

*What are the common sites of oral cancer?

Common sites of oral cancer:-

  • Lower lips.
  • Lateral or under the surface of the tongue.
  • Buccal mucosa.
  • Hard and soft palate.
  • Pharyngeal wall.

Incidence:-

  • More common after 45 yr of age – male: female is 2:1.
  • Oral cancer accounts for 50% of 70% of total cancer mortality.

*Enlist the clinical manifestation of oral cancer?

Clinical manifestation:-

  1. Leukoplakia:- White patches on the mucosa of the mouth or tongue.
  2. Hyperkeratosis:- Hard and lethargy White patches.
  3. Erythroplakia:- Rad velvety patch on the mouth or tongue.
  • Painful ulceration.
  • Soreness of tongue.
  • Increased salivation.
  • Dysphagia.
  • Slurred speech.
  • Toothache.
  • Earache.
  • Difficulty in chewing/mastication.
  • Mouth, lip, tongue, maybe pale or dark color or disorder.

*Enlist the diagnostics evaluation of oral cancer?

Diagnostic evaluation:-

  • P.E.T.
  • X-ray.
  • CT scan.
  • MRI.
  • Biopsy.
  • Oral exfoliative cytology.
  • Toluidine blue test.

*Describe the management of oral cancer?

Management:-

Surgical management:-

  • remove tumor.
  • Removal of the cancerous lymph node.
  • Glossectomy (partial /complete).
  • Removal of the lower jaw.

Medical management:

  • Radiation therapy.
  • Chemotherapy.
  • Immunotherapies.
  • Molecularly target therapy:- Targeted cancer therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules that are involved in the growth progression and spread of cancer.

Management in case of metastatic cancer:-

  • Radial neck dissection:- It includes wide excision of the involved area.
  • A lesion with the removal of regional lymph nodes the deep cervical lymph nodes and their lymphatic Channels (depending upon the extensiveness) the sternomastoid muscle, internal jugular vein mandible, the submaxillary gland.
  • Modified neck dissection:- It involves dissection of major cervical lymphatic vessels and lateral cervical space with preservation of nerve blood vessels and jugular vein.

Palliative care:-

  • It aims to treat symptoms and make the patient more comfortable.
  • Dysphagia – Gastrostomy
  • Pain – Analgesic, and narcotics.
  • Increased salivary secretion:- Frequent suction of the oral cavity.

Nursing management:-

  • The risk for ineffective airway clearance related to oral surgery.
  • The risk of imbalanced nutrition less than body requirement related to oral surgery.
  • Impaired verbal communication related to glossectomy.
  • Disturbed body image related to surgical excision of the tongue.

Lung cancer: Risk Factor, Types, Stages of Cancer, Symptoms, Investigation, Nursing Management

Lung cancer is cancer that starts in the cells that make up the lungs. Many other types of cancer such as breast or kidney can spread to the lungs.
lung cancer is the fourth most common cancer reportedly in Indian males. It accounts for 6.8% of all malignancies in India.Commonly occur in individuals more than 50yrs of age who have a long history of cigarette smoking.

Introduction | Definition |Risk factor |Types of Lung Cancer | Pathophysiology | Stages of Cancer | Clinical Manifestation | Diagnostic Evaluation | Management |Nursing Management |

Introduction:-

  • Lung cancer is cancer that starts in the cells that make up the lungs. Many other types of cancer such as breast or kidney can spread to the lungs.
  • lung cancer is the fourth most common cancer reportedly in Indian males. It accounts for 6.8% of all malignancies in India.
  • The incidence is estimated to be about 6.6 per 100000 in males and 1.7 per 100000 in females.
  • Commonly occur in individuals more than 50yrs of age who have a long history of cigarette smoking.

* What is the definition of lung cancer or define lung cancer?

Definition:-

  • “Lung cancer also known as lung carcinoma is a malignant lung tumor characterized by uncontrolled cell growth in tissue of the lung.”
  • “Lung cancer is a neoplasm of the lung.”

* What are the causes of lung cancer?

Etiology:-

  • The exact cause is unknown.

* What are the risk factors of lung cancer?

Risk factor:-

  • Genetic (transformation from one generation to another generation.)
  • Age (mostly in older age, 65 or older age, the average age is 70 year)
  • Past lung disease ( can cause inflammation and scarring in the lung, eg: Tuberculosis, COPD)
  • Radiation therapy to the chest (eg. breast therapy, Non-Hodgkin’s lymphoma)
  • Second-Hand Smoking
  • Smoking
  • Diet (low intake of vitamin-A, unbalanced diet)
  • Environmental factor :- Asbestosis,Radon,Tar,Arsenic,Vinyl chloride)

* What are the types of lung cancer? Or Enlist and explain the types of lung cancer?

* Explain NSCLC? What are the subtypes of NSCLC? Explain with its characteristics?

Types of Lung cancer:-

There are two types of lung cancer:-

  1. Non-Small Cell Lung Cancer (NSCLC)
  2. Small Cell Lung Cancer (SCLC)

Non-Small Cell Lung Cancer (NSCLC):-

  • NSCLC is any type of epithelial lung cancer other than small cell lung carcinoma.
  • NSCLC accounts for about 85% of all lung cancer.
  • NSCLC is relatively insensitive to chemotherapy compared to small cell lung cancer.
  • When possible they are primarily treated by surgical resection with curative intent, although chemotherapy has been used increasingly both pre-operative and post-operative.

The most common type of NSCLC are:-

  • Squamous cell carcinoma
  • Adenocarcinoma
  • Large cell carcinoma
  1. Squamous cell carcinoma:- Arrives from bronchial epithelium & is more centrally located and its growth rate is slow.

Characteristics:-

  • Accounts for 20-30% of lung cancers.
  • more common in men. Centrally located producing early symptoms of non-productive cough and hemoptysis.
  • do not have a strong tendency to metastasis.

Response to therapy:-

  • Surgically resection may be attempted.
  • Adjuvant chemotherapy and radiation.

2. Adenocarcinoma:- It arrives from the periphery of the lung and looks like nodules often metastasized. Its growth rate is moderate.

Characteristics:-

  • Accounts for 30-40% of lung cancer.
  • The most common lung cancer in people.who has not smoked more common in women.
  • Peripherally located often has no clinical manifestation until widespread metastasis is present.

Response to therapy:-

  • Surgical resection may be attempted depending on the staging.
  • Doesn’t respond well to chemotherapy.

3. Large cell carcinoma (undifferentiated):-

It is the fast-growing carcinoma that arrives from the periphery branches of bronchi.

characteristics:-

  • Accounts for 10% of lung cancers.
  • Composed of large cells that are anaplastic and often arise in the bronchi.
  • It is highly metastatic via lymphatics and blood.

Response to therapy:-

  • Surgery is not usually attempted.because of the high rate of metastasis.
  • A tumor may be radiosensitive but often recurs.

Small cell lung cancer (SCLC):-

  1. Small cell carcinoma (SCC):– Arrives from the major bronchi & spread by infiltration along with bronchial walls. The growth rate is very rapid.

Characteristics:-

  • Accounts for about 20% of lung cancers.
  • The most malignant form of the lung.
  • Spread early via lymphatics & bloodstream, frequent metastasis to the brain.
  • Associated with endocrine disturbances.

Response to therapy:-

  • Chemotherapy’s mainstay of treatment but overall poor prognosis.
  • Radiation is used as adjuvant therapy and palliative measure.

* Describe or explain the pathophysiology of lung cancer?

Pathophysiology:-

  • The carcinogens bind to the DNA
  • Damage it.
  • Cellular changes and abnormal growth
  • Malignant cells.

As the damaged DNA is passed on to daughter cells, the DNA undergoes further changes and becomes unstable with the accumulation of genetic changes the pulmonary epithelium undergoes a malignant transformation.

* What are the stages of cancer?

Stages of cancer:-

  1. T o:- No evidence of tumor.
  2. T x:- Tumor proved by cytologic studies, but visualize by radiography.
  3. T is:- Carcinoma in situ.
  4. T 1:- Tumor 3cm or less.
  5. T 2:- Tumor greater than 3cm.
  6. T 3:- Direct extension of the chest wall.
  7. T 4:- Tumor invading mediastinal.
  8. N o:- No nodule metastasis.
  9. N 1-3:- According to the progress of nodule involvement.
  10. M o:- NO known metastasis.
  11. M 1:- Presence of distant metastasis.

* What are the clinical manifestation or Enlist clinical manifestation of cancer?

Enlist clinical manifestation:-

  • Asymptomatic till diagnosis.
  • Persistent.
  • Non-productive cough at earlier and in later productive cough.
  • Blood tinged sputum.
  • Chest pain.
  • Dyspnoea.
  • Wheezes.
  • Palpable lymphnodes in neck or axilla.
  • Unilateral paralysis of the diaphragm.
  • Superior vena cava obstruction. (Due to into the thoracic spread of malignancy )
  • Pericardial effusion and dysrhythmia. (if mediastinum is involved)
  • Anorexia.
  • Fatigue.
  • Weight loss.
  • Fever.
  • Nausea, Vomiting.

* What is the diagnostic evaluation or Enlist diagnostic evaluation of cancer?

Diagnostic Evaluation:-

  • Chest x-ray:- shows the presence of tumor or evidence of metastasis to ribs or vertebrae.
  • CT-Scan and MRI:- shows the location and extent of masses.
  • PET:- Helps in early detection of cancer staging and monitoring effects of treatment.
  • Sputum specimen for cellular studies.
  • Bronchoscopy:-Helps in direct visualization, allows taking biopsy specimen.
  • Mediastinoscopy:- Involve insertion of scope through a small anterior chest incision into the mediastinum. It is done to examine metastasis in the anterior mediastinum or in the chest extrapleural.
  • Biopsy.
  • Pulmonary Angiography.
  • Lungs scan.
  • Fine needle aspiration.

* What are the complications of lung cancer?

Complication:-

  • Airway obstruction
  • Atelectasis
  • Plural effusion
  • Pulmonary Abscess
  • Pneumonia
  • Paraneoplastic syndrome

Prognosis:-

Prognosis is generally poor,13%of patients with lung cancer survivors.

* Describe the management of lung cancer?

Management of Lung cancer:-

Surgical management:-

  1. lobectomy
  2. wedge resection
  3. Pneumonectomy

Medical management:-

  1. Radiation therapy
  2. Chemotherapy
  3. Laser surgery

Nursing management:-

  1. Ineffective breathing pattern resulting from compression of lung tissue.
  2. Impaired gas exchange resulting from retained secretion and occluded bronchial.
  3. Acute pain related to surgical incision tissue trauma and disruption of inter-coastal nerves, presence of chest tube.
  4. Fear and anxiety related to situational crises, change in health status, and perceived threat of death.

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