UNIT 11

LIVER
CANCER
KIARRA NERI, RN

1
 WHAT IS LIVER CANCER?
Several types of cancer can form in
Liver cancer is a life-threatening
the liver. The most common type
illness and one of the fastest-
of liver cancer is hepatocellular
growing cancer types in the United
carcinoma, which begins in the
States. There are two kinds of liver
main type of liver cell
cancer: primary and secondary.
(hepatocyte). Other types of liver
Primary cancer starts in your
cancer, such as intrahepatic
liver. Secondary cancer spreads to
cholangiocarcinoma and
your liver from another part of
hepatoblastoma, are much less
your body.
common.
2
 Liver cancer begins
in the cells of the
liver. The most
common form of
liver cancer begins
in cells called
hepatocytes and is
called
hepatocellular
carcinoma.
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 Types of Liver Cancer
There are different types of liver cancer, but the primary classifications are:

4
 SYMPTOMS
Losing weight without trying
Loss of appetite
Upper abdominal pain
Nausea and vomiting
General weakness and fatigue
Abdominal swelling
Yellow discoloration of your skin and the
whites of your eyes (jaundice)
White, chalky stools
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 Risk factors
Factors that increase the risk of primary liver cancer include:
Chronic infection with HBV or HCV.  increases your risk of liver cancer.
Cirrhosis. causes scar tissue to form in your liver
Certain inherited liver diseases.  hemochromatosis and Wilson's disease.
Diabetes. 
Nonalcoholic fatty liver disease. 
Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that
are stored poorly.
Excessive alcohol consumption.  can lead to irreversible liver damage and increase your
risk of liver cancer.
6
 
 Causes of liver cancer
Hepatitis B or C viruses which result in long term (chronic) infection can cause liver cancer. 

There are other factors that can increase the risk of developing liver
cancer, such as: 

fatty liver disease or genetic disorders including

haemochromatosis, or alpha 1-antitrypsin deficiency 
type 2 diabetes
hepatitis B or C
high alcohol consumption
obesity
smoking tobacco
exposure to certain chemicals.
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 Diagnosis of liver cancer
Tests to diagnose both liver cancer and secondary
cancer of the liver include: 
Blood tests - can check how well the liver is working
Ultrasound – most commonly used method to look for primary liver cancer.
CT scan – three-dimensional view; it can also see if the cancer has spread. 
MRI – can show the extent of a tumor.
PET-CT scan – used for secondary cancers in the liver. 
Biopsy – is when a small amount of tissue is removed for examination.

8
Stages of Liver
Cancer
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 Treatment for liver cancer
➜ Surgery
➜  can involve removing part of the liver, or a liver transplant, where the
whole liver is replaced by a donor liver. 
➜ Tumour ablation
➜ Tumour ablation is used most commonly for small primary liver cancers.
It is rarely used for secondary cancer in the liver. 
➜ Chemotherapy
➜ Depending on the type of liver cancer you have, you may
receive chemotherapy drugs to kill, shrink or slow the growth of the
tumours. 
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➜ Biological therapy
➜ A range of treatments that work against the cancer cells by either stopping their
growth or function, or by helping the body's immune system destroy them.
➜ Selective internal radiation therapy (SIRT)
➜ Also known as radioembolisation, this treatment targets liver tumours directly with
high doses of internal radiation in tiny beads
➜ Endoscopic stent placement
➜ a stent (thin tube) is placed in your liver to drain the bile and ease symptoms. 
➜ Palliative care
➜ aims to improve your quality of life by alleviating symptoms of cancer. 

14
Prevention
Reduce your risk of cirrhosis
Cirrhosis is scarring of the liver, and it increases the risk of liver cancer. You can reduce
your risk of cirrhosis if you:
➜ Drink alcohol in moderation, if at all. limit the amount you drink. For women, this
means no more than one drink a day. For men, this means no more than two drinks a
day.
➜ Maintain a healthy weight. If your current weight is healthy, work to maintain it by
choosing a healthy diet and exercising most days of the week. If you need to lose
weight, reduce the number of calories you eat each day and increase the amount of
exercise you do.

15
Get vaccinated against hepatitis B
Take measures to prevent hepatitis C
➜ No vaccine for hepatitis C exists, but you can reduce your risk of infection.
Know the health status of any sexual partner. 
➜ Don't use intravenous (IV) drugs, but if you do, use a clean needle. 
➜ Seek safe, clean shops when getting a piercing or tattoo. 
Seek treatment for hepatitis B or C infection
➜ Treatments are available for hepatitis B and hepatitis C infections. Research shows that treatment
can reduce the risk of liver cancer.
Ask your doctor about liver cancer screening
➜ Consider screening if such is present and or to people who have: Hepatitis B infection; Hepatitis C
infection, and Liver cirrhosis

16
Alternative Medicine
Alternative treatments may help control pain in people with advanced liver cancer. Your
doctor will work to control pain with treatments and medications. But sometimes
your pain may persist or you may want to avoid the side effects of pain medications.
Alternative treatments that may help you cope with pain, are the likes of:
➜ Acupressure
➜ Acupuncture
➜ Hypnosis
➜ Massage
➜ Relaxation techniques

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UNIT 11

THYROI
D
CANCER KIARRA NERI, RN
 Thyroid cancer is a disease in which malignant (cancer) cells
form in the tissues of the thyroid gland.
Thyroid cancer might not The thyroid uses iodine,
cause any symptoms at a mineral found in some foods
first. But as it grows, it can and in iodized salt, to help
cause signs and make several hormones. 
symptoms, such as
swelling in your neck, voice Thyroid hormones do the
changes and difficulty following:
swallowing.
Control heart rate, body
The thyroid is a gland at the base of temperature, and how
the throat near
the trachea (windpipe). It is shaped quickly food is changed
like a butterfly, with a right lobe and into energy (metabolism).
a left lobe. The isthmus, a thin piece
of tissue, connects the two lobes. A
healthy thyroid is a little larger than Control the amount
a quarter. It usually cannot be felt of calcium in the blood.
through the skin.
According to Inquirer (2022), for
many years, cancer has been
one of the leading causes of
death in the Philippines—and it
continues to do so as of 2021.
According to the Philippine Statistics
Authority (PSA), neoplasms,
commonly known as cancer, ranked
as the fourth leading cause of death
in the Philippines last year with
59,503 or 7.8 percent of the same
year’s total deaths.
Some of the most common types of
cancer among Filipinos, based on
data by the Global Cancer
Observatory (GCO) published in its
online database (GLOBOCAN 2020),
was thyroid cancer.
Thyroid nodules are common but
usually are not cancer.
Your doctor may find a lump (nodule) in your thyroid during a routine medical
exam. A thyroid nodule is an abnormal growth of thyroid cells in the thyroid.
Nodules may be solid or fluid-filled.

Thyroid nodules usually don't cause symptoms or need treatment. Sometimes the

thyroid nodules become large enough that it is hard to swallow or breathe and
more tests and treatment are needed. Only a small number of thyroid nodules
are diagnosed as cancer.
Thyroid cancer can be described as either:
Differentiated thyroid cancer, which includes well-differentiated tumors,
poorly differentiated tumors, and undifferentiated tumors; or
Medullary thyroid cancer.

Well-differentiated Poorly differentiated and Medullary thyroid cancer is

undifferentiated tumors
tumors (papillary (anaplastic thyroid cancer)
thyroid cancer are less common.
and follicular thyroid
cancer) can be These tumors grow and
treated and can spread quickly and have a
poorer chance of
usually be cured. recovery.
a neuroendocrine tumor that
develops in C cells of the
thyroid.
The C cells make
a hormone (calcitonin) that
helps maintain a healthy level
of calcium in the blood.
Age, gender, and being exposed to radiation can affect
the risk of thyroid cancer.
Asian
Obesity
Low Iodine Intake
Enlarged thyroid or goiter

Being between 25 and 65 years old. 15 to 24 years old or

women.

Female sex. may be related to the hormone estrogen

Exposure to high levels of radiation. may occur as soon

as 5 years after exposure.
Certain inherited genetic syndromes.
Thyroid cancer may not cause early signs or
symptoms. It is sometimes found during a
routine physical exam. Signs or symptoms
may occur as the tumor gets bigger. 

According to DOH and the US CDC, among

the symptoms and warning signals of
thyroid cancer include:

• A lump (nodule) in the neck.

• Trouble breathing.
• Trouble swallowing.
• Pain when swallowing.
• Hoarseness.
PREVENTION
#1 Minimize Radiation Exposure
#2 Know Your Family History
#3 Do Self-Checks or Get Examined by Your Physician
#4 Get an Ultrasound
#5 Live a Healthy Lifestyle
DIAGNOSIS
Physical exam.  Will examine your neck to feel for changes in your thyroid, such as a lump (nodule) in the
thyroid.

Thyroid function blood tests. Tests that measure blood levels of thyroid-stimulating hormone (TSH) and
hormones produced by your thyroid gland.

Ultrasound imaging.  To create an image of the thyroid, the ultrasound transducer is placed on your lower
neck

Removing a sample of thyroid tissue. 

An imaging test that uses a radioactive tracer. To detect thyroid cancer cells in your body.

Other imaging tests. Determines if cancer has spread beyond the thyroid, includes ultrasound, CT and MRI.

Genetic testing.  If you're diagnosed with medullary thyroid cancer, your provider may recommend meeting
with a genetic counselor to consider genetic testing.
 
 TREATMENT
Six types of standard treatment are
used:
• Surgery
• Radiation therapy, New types of treatment are being tested
including radioactive in clinical trials.
iodine therapy
Immunotherapy
• Chemotherapy
• Thyroid hormone
therapy This cancer treatment is a type
• Targeted therapy of biologic therapy.
• Watchful waiting
 NURSING
INTERVENTIONS
Observe patient for signs of pain both verbal Give several small meals and snacks daily to
and nonverbal relieve dysphagia.

Teach and encourage patients to use relaxation Promote adequate and timely fluid intake to
techniques reduce possibility of early satiety.

Assess for dyspnea, stridor and cyanosis Periodically examine the function of speech
of patient
Determine the patient’s ability to chew,
Keep communication simple
swallow and taste food.
Anticipate patient needs as possible
Promote a pleasant, relaxing environment
35
UNIT 11

CERVICA
L
CANCER KIARRA NERI, RN

36
 What is cervical
cancer?
Cervical cancer, or cancer of the cervix,
begins on the surface of your cervix. It
happens when the cells on your cervix
begin to change to precancerous cells.
Not all precancerous cells will turn to
cancer, but finding these problematic
cells and treating them before they can
change is critical to preventing cervical
cancer.

37
 Types of cervical cancer
There are two main types of cancer of the
cervix: 
squamos cell carcinomas 
and 
Adenocarcinomas

About 80% to 90% of cervical cancers are

squamous cell carcinomas, while 10%
to 20% are adenocarcinomas.

38
 In the Philippines, Cervical Cancer is the
2nd leading cancer site among women. An
estimated 7,277 new cases of, and 3,807
deaths due to, cervical cancer are expected to
occur every year.

Generally, all women who have had sexual

intercourse are at risk of cervix cancer.
However, rare types of cervical cancer can
occur even in women who never had any
sexual intercourse in their life.
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 CAUSE
In recent studies, there had been overwhelming evidence that an
infectious agent particularly human papiloma virus (HPV) that is
transmitted through sexual intercourse causes cancer of the cervix.

The following had been established as possible causes of cervix cancer:

have had multiple sexual partners

have had sexual partners (regular or casual) who themselves had several
sexual partners
have had sexual partner who is infected with human papilloma virus
had first sexual intercourse at a very early age, possibly 15 or 16 years old
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 SYMPTOMS
Early-stage cervical cancer generally produces
no signs or symptoms.
Signs and symptoms of more-advanced cervical
cancer include:
➜ Vaginal bleeding after intercourse, between
periods or after menopause
➜ Watery, bloody vaginal discharge that may be
heavy and have a foul odor
➜ Pelvic pain or pain during intercourse

41
Early Detection
➜ Cervical cancer when detected early is curable. At present, the most
reliable and practical way to diagnose early cervical cancer is through Pap
smear.

➜ A woman’s first Pap smear should be done 3 years after the first vaginal
intercourse. After that, it should be done every year for 3 years. If the Pap
smear test is negative for the consecutive 3 years, then it can be done every
two or three years. In unmarried women who never had sexual activity in
their life, Pap smear should be done at age 35.

42
Preventive Measures
Since there is almost universal acceptance that cervical cancer is
primarily transmitted through sexual intercourse, the following
preventive measures should be followed:
➜ a one-partner sexual relationship between partners should be
observed
➜ a delay on the first sexual intercourse
➜ use of barrier contraceptives like condoms during sexual
intercourse

43
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 Management
and Treatment
The treatments for
cervical cancer are
radiation,
chemotherapy,
surgery, targeted
therapy and
immunotherapy.

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UNIT 11

NON-
HODGKIN
LYMPHOMA KIARRA NERI, RN

49
What Is Non-Hodgkin Lymphoma?
Non-Hodgkin lymphoma is a group of blood cancers that
develop in your lymphatic system. People are living
longer with these conditions thanks to new treatments,
including targeted therapies. In some cases, treatments
eliminate non-Hodgkin lymphoma signs and symptoms,
putting the disease into remission for months or years.

50
 How does non-Hodgkin lymphoma affect my body?
➜ Non-Hodgkin lymphoma isn’t a single disease. There are many different types of non-Hodgkin
lymphomas. These types have the same kinds of symptoms. However, each type of lymphoma may affect
your body in different ways. For example, some types of non-Hodgkin lymphoma spread more quickly
than other types. Some types affect organs like your spleen and liver while other types affect your skin.

➜ Some non-Hodgkin lymphomas may affect your lymphatic system and your ability to fight infection.
These cells include B cells, T cells and natural killer (NK) cells.

➜ When these cells mutate, they continuously multiply, eventually becoming tumors. Since your lymphatic
system touches nearly every part of your body, non-Hodgkin lymphoma frequently spreads from where it
started to other areas of your body. Non-Hodgkin lymphomas may grow slowly (indolent) or spread very
quickly (aggressive).

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 Types of non-Hodgkin lymphoma
Treatment for NHL depends on which type it is, so it’s important for doctors to find out the exact type
of lymphoma you have. The type of lymphoma depends on what type of lymphocyte is affected (B
cells or T cells), how mature the cells are when they become cancerous, and other factors. 

Types of NHL can also be grouped based on how fast they grow and spread:
➜ Indolent lymphomas grow and spread slowly Some indolent lymphomas might not need to
be treated right away, but can be watched closely instead. The most common type of
indolent lymphoma in the United States is follicular lymphoma.
➜ Aggressive lymphomas grow and spread quickly, and usually need to be treated right away.
The most common type of aggressive lymphoma in the United States is diffuse large B cell
lymphoma (DLBCL).
Some types of lymphoma, like mantle cell lymphoma, don’t fit neatly into either of these categories.

52
What causes non-Hodgkin lymphomas?
Non-Hodgkin lymphomas happen when your body produces too many
leukocytes or white blood cells. Healthcare providers don’t know all
the reasons why this happens. Genetic mutations that affect white
blood cell growth play a part.
(These are acquired genetic mutations, meaning you develop them
during your lifetime instead of being born with them.)
They also know people who have certain infections or problems with
their immune system are more likely to develop a non-Hodgkin
lymphoma.
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Risk Factors
➜ Medications that suppress your immune system. If you've had an organ transplant and take
medicines that control your immune system, you might have an increased risk of non-Hodgkin's
lymphoma.
➜ Infection with certain viruses and bacteria. Viruses linked to this type of cancer include HIV and
Epstein-Barr infection. Bacteria linked to non-Hodgkin's lymphoma include the ulcer-causing
Helicobacter pylori.
➜ Chemicals. Certain chemicals, such as those used to kill insects and weeds, may increase your risk
of developing non-Hodgkin's lymphoma. More research is needed to understand the possible link
between pesticides and the development of non-Hodgkin's lymphoma.
➜ Older age. Non-Hodgkin's lymphoma can occur at any age, but the risk increases with age. It's most
common in people 60 or over.

56
DIAGNOSIS
➜ Physical exam. Your doctor checks for swollen lymph nodes, including in your neck, underarm
and groin, as well as for a swollen spleen or liver.
➜ Blood and urine tests. may help rule out an infection or other disease.
➜ Imaging tests. to look for signs of lymphoma cells elsewhere in your body.
➜ Lymph node test. to remove all or part of a lymph node for laboratory testing. Analyzing lymph
node tissue in a lab may reveal whether you have non-Hodgkin's lymphoma and, if so, which type.
➜ Bone marrow test. The sample is analyzed to look for non-Hodgkin's lymphoma cells.
➜ Lumbar puncture (spinal tap). If there's a concern that the lymphoma may affect the fluid around
your spinal cord, your doctor might recommend a procedure to remove some of the fluid for
testing.

57
58
ALTERNATIVE MEDICINE
No alternative medicines have been found to cure non-Hodgkin's lymphoma. But alternative
medicine may help you cope with the stress of a cancer diagnosis and the side effects of
cancer treatment. Talk with your doctor about your options, such as:
Art therapy
Exercise
Meditation
Music therapy
Relaxation exercises
Spirituality

59
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UNIT 11

PROSTATE
CANCER
KIARRA NERI, RN
Prostate cancer is a common type of cancer
in males, but it is highly treatable in the
early stages. It begins in the prostate gland,
which sits between the penis and the
bladder.
The prostate has various functions. These include producing
the fluid that nourishes and transports sperm, secreting
prostate-specific antigen (PSA), a protein that helps semen
retain its liquid state, and helping aid urine control.
What causes prostate cancer?
While it is unclear why this happens, doctors know that it
begins when prostate cells undergo genetic changes.
This leads to rapid and abnormal growth and division
of cells which form a malignant tumour. These
cancerous cells then invade surrounding tissue such as
the seminal vesicles and bladder neck.
 Risk factors for prostate cancer
Increasing age, as prostate cancer is more common in men above 50 years

Ethnic background, with prostate cancer significantly more common

among Chinese men in Singapore compared to other ethnic groups

Family history of prostate cancer or breast cancer

Obesity, with some studies finding that cancer in obese persons is more
likely to be aggressive and to return after treatment
 How Prostate
Cancer Is
Diagnosed?
A diagnosis of prostate cancer can
involve screening tests such as a
serum PSA or digital rectal exam, as
well as procedures that can include
MRI-TRUS fusion with targeted
biopsy, or an ultrasound-guided
random 12-core biopsy.
UNIT 11

SKIN
CANCER
KIARRA NERI, RN

74
 What is skin cancer?
➜ Skin cancer — the abnormal growth of skin
cells — most often develops on skin exposed
to the sun. But this common form of cancer
can also occur on areas of your skin not
ordinarily exposed to sunlight.

➜ Skin cancer happens when normal cells in the

skin change into abnormal cells and grow out
of control. 

75
 Skin cancer has a lower incidence in the
Philippines compared to western populations
but skin cancer can affect anyone, regardless
of skin color.

In patients with skin of color, such as Filipinos,

it is often diagnosed in its advanced stages,
when it’s more difficult to treat.
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➜ The 2 most common types of
nonmelanoma skin cancer are
basal cell carcinoma (BCC) and BCC and SCC are also the
squamous cell carcinoma (SCC) 2 most common skin
cancers found in Filipinos.
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 According to the index, the Philippines ranked 55th out of 62
countries with only 298 annual cases and a skin factor score (based
on the Fitzpatrick scale: 1 being the darkest and 10 being the fairest)
of 1.03 in the Skin Cancer Incidence Scale.

While this is great news, it doesn’t mean that our naturally brown skin
is completely immune to cancer.

Tons of scientific studies have documented the protective role of

melanin (the pigment in our skin) through the “shielding effect of
melanin, especially eumelanin, is achieved by its ability to serve as a
physical barrier that scatters UVR, and as an absorbent filter that
reduces the penetration of UV through the epidermis.”

82
How do you prevent skin cancer?
You can help prevent skin cancer by protecting your skin from the sun’s rays every day,
even on a cloudy day. To reduce the chances of getting skin cancer, you can:

■ Avoid going out in the middle of the day from 10am to 3pm
■ Stay in the shade
■ Use an umbrella
■ Wear broad spectrum sunscreen and reapply every 2-4 hours
■ Wear a wide-brimmed hat, long-sleeved shirt or long pants, sunglasses
■ Do not use tanning beds

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UNIT 11

CANCER CARE
KIARRA NERI, RN

86
 Key facts about Cancer
Cancer is a leading cause of death worldwide, accounting for nearly 10 million
deaths in 2020, or nearly one in six deaths.

The most common cancers are breast, lung, colon and rectum and prostate cancers.

Around one-third of deaths from cancer are due to tobacco use, high body mass
index, alcohol consumption, low fruit and vegetable intake, and lack of physical
activity.

Cancer-causing infections, such as human papillomavirus (HPV) and hepatitis, are

responsible for approximately 30% of cancer cases in low- and lower-middle-income
countries.

Many cancers can be cured if detected early and treated effectively.

87
 What’s the best way to fight cancer? By preventing it — or
catching it early. More than 40% of cancer cases can be
prevented. Your best defense against most cancers is a healthy
lifestyle and regular screenings for early diagnosis.

Regular cancer screenings save lives

Many types of cancer can be detected early, leading to better outcomes. And
some people should be screened more often than others. For example,
family history can increase your risk, and some cancers are more common
among certain racial and ethnic groups. Your doctor will create a
personalized screening schedule based on your risk factors. And your
electronic health record will keep track of your screenings — and let you
know when it’s time for the next one.
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Cancer treatment
A cancer diagnosis can feel overwhelming — but getting the care
you need shouldn’t be.

Coping with a cancer

diagnosis
When faced with the possibility of cancer, you may
feel a range of emotions, such as disbelief, fear,
sadness, anger, and anxiety. Waiting only increases
these feelings. That’s why we focus on finding out
everything we can about your cancer by utilizing
diagnostic specialists and innovative tools to help
begin treatment for your specific cancer type as
soon as possible.
89
 PALLIATIVE CARE
Palliative care is treatment to relieve, rather than cure, symptoms and suffering caused
by cancer and to improve the quality of life of patients and their families. It can help
people live more comfortably.

Relief from physical, psychosocial, and spiritual problems through palliative care is
possible for more than 90% of patients with advanced stages of cancer.

Effective public health strategies, comprising community- and home-based care, are
essential to provide pain relief and palliative care for patients and their families.

Improved access to oral morphine is strongly recommended for the treatment of

moderate to severe cancer pain, suffered by over 80% of people with cancer in the
terminal phase. 

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Managing Your Care
Treatment for cancer is complex, and managing all of the different aspects of
treatment can be stressful. There are different doctors to consult, many tests
to schedule, and instructions relating to your care to understand.

Taking Charge of Your Cancer

You can be a self-advocate by taking an active role in your cancer care. This can be a
positive experience that gives some people a sense of control in a time of uncertainty.

Self-advocacy does not have to be time-consuming or difficult. It can be as easy as

asking more questions at a doctor's appointment. It also does not mean that you
alone are responsible for your cancer care. In fact, it commonly involves seeking
additional support from others.

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 When Cancer Is Not Your Only Health Concern
Many people have health conditions in addition to cancer. Any health concern that
you have at the same time as cancer can be called a co-existing condition, a
chronic condition, or a comorbidity.

One in 4 adults have at least 2 chronic conditions and they are even more frequent
in adults who are aged 65 and older. It is important that your other health conditions
are treated, managed, and monitored.

Some common types of co- It can be easy to ignore other health conditions when you
existing conditions are: have cancer. For example, taking care of your high blood
pressure or diabetes can seem less important than
High blood pressure getting cancer treatment. But the success of your cancer
Heart disease treatment is partly based on your general health and
Lung disease sometimes cancer treatment can make other conditions
Diabetes worse. That is why it is important that your other health
Kidney disease conditions are treated, managed, and monitored.
Arthritis
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 For
Children

93
 Preparing Your Child for Medical Procedures
It is common for both children and parents to feel anxiety about
tests and procedures. But with preparation, you can lower anxiety
for you and your child.

Common fears:
Children's fears may depend on their age and personality:

Infants and younger children. Often, they fear being separated

from their parents.
Older children. Often, they fear pain.
Teenagers and young adults. Often, they fear pain. But they may
be embarrassed to admit their fear. They may also feel self
conscious about their bodies. 
Procedures involving needles. Pain is usually the biggest fear
related to needles.
Surgery. Children may fear feeling pain during surgery. They may
not understand general anesthesia. They may also need
reassurance that you will be there after the surgery.
94
Tips in Preparing your child:
Be honest and open. But avoid graphic or overly
frightening descriptions.

Prepare his or her senses. Address what the child

will see, smell, hear, taste, or touch during the
procedure.

Encourage questions. But look for signals that your

child has received enough information, such as
changing the subject or expressing a lack of interest
in talking.

Ask about preadmission programs. These hospital-

provided programs allow children and families to learn
about the procedure and the equipment that will be
used. 
95
Tips in Preparing your child:
Seek out educational materials. Many hospitals provide
stories, coloring books, videos, or pamphlets designed for
children.

“Play” a procedure with your child. Younger children

may want to watch the procedure being done on a teddy
bear or doll first.

Keep your child’s bed a safe space. speak to the nurse

or child life specialist about using the treatment room bed
instead of the child's hospital bed for any procedures.

Prepare for separation. Most children count on their

parents for support during procedures and want a parent
to stay with them. But this may not always be possible.
Ask the doctor who will be doing the procedure to help
comfort and support your child.
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 For Young
Adults &
Teenagers

97
98
 Being a Young Adult or Teen With Cancer
As a young adult or teen, you are either becoming independent or you already are.
Depending on your age, you might live on your own or even have your own family. But you
will probably need some support to cope with cancer.

Having cancer as a young adult or teenager is very different from having it as a child or later in
life. Getting a diagnosis and treatment can be challenging for many reasons. Like:

If you get sick as a young adult or teen, you or your doctor might not consider cancer as
a cause.

You might not have health insurance. Or you might have difficulty paying for cancer
treatment, even with health insurance.

You probably have little experience getting medical treatment for a complex condition
like cancer. So, it might be challenging to arrange the care you need. 
99
 Coping with Changes to Your Body as a Young Adult
Your body image is how you feel about the way you look. Cancer and its treatment can change how
you look and feel about yourself. Coping with these changes is part of dealing with cancer.

If you are a teenager, your body is already changing. Trying to figure out which changes are part of
normal development and which are from cancer can be confusing.

Cancer Support for Young Adults

It might be difficult to talk with your health care team at first. But the more you do it, the
easier it becomes. It is important to remember that you are the expert on how you feel.
Your doctors and nurses are cancer experts who want to help, but they are not mind
readers. 

Talking with someone you trust, such as a friend, teacher, or someone in your religious
community can help you sort out what you are feeling and thinking. 

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Dating & Intimacy
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 Single adults may experience physical and emotional changes
during and after cancer treatment. These may affect dating and
sexual relationships.

Communication is important for healthy sexual feelings in any

relationship. In particular, sharing cancer-related concerns can help
relieve worries. It can also help boost emotional intimacy and trust.

There is no perfect time to talk about sex. But it is best to discuss it

before becoming sexually intimate.

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 Cancer During Pregnancy

Cancer during pregnancy is uncommon.

Cancer itself rarely affects the growing fetus
(unborn baby).

When it does happen, cancer during

pregnancy can be more complex to diagnose
and treat. This is because tests to diagnose
cancer and treatments can affect the fetus,
so each step in your medical care will be
done carefully.

It is important to work with a health care

team that has experience treating cancer in
pregnancy. 
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Recovery and life after cancer
Experiencing cancer can be life changing both
physically and emotionally. Throughout your treatment
and into your recovery, support could really be helpful.

Healing mind, body, and spirit

Small acts of self-care can have a big impact.

Connecting with others who share similar experiences can be incredibly

powerful.

Get personalized advice, encouragement, and support to reach your health

goals.

Making healthy lifestyle changes can have big mental health benefits. A
wellness coach can help you get started, overcome obstacles, and achieve
your goals — including reducing stress, quitting smoking, and more.

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105
BRACHYTHERAP
UNIT 11

Y KIARRA NERI, RN

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 Brachytherapy to Treat Cancer
Brachytherapy is a type of internal radiation therapy in which seeds,
ribbons, or capsules that contain a radiation source are placed in your
body, in or near the tumor. Brachytherapy is a local treatment and treats
only a specific part of your body. It is often used to treat cancers of the
head and neck, breast, cervix, prostate, and eye.

Brachytherapy may cause fewer side effects than does external beam
radiation, and the overall treatment time is usually shorter with
brachytherapy.

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 Your doctor works out how
much radiation you need. This
affects how long the
radioactive source stays inside
you for. This can be anything
from several minutes to a few
days, or can stay in place
permanently. If the source
stays inside you permanently, it
stops giving off radiation after
a few weeks or months.

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 Brachytherapy is used to treat
Why it's done? several types of cancer, including:

Bile duct cancer Head and neck cancers

Brain cancer Lung cancer

Pancreatic cancer
Breast cancer
Prostate cancer
Cervical cancer
Rectal cancer
Endometrial cancer Skin cancer
Esophageal cancer Soft tissue cancers
Eye cancer Vaginal cancer

Brachytherapy can be used alone or in conjunction with other cancer treatments. For instance, brachytherapy
is sometimes used after surgery to destroy any cancer cells that may remain. Brachytherapy can also be used
along with external beam radiation.
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 Types of brachytherapy
High dose rate (HDR) brachytherapy
With high dose rate brachytherapy, the radioactive
source is put in your body for several minutes. The
radioactive source travels from the brachytherapy
machine through hollow tubes or needles (called
applicators) to get to the right position. You may have
the applicators put in while under general anaesthetic.
After 5 to 20 minutes of treatment, the source travels
back along the applicators to the brachytherapy
machine and you are no longer radioactive.
You might have:
a single treatment
several treatments over a number of days
Sometimes you have two treatments on one day.
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Low dose rate (LDR) brachytherapy
With low dose rate brachytherapy, you have a lower
dose of radiation over a longer time. You might have
the radioactive source in place for up to a week.
After treatment, your doctor removes the radioactive
source and you can go home. Once the source is
take away you are no longer radioactive. 
There is a type of low dose rate brachytherapy called
permanent seed brachytherapy for prostate cancer.
The radioactive source is in the form of tiny metal
seeds that are left in the prostate forever. You can be
at home after having the seeds put in. But as you are
slightly radioactive for a time, you have to avoid very
close contact with children and pregnant women.
 Side effects
The side effects that you may get from
brachytherapy depend on which part of the Fatigue
body you’re having treatment to. Because
brachytherapy treats a small area close to
the cancer, fewer healthy cells are affected
Diarrhea
and so side effects are often less than they
would be if you were having external Nausea
radiotherapy.

The most common side effects often

Irritation of the
happen shortly after having treatment and
may last for a couple of weeks. There is a bladder Low
risk of late side effects that happen months
or years after having treatment.
blood counts
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Safety precautions
When the radioactive source is in your body you will give off some radioactivity. So
to protect others from exposure to radiation you may need to follow certain safety
precautions.

You have brachytherapy treatment in a room on your own, and if you’re staying as
an inpatient you may need to limit visitors. Pregnant women and children may not
be allowed to visit. Once the source is removed from your body you are no longer
radioactive and can be with other people.

With permanent brachytherapy, the radiation gradually fades over weeks or months.
Although the radiation doesn’t travel much further than the area being treated, as a
precaution your team may tell you to avoid very close contact with pregnant women
and children during this time.

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113
Thank You
for
Listening
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