NCM 106 – Cellular Aberration Sir Siroy Cellular Aberration ➢ Group of disorder characterized by abnormal cell growth and

the ability to metastasize with potential killing the host ➢ Term “cancer” refers to the group of disease in which cells grow and spared unrestrained throughout the body ➢ Normal cells mutate into abnormal cells that take over normal tissue, eventually harming and destroying the host ➢ Latin word “Carab” –cancer ➢ Synonymous with neoplasm Biology of cancer ➢ Cell is the functional unit of the body in humans and animals ➢ The type of cell: EUKARYOTIC (contains nucleus) ➢ Whist bacteria are prokaryotic ➢ Being multi-cellular humans are made from 100,000,000,000,000 cells, all are derived from a single fertilized ovum Cancer ➢ Single word, incorporates a vast diversity of diseases since there are as many tumor types as there are cell types in the human body. ➢ It is not a single disease, but a group of heterogeneous disease that share common biologic properties (e.g. clone cell growth and invasive ability) ➢ Cancer research revolution has also demonstrated that all cancers are genetic and share common MOLECULAR PATHOENSIS ➢ All CA are the result of mutations in oncogenes. Each specific cancer occurs thru mutation in specific genes Oncogene – a gene that played a normal role in the cell as a proto-oncogene and that has been altered by mutation and now may contribute to the growth of a tumor -it is a gene that has potential cause cancer Gene– the basic biological unit of heredity a segment of DNA needed to contribute to a function Proto-oncogene– a normal gene that can become an oncogene due to mutations -To help regulate cell growth and differentiation Chromosomes – thread like linear stand of DNA and associated proteins in the nucleolus of eukaryotic cells that carries the genes and functions in the transmission of heredity information.

Proliferation of growth pattern ➢ Cell proliferation is the process by which cells divide and reproduce in normal tissue, cell proliferation is regulated so that the number of cell dying or being shed. Benign Growth Pattern ➢ The most significant growth patter are: -Hypertrophy -Hyperplasia -Metoplasia -Dysplasia Hypertrophy – an increase in cell size resulting in an increase in organ size. It commonly results from increases workload, hormonal stimulation, or compensation directly……….. Hyperplasia– reversible increase of number of cells in response to a specific growth stimulant Ex: endometrial hyperplasia and BP are the result of excessive hormone stimulation. But cancer can develop if the growth mechanisms become defective Metaplasia - The conversion of one cell type to another type not usually in the involved tissue -It can be induced by inflammation, vitamin deficiencies, chronic irritation, or various chemical agents Ex: Substitution of columnar epithelial cells of the respiratory irritations such as cigarette smoking -The process is reversible Dysplasia– Abnormal change in size, shape or organization of cells. The common stimulus creating a dysplasia is radiation, inflammation of toxic chemicals or chronic irritation Ex: chronic bronchitis (smokers) -reversible if stimulus is removed -some forms of dysplasia are known as precancerous lesions

The cell cycle (Cell cycle/Cell Division cycle) ➢ Series of events that takes place in a cell leading to its division and duplication (Replication) ➢ The cell cycle consists of 4 distinct phases: – G1 phase – S phase – G2 phase – M phase (mitosis) ➢ Composed of 2 processes: -Mitosis – chromosomes are divided between 2 daughter cells

Mitosis (m phase / mitotic phase)  Relatively brief m phase consists of nuclear division (KARYOKINESIS) divided into 5 phases • Prophase • Metaphase • Anaphase • Telophase • Cytokinesis  KARYOKINESIS – “cellular division” ➢ CDK the catalytic subunits but inactive in the absence of cyclin when CDK is activated by cyclin it performs a common biochemical reaction called Phospharylation that a activates target CHON to orchestrate coordinated cntry into the next phase of cell cycle ➢ Synthetic inhibitors – Arrest cell cycle and useful as antineoplastic and anticancer agent ➢ Cell cycle checkpoint – Used by the cell to monitor and regulate the progress of the cell cycle. Terminologies*: ➢ Oncology– study of tumors of neoplasm ➢ Oncos– Greek word for tumor ➢ Cancer– Common term for all malignant tumors ➢ Neoplasia – New growth ➢ Neoplasm – new growth of tissue that has no purpose or function in the body ➢ Tumor – Broad term to identify any growth within the body ➢ Carcinogen – Any substance that initiates and promotes cancer formation ➢ Mutation – Any substance that promotes the formation of potentially dangerous changes called mutations in genes ➢ Teratogen – Substance that cross placenta from mother to the child and harm the fetus ➢ Benign – Condition. whereas prostate may double every year.-Cytokiness – cells cytoplasm divides in half forming distinct cells ➢ G0 Phase – Cells that have temporary or reversibly stopped dividing are said to have entered a state of quiescent ➢ “post-mitotic” – both quiescent and senescent cells Example of cells entering into quiescent state are neurons (non-proliferative cells) Phases of Cell Cycle ➢ Interphase – Before the cell division. all chromosomes have been replicated ie each chromosomes has 2 (sister) chromatids III. G1. G1 Phaseor the growth phase from the end of the previous m phase until the beginning of the DNA synthesis. this means that it does not spread to other parts of the body or destroy nearby tissue . it needs to take in nutrients. cannot progress to the next phase” Role of Cylin and Cyclin Dependent Kinases ➢ Regulatory molecules (CHON enzymes) ➢ Cyclin form the regulatory molecules and has no catalytic Cell-cycle Time ➢ The amount to time regulated for a cell to move from one mitosis to another mitosis. tumor or growth that is not cancerous. DOUBLING TIME is the length of time it takes for the tumor to double its volume. The cell can’t proceed to the next phase until checkpoint requirements have been met “if cell s lack nutrient. when it is complete. S. duration is highly variable even among different cell of the same species II. All the preparation are done during interphase ➢ Three (3) of interphase I. S Phase – starts when DNA synthesis commences. G2 ➢ The length of the total cell cycle varies with the specific type of cell ➢ A common misconception is that the rate of Cancer cells proliferation is faster than that of a normal cell. G2 Phase  Cell enters G2 which lasts until the cell enters mitosis  Produtiion of microtubules  Inhibition of protein synthesis is during G2 prevents the cell growth IV. or the sum of M. ➢ The average Doubling Time for most primary solid tumors is approximately 2 months ➢ Rapidly growing tumors such as testicular cancer may double every month. Usually cancer cells proliferate at the same rate as the normal cells of the tissue or origin ➢ The difference is that the proliferation of cancer cells isCONTINUOUS ➢ The growth rate tumors are expressed in doubling time.

fixed -irregular shaped . thus forming a malignant mass ➢ Apoptosis – Process of programmed cell death Differences between Benign and Malignant Tumor* Benign Malignant -Mobilemass -Smooth andround .Difficult to remove and recurs after excision Diagram Representation of General Pathophysiology of Cancer Acquired (environmental) DNA damaging agents Chemicals Radiation Viruses Normal Cell DNA damage Failure of DAN Repair Inherited mutation in: -Genes affecting DNA repairs -Genes affecting cell growth or apoptosis Activation growth promoting oncogenes Mutation in the genome of somatic cells Inactivation of tumor suppressor genes Alteration in genes that requires apoptosis Unregulated cell proliferation Angiogensis Escape from immunity Clonal Expansion Decreased apoptosis Additional mutation .➢ Malignant– Tumors are ambitious.) to conquer new territory ➢ Carcinogenesis /Oncogenesis– creation of cancer. Malignant tumors have 2 goals: 1.multiply rapidly . it is characterized by a progression of changes on cellular and genetic level that to undergo cell division. A process by which normal cells are transformed into cancer cells.) to survive and 2.almost always spreads .cells multiply .tumor grows by invading and destroyingsurroundin g tissue -Attached to surrounding tissue .Have surrounding fibrous capsule .tumor grow by expanding and pushing awayand against surrounding tissue -Not attachedto surrounding tissue -Never spreads -Easier to remove and does not recur after excision -no capsule .

having one or more risk factors does not necessary mean that a person will get cancer. genetic factors. morphologic traits. mineral. . viral. Some people with one or more risk factors never develop the disease. plants products. that 5% to 10% of all cancer result from heredity or genetic predisposition. (2nd Day) Immunology and epidemiology Carcinogenic factors – it is becoming increasingly evident that cancer occurs because of interactions among multiple risk factors of repeated exposure to a single carcinogenic agent Risk factors of Cancer: Having risk factor for cancer means that a person is more likely to develop the disease at some point in his/her life. Genetics – est. environmental. Promotion  Promoting agents or cocarcinogenscause unregulated accelerated growth in previously initiated cells. • EX: Vitamins. or certain host characteristics (eg. theses are capable of producing irreversible changes in the DNA of a cell II. Progression  Tumor cells acquire malignant characteristics that include changes in growth rate invasive potential. biological. Initiation  Cells are exposed to an initiating agent or carcinogen that makes them susceptible to manage transformation  Initiating agents: Chemical. lifestyle. hormones may increase the risk of mutation and at the same time stimulate the replication of the mutated cell. and responsiveness to therapy. while other people who so develop cancer have no apparent risk factors. thus hormones are complete carcinogen. age.However. Hormonal factors – hormones are important regulators of growth. Immune function. By stimulating proliferation. III. metastatic frequency. physical agents. This has to do with the pt IMMUNE SYS.  Is reversible if the promoting agents are removed during agents of carcinogenesis  Examples are hormones. caretenoids. Heredity cancer syndromes are characterized by the same pr related cancer in multiple family member in multiple generation 2. chemicals and drugs  Chemical carcinogensare called complete carcinogens because they can initiate and promote malignant transformation • Ex: Cigarette  The effect of cocarcinogensmay be inhibited by certain cancer – reversing or cancersuppressing agents.Tumor progression Malignant neoplasm Invasion of metastasis Theories of Carcinogensis ➢ Proposes the process of transforming a normal cell into a cancer cell ➢ Consists of stages: I. hormonal factors) or both. 1. flavonoids.

nasopharyngeal cancer c) Hepatitis B virus (HBV) – hepatocellular cancer d) Hepatitis C virus (HBC) – hepatocellular cancer e) Human herpes virus-8 (HHV-8) – Kaposi’s sarcoma f) Human immunosuppressive virus (HIV) – important cofactor in many human cancers because of its immunosuppressive effects ➢ Bacteria and parasites – gastric infection with the Helicobacter pylori bacteria to the dev of gastric lymphoma and gastric cancer ➢ Infection with Schistosomahematobium parasite-linked to bladder cancer and liver cancer 1. more than 1000 of chemicals have been examined for their potential to cause cancer. Oncogenic viruses – can induce or cause cancer and contribute to human carcinogenesis by infecting the host DNA resulting in proto-oncogenic changes and cell mutation 6. skin.Prolonged exposure -recreational or occupational activities -lighter skin pigmentation -greater intensity -duration of exposure . diet and alcohol consumption. radium and uranium -it can also occur from exposure to -dx and therapeutic sources like: -Gamma radiation (xrays -radiation therapies -imaging studies -atomic power -nuclear weapons -gamma radiation comes naturally from the rocks and soil as low level radiation -Visible and infrared light– are form of non-ionizing radiation -Electromagnetic radiation with a wavelength bet 10.EX: a direct carcinogen effect or estrogen is known from the occurrences of vaginal and clear…. -Since then.2m (or cm) is call microwave radiation EX: of microwave radiation are microwave ovens and mobile phones -there are non-ionizing but still has potential hazard and should be used in caution Radon gas-inhalation of this gas is dangerous -cosmic radiation comes from the outer space. breast . and leukemia 5. prostate. Most chemical isprocarcinogen. anal cancer b) Epstein-Barr virus (EBV) – Burkitt’s lymphoma. Some studies have shown aircrew to have higher than average number of cancers like Cancer of the brain. 3.if not repaired causing malignant transformation –squamous cell cancer of the exposed area of the skin . germicidal lights -UVR induces a change in DNA--DNA damage -. B-cells lymphoma.The majority of ionizing radiation exposure is from natural sources such as: -cosmic rays -radioactive ground minerals -gases like radon. Environment agents – 75% of cancers occur as the result of environmental exposure.. some people are born with defects in their immune system -Secondary immunodeficiency ➢ results of particular external processes of disease: the resultants state is called secondary of acquired immunodeficiency ➢ Common causes of acquired immunodeficiency are . colon. arcs.Exposure too many chemicalcarcinogens are associated w lifestyle risk factors such as smoking. coal tar products and cigarette smoke . Radiation– 2 forms: -ultraviolet -ionizing -sources of UVR including the sun. Immune system deficiencies or immunodeficiency is a stat in which the immune sys ability to fight infectious disease is compromised or entirely absent ➢ Types of immunodeficiency: -Primary immunodeficiency ➢ Inborn. -CHEMICALS -Cancer of the scrotum in chimney sweeps was due to their exposure to coal tars (1775 London) -Bladder cancer – among workers exposed to aromatic amines (chemical used in dying and pigment industry a century later in Germany. -EX: Soot. welding. 4. Five (5) DNA viruses have been linked to cancer in humans: a) Human Papillomavirus (HPV) – Cervical cancer.

536 15. and particular medications like chemotherapy. cigar.2 7. some cancer cells are capable of by passing surveillance. such as age a first menstruation. More men die from cancer than women 2. including cigarettes. African American men have 2.3 . Age– with few exceptions cancer becomes more prevalent in older persons. Over half of all cancers occur in person age 65 or older 3. pipe.3 6.4 % higher incidence rate and 40% higher in mortality rate that white men. -Different kinds of cancer have diff risk factors: some of the major risk factors associated with particular types of cancer include the following: Risk factors of the lungs: -tobacco use. 1. organic solvents -Age. immune ……… In spite of the immune systems’ ability to identify and destroy cancer cells. Gender– more men develop cancer that women. Race and Ethnicity – incidence and mortality varies among racial and ethnic groups.malnutrition. aging.6 13. wheat.249 4. chewing tobacco and snuff -radiation exposure -second-hand smoke Risk factors of oral cancer* -tobacco use (cigarette. cigar. number of pregnancies and age at menopause -High fat diet -Obesity -Physical inactivity -Alcohol in take -women with a mother of sister who have had breast are more likely to develop the disease factors of Prostate cancer: -Only men -Advance age -Race: more common among African American men than among white men -High fat diet -Men with a father or brother who has had prostate cancer are more likely to get prostate cancer factors of Liver Cancer: -Certain types of viral hepatitis -cirrhosis of the liver -Long term exposure to aflatoxin (carcinogenic substance produced by a fungus that often contaminates peanuts. thus escaping and causing cancer. smokeless tobacco) -Excessive alcohol use -excessive irritation (ill-fitting dentures) -Vitamin A deficiency Risk factors for laryngeal cancer: -Tobacco use -poor nutrition -alcohol -weakened immune system -occupational exposure to wood dust. 50-70 years old Risk factors of Cervical Cancer* -Tobacco use -HPV -Chlamydia infection -Diet: low in fruits and vegetables -Family history of cervical cancer Risk factors of Esophageal Cancer: -Tobacco use -Gender: 3 times more common in men -alcohol -Diet: low in fruits and vegetables factors of Brest Cancer: -Early menarche/late menopause -age: changes in hormone levels throughout life. solvents -chronic bladder inflammation Risk factors of Renal Cancer: -Tobacco use -Obesity -Diet: well-cooked meat -Occupation exposure: asbestos. paint fumes -Age: more than 60 years old Risk factors of Bladder cancer: -Tobacco use -occupational exposure: dyes. PI Disease Number % Lung Breast Liver Cervix 11. diseasemodifying anti-rheumatic drugs. soybeans.123 9436 5. corn and rice) factors of Skin cancer: -Unprotected exposure to strong Risk Risk Risk Risk sunlight -Fair complication -Occupational exposure Risk factors of Colonic Cancer: -Personal/family hx of polyps -high fat diet and/or low fiber diet -history of ulcerative colitis -Age: > 50 years Risk factors of Uterine/endometrial Cancer: -estrogen replacement therapy -early men TEN LEADING SITES OF CANCER ON 1998 BOTH SEXES.

1 3.088 4. E. result in the elimination of certain cancer.9 2.026 1. polysaccharides. tea. ASA. changes in lifestyle. solvents ect… THE LEADING SITES OF CANCER ON FEMALE. one day. garlic. lutein.6 2. physical in activity resulting to obesity. omega 3 fatty acids. poor nutrition. Etc… -Research on nutritional supplements and pharmaceutical agents with potential cancer prevention benefits is going -Ex: Lycopence.4 4. Diagnosis PREVENTION: -Primary cancer prevention guidelines is aimed at measures to ensure that the cancer never develop -Secondary prevention is aimed that detecting and treatmentthe cancer early.4 .9 Quiz leakage: Risk Factors of Breast.9 3. paints.4 . gotulola. carotenoids. Like careful in handling pesticides.649 2.906 2.9 4.3 6. NSAIDs.6 3.1 2.6 3. celecoxib. polysaccharides. Chemical exposure – follow instructions and safety tips to avoid or reduce contact with harmful substances both at work and at home.068 2032 1488 1415 1343 1052 1052 25. 1998 PI Disease Number % *Breast Cervix Lung Thyroid Ovary Leukemia Colon Liver Stomach Corpus Uteri 9. Cervical and Prostate Cancer Cell cycle: understand Diff bet Benign and malignant 5-10 exact 5 multiple choice Enumeration _________________________________________________ Unit III: Prevention.4 5. Detection.536 2.563 2.474 3. 1998.1 3. PI Disease Number % *Lung Liver Prostate Leukemia Colon Stomach Nasopharynx Lymphoma Rectum Oral 8.7 12.6 3.9 TEN LEADING SITES OF CANCER ON MALES.Further reductions in cancer incidence – through elimination of occupational and environmental risks.Leukemia Colonn Thyroid Stomach Nasopharynx Lymphomas 3. .325 4.584 2. zinc (ants) and many more -as the saying goes (an ounce of prevention is much much better than a kilogram of cure” -Prevention rather than cure is the ultimate way to defeat cancer so you should absolutely make sure your dietary intake contains copious amounts of a wide range of anticancer nutrients every single dat.963 2. -Vaccines are begin designed to prevent cancer -Immunization may. vitamin C.200 2. No more than I drink a day for women and no more than 2 in men 2.7 2.659 1548 1511 1475 1253 1142 810 26.9 3.8 4. preventable and 1/3 of all cancer deaths in 2006 is directly to tobacco use. -several chemo-preventive agents have been found to effectively reduce cancer risk and re currently I use -Ex: anti-androgens. The American Cancer Society estimates that 80% if all cancer may be associated with environmental w\exposures and are potentially.6 7. Alcohol use – drink in moderation.8 5. Preventive measures to specific risk factors: 1.9 12. focusing on healthy choices in diet and exercise.7 4. during the most curable stage. aloe vera. grape seed.147 2. D.52 4.

3. vitamins A. and salt-pickled foods. 5. fruits and vegetables. 6. smoking etc—cancer risk. red meats etc. Prevent passive smoking. vitamins and minerals. Betacaratene. -promote a smoke-free environment -sooner a cancer is diagnosed and treatment begins. a healthy diet includes plenty of food high in fiber. 4.E. 5. cortisol to hep the body to react with more strength and speed-increases Bb. HPV prevention -vaccine for hepa B 6. 2. Brisk walking for at least 30 min or 5 or more days a week. -stress releases stress hormones-epinephrine.C. -small amount of stress is beneficial but chronic (persisting or progressing) is harmful. -drink alcoholic beverages in moderation. Promote lifestyle change. fruits and unrefined cereals. Therefore. BREAST CANCER Warning signs -skin changes -edema -inflammation “peau de orange” –orange peel like skin -ulceration -prominent venous pattern Nipple abnormalities -retraction -rashes or discharge ABNORMAL CONTOURS -variation in size and shape of breast EARLY DETECTION . Increase intake of dietary fiber by eating more leafy green and yellow vegetables. salt-cured. heart rate. the better the chances of living longer and enjoying a better quality of life. charcoalbroiled. psychosocial factors. The earlier cancer is detected. Advise smokers not to smoke inside living areas and workplace to prevent exposure of others to secondhand smoke. guidelines for screening and early detectin will vary depending on the type of CA. Advocate an environment supportive of a healthy lifestyle. Eat less fatty foods 4. -The acronym CAUTION US (ACS) provides a systematic way of remembering the cancer … C-change I bowel or bladder habits A-a sore that does not heal U-unusual bleeding or discharge T-thickining or lump in the breast or else where I-indigestion and difficulty in swallowing O-obvious change in wart or mole -warts sor moles are circumscribed cutaneous discolorations to skin elevations that should not increase in size. talk to your doctor and will suggest exams that can detect cancer early. –smoking cessation. 3. Viruses and bacteria-the FDA (DOH/PHIL) approved a vaccine for the prevention of cervical cancer -avoid unprotected sex or share needles. nor elcerate. blood sugar. Family history of cancer – If you think you have a pattern of a certain type of cancer in our family. N-nagging cough or hoarshness of voice -evaluate for symptoms related for persistent cough and its quality eg dry U-unexplained anemia S-sudden wt loss SPECIFIC GUIDELINES FOR EARLY DETECTIN OF COMMON CANCER: There are many types of cancers. It can lead into unhealthy behavior like overeating. Marital problems. breads and cereals. the more likely it is to be cured. financial crises ect. health problems. HIV. limit diet rich in fat like butter. Limit consumption of smoked. Avoid moldy foods -control obesity through proper nutrition and exercise. Poor diet and exercise. Ex. Early detection techniques enable health care providers to screen for and diagnose cancer while it is localized and potentially curable. death of loved ones.quit smoking for active smokers. -stress weakens immune system KEY AREAS FOR PRIMARY PREVENTION OF CANCERS (DOH/PHIL) Quiz tom 1. SCREENING FOR CANCER DOH/PHIL -early detection and prompt treatment are keys to curing cancer (note: “ cure rate” in cancer is relative and depends on the type of cancer). or being overweight – eat well. Assignments: Types of cancer Research: update 2 nsg dx (risk and actual) Outcome criteria And intervention Present Pass before midterm -be active and maintain a healthy wt.psychological stress from the environment or society or people that surrounds us.

have multiple partners. BREAST CANCER -A. STAGING. such as CA. a week after onset of menstrual period.--perform BE a week after menstrual period -pregnancy -lactation. -put in mind that BSE does not take the place of a Mammography or vice versa.g. localized pain -history of wt loss EARLY DETECTION -CXR q6months for patients who have history of smoking 2 packs a day -sputum cytology DIAGNOSTIC EVALUATION. M should be started at age 30.1. –best time to do BSE is one week after menstrual period while taking a shower. -b. If lumps or lymph nodes swelling is present. -if with family history of breast cancer. NR -explain the procedure that this is done to find a lump or change in the breast that may mean serious problem. sputum cytology. Mammogram or mammography. AND NURSING RESPONSIBILITIES. LUNG CANCER -persons with a long history of smoking and/or smoking 2 or more packs of cigarette a day -chronic cough or nagging cough -dull intermittent.----teach BSE to women early in their teens. -Pap’s smear should be done in between menses (2 weeks after menses). LUNG CANCER -a. Just instruct client to cough our sputum in a sterile container and label properly.examine a sample of sputum under a microscope to determine whether abnormal cells are present Nursing responsibilities -no special prep is required. commercial sex workers. Breast self-examination-cheapest and most affordable screening procedure. Yearly breast examination by a health care provider. starndard roentgenogram or x-ray on chest. Breast mammography -if a mass is detected and confirmed by the health worker. Nursing responsibilities -avoid excessive exposure of client and self -remove radiopaque objects that can interfere with the results -explain procedure to client. confirms diagnosis. This include those who are: sexually active. –this can be easily taught to women to increase awareness and promote selfcare. A woman should not douche. -baseline M is suggested for all women between the ages 35-39 and yearly after age 40. clinical breast a special type of x-ray imaging used to create detailed images of the breast. -b. a mammogram usually confirms it. . it should be done yearly. have intravaginal medications nor have sexual intercourse 24 hours prior to test. -by age 20. Detect any abnormalities in the lungs. -should be done annually for 2 consecutive years and at least every 3 years until age 65 for those with normal findings -for persons at high risk. post-coital bleeding) EARLY DETECTION: -pap’s smear is the primary screening tool for women over age 18. -breasts tend to undergo changes during: -pre-menstrual period. women should have developed the habit of doing BSE monthly. COLON RECTAL CANCER -change in stool -rectal bleeding -pressure on the rectum -abdominal pain EARLY DETECTION: -annual digital rectal exam starting at age 40 -annual stool blood test starting at age 50 -annual inspection of colon PROSTATE CANCER Symptoms of urethral obstruction: -urinary frequency -nocturia -decrease in stream -post-void dribbling EARLY DETECTION: -digital rectal exam for men -Prostate specific antigen (PSA) determination a blood test. CERVICAL CANCER -often asymptomatic -abnormal vaginal bleed (e.this is to detect masses/lumps missed by the client or to confirm presence of mass detected by client on BSE. facing the mirror standing up or lying down 2. assess also for the following: -location -number of lumps or nodes (solitary or multiple) -consistency: soft or hard -size (estimation) -fixed or movable -tenderness along the area 3.a physical exam of the breast done by a health professional. REMEMBER!! BSE -should be done monthly.

-c. -4. mimimally invasive procedure. Slightly uncomfortable but not painful. PSA . Maybe peptic ulcer or malignancy.a procedure used to examine the vagina. Useful in diagnosing tumors. Tissue UTERINE CANCER -A. hysteroscopy. usually protein. that are produced by the body in response to ca growth or by the cancer tissue itself and maybe detected in blood. NR -explain -that eliminates the need for full bladder.bleeding from upper or lower GIT. Prevents dehydration and constipation. NR -explain -done in OR -C. pap smear. But this alone is not diagnostic for CA ex. digital rectal exam. which creates a picture called a sonogram. momentary discomfort during the test -normal activities after the exam -b. rectal penetration. It is a biological marker or tumor marker. -change clothing into hospital gown -perform one week after mensttuation to avoid the risk of infection. urine. -normal to have white stool for a few days after the procedure. -screening test for malignant and premalignant changes in the cervix NR -explain the procedure. it is done only to normal women. fallopian tube. -level below 4. -remain still through out the procdure. surgery. Thus. Thie sound waves create echoes that are sent to a can be raised by a ca cells. -not for pregnant women -no special prep before exam-30 min procedure. giving improved visualization of uterine and endometrial pathology NR -explain. BPH. OTHER TEST 1. positioning-speculum and spatula. CERVICAL CANCER -a. NR -explain procedure -be aware that it is contraindicated to clients with metallic -implants. It uses an infusion of sterile saline through a soft plastic catheter placed in the cervix in conjunction with transvaginal UTZ. lumpy or abnormal areas. hearing technique developed to better image the uterine cavity. COLORECTAL CA -a. or tissue samples. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention.Tumor Marker. pacemaker. -are done to women who have no symptoms of ca and have no findings suggesting a ca.a series of xrays of the colon and rectum are taken after a liquid containing barium is put into the rectum. sharpnels.(apapanicolaou test). a protein produced by cells of the prostate gland. Prostate-specific antigen (PSA). NR -explain the procedure -slight. -b. Transvaginal sonography. -simple test and takes less than 5 minutes. An instrument (utz probe) is inserted into the vagina that causes sound wavest to bounce off organs inside the pelvis. Barium is a dehydrating examination of the rectum and lower colon using a sigmoidoscope. fecal occult blood test. Sigmoidoscopy. prolonged exercise. -positive result.-double contrast barium the inspection of the uterine cavity by endoscopy with access through the cervix. NR -explian -liquid diet before exam for 24 to 48 hours -NPO post midnite -cleansing enema or laxitives -encourage to consume plenty of fluids before and after the exam.Colonoscopy-exam of the rectum and entire colon by using a colonoscope. -it distends the uterine cavity. uterus. Involves collecting cells from your cervix. This procedure of full bladder is true only to abdominal utz (1quart/1L) in 2 hours and don’t void. The test measures the PSA level in the blood.are substances. sonohysterography. ovearies and bladder. -can detect changes in your cervical cells that suggest ca may develop in the future.. -this doesn’t detect colon ca but is often used in clinical screening NR -explain -stool is collected in a container send it right away to lab -if positive maybe recommended for sigmoidoscopy or colonoscopy -b.test for cervical ca in women. NR -same as sigmoidoscopy -d. and ejaculation. Full bladder serves as a landmark to define other pelvic organs. urethral cath.-MRI-radiowaves and magnetic field are used to view soft tissues. obesity.o ng/ml-normal .checks for hidden (occult) blood in the stool. PROSTATE CANCER -a.insertion of a glovedlubricated finger into the rectum and feel the prostate for hard.

. The tumor-node metastasis (TNM) system of the American Joint Committee on Cancer (AJCC) T= characteristics of a givien tumor (size.branch of medicine that uses manual and instrumental means to deal with diagnosis and treatment of injury. and other parts of the body using a small dose of a radioactive chemical.defined as the branch of surgery focusing on the surgical management of malignant neoplasms. STAGING: is used to determine the extent of disease in an individual patient. surgical oncology procedure may be used to prevent a cancer occurrence in the high risk patient removal of mass (breast) or cyst to patient who has a familial tendency. 2. including biopsy.extent of disease often dictates treatment 3. TNM results …. deformity and disease. M= presence of absence of metastasis.. staging and surgical resection. extent to which a disease has spread is prognostic. Key areas 6 Caution us! IV Treatment Principles of various modalities of management against cancer 1. involvement of surroundings structures) N=presence or absence of involved nodes and size or number of involved nodes.way of imaging bones. NR -explain the procedure -injected IV like Na pertechnate/radioactive iodine -care for iv sites Possibility….Surgery. where as a T2N1 M0 breast cancer is stage 2 . 2. T2N1M1 breast cancer is stage 4. Stage 1 disased is confined to the organ of origin -such system allows the clinician to assign a prognosis usually guides treatment -Why is staging important 1. -important option in the treatment of cancer -potentially. Radioisotope Scan. Accurate staging allows collection of data that eventually provides information is collected by a tumor registry. organs. Stage 4 disease is generally metastatic. depth of invasion.Surgical oncology. A.2.

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