Oncology Nursing

By: Nini A. (BSC, MSC)

 Objectives
At the end of this lesson students will be able to;
• Define oncology and cancer
• Describe the diagnostics methods of ca
• Describe the general treatment of ca
• Explain the nursing care of cancer patient

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 Introduction
• Oncology: field or study of cancer
• Cancer: a disease process whereby cells
proliferate abnormally, ignoring growth
regulating signals in the environment
surrounding the cells
• Cancer is a disease process that begins when
an abnormal cell is transformed by the genetic
mutation of the cellular DNA.

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 Epidemiology of cancer
• Although cancer affects every age group, most
cancers occur in people older than 65 years of age.
• More than 1.2 million Americans are diagnosed
each year with a cancer affecting one of various
body sites.
• Cancer is second only to cardiovascular disease as
a leading cause of death in the United States.
• Each year, more than 550,000 Americans die of a
malignant process.

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 Pathophysiology
• The abnormal cell forms a clone and begins to
proliferate abnormally, ignoring growth-regulating
signals in the environment surrounding the cell.
• The cells acquire invasive characteristics, and changes
occur in surrounding tissues.
• The cells infiltrate these tissues and gain access to
lymph and blood vessels, which carry the cells to
other areas of the body.
• This phenomenon is called metastasis (cancer spread
to other parts of the body).
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• Cancerous cells are described as malignant
neoplasms and are classified and named by
tissue of origin.
• The failure of the immune system to promptly
destroy abnormal cells permits these cells to
grow too large to be managed by normal
immune mechanisms.

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 Risk factors of ca
• Virus and bacteria,
• Physical agents,
• Chemical agents,
• Genetic or familial factors,
• Dietary factors,
• Hormonal agents.

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 Clinical Manifestations
Clinical manifestations are related to the system
affected and degree of disruption.
General manifestations include;
• Anemia,
• Weakness,
• Weight loss (dysphagia, anorexia)
• Pain (often in late stages).

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• Symptoms are from tissue destruction and
replacement with nonfunctional cancer tissue
or
• Over productive cancer tissue (eg, bone
marrow disruption and anemia or excess
adrenal steroid production); pressure on
surrounding structures; increased metabolic
demands; and disruption of production of
blood cells.
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 Assessment and Diagnostic Methods

Patients with suspected cancer undergo extensive

testing to:
• Determine the presence and extent of tumor.
• Identify possible spread (metastasis) of disease or
invasion of other body tissues.
• Evaluate the function of involved and uninvolved
body systems and organs.
• Obtain tissue and cells for analysis, including
evaluation of tumor stage and grade.
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Diagnostic tests may include ;
 Tumor marker identification,
 Genetic profiling,
 Imaging studies (mammography, MRI, CT,
fluoroscopy, ultrasonography, endoscopy, and
biopsy.

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 Tumor Staging and Grading
Staging
• Staging determines the size of the tumor and the
existence of local invasion and distant metastasis.
• Several systems exist for classifying the anatomic
extent of disease.
• The TNM system is frequently used (T [extent of
the primary tumor], N [lymph node involvement],
and M [the extent of metastasis]).

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 Stages of Tumors
• Stage I: tumor less than 2 cm, negative lymph node
involvement, no detectable metastases
• Stage II: tumor greater than 2 cm but less than 5 cm,
negative or positive unfixed lymph node involvement, no
detectable metastases
• Stage III: large tumor greater than 5 cm, or a tumor of any
size with invasion of the skin or chest wall or positive fixed
lymph node involvement without evidence of metastases
• Stage IV: tumor of any size, positive or negative lymph
node involvement, and distant metastases

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 Grading
• Grading refers to the classification of the tumor cells.
• Samples of cells to be used to establish the grade of a
tumor may be obtained from tissue scrapings, body
fluids, secretions, or washings, biopsy, or surgical
excision.
• This information helps the health care team predict the
behavior and prognosis of various tumors.
• The tumor is assigned a numeric value ranging from 1
(well differentiated) to 4 (poorly differentiated or
undifferentiated).
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 Management
• The range of possible treatment goals may
include complete eradication of malignant
disease, prolonged survival and containment
of cancer cell growth (control), or relief of
symptoms associated with the disease
(palliation).

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• A variety of therapies may be used, including
the following:
• Surgery (eg, excisions, salvage surgery,
electrosurgery, cryosurgery, chemosurgery, or
laser surgery).
• Surgery may be the primary method of
treatment or it may be prophylactic, palliative,
or reconstructive.

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• The goal of surgery is to remove the tumor or
as much as is feasible.
• Radiation therapy and chemotherapy (may be
used individually or in combination).

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 Nursing care of cancer patients
• Providing time and assistance to the patient
and family to deal with the possible changes
and outcomes resulting from the surgery.
• Providing education and emotional support by
assessing patient and family needs, their fears
and coping mechanisms, encouraging them to
take an active role in decision making when
possible.

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• Postoperatively, assess the patient’s responses
to the surgery and monitor for possible
complications.
• Provide for patient comfort.
• Postoperative teaching about wound care,
activity, nutrition, and medication information.

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Reading assignment??
• Epidemiology of cancer in Ethiopia.

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 Thank you!

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