CANCER:

BY
Asif Ali Magsi 1
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CANCER:
Abnormal cells division in an
uncontrolled way. Some cancers may
eventually spread into other tissues.
A disease caused by an uncontrolled
division of abnormal cells in a part of the
body.
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The main types of cancer

 According to the type of cell they start in. There are 5 main
types:
 Carcinoma :
 Carcinomas start in epithelial tissues. These cover the outside
of the body as the skin. They also cover and line all the
organs inside the body, such as the organs of the digestive
system. And they line the body cavities, such as the inside of
the chest cavity and the abdominal cavity
 Cancer that begins in the skin or in tissues th at line or cover
internal organs.
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Cont…
 Adenocarcinoma: start in glandular cells called
adenomatous cells. Glandular cells produce fluids to
keep tissues moist for example Lungs ,colon and rectum,
breasts ,esophagus pancreas and prostate cancers
 Basal Cell Carcinoma: Basal cells line the deepest layer of
skin cells. Cancers that start in these cells are called basal
cell carcinomas.
 Basal cell carcinomas often look like:
 Open sores
 Red patches
 Pink growths
 Shiny bumps or scars
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CONTINUE
 Squamous Cell Carcinoma: Squamous cell carcinoma
starts in squamous cells. These are the flat, surface
covering cells found in areas such as the skin or the lining
of the throat or food pipe (oesophagus
 Transitional Cell Carcinoma: Transitional cells are cells
that can stretch as an organ expands. They make up tissues
called transitional epithelium. An example is the lining of
the bladder. Cancers that start in these cells are called
transitional cell carcinoma.
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CONTINUE
 sarcoma – cancer that begins in the connective or supportive
tissues such as bone, cartilage, fat,
 muscle or blood vessels
 leukemia – cancer that starts in blood forming tissue such as
the bone marrow and causes abnormal blood cells to be
produced and go into the blood
 lymphoma and myeloma – cancers that begin in the cells of
the immune system
 brain and spinal cord cancers – these are known as central
nervous system cancers
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CONTONU…….
 Sarcomas
 Sarcomas start in connective tissues, which are the supporting
tissues of the body. Connective tissues include the bones,
cartilage, tendons and fibrous tissue that support organs.
 Sarcomas are much less common than carcinomas. They are
usually grouped into 2 main types:
 bone sarcomas (Osteosarcoma)
 soft tissue sarcomas
 Altogether, these make up less than 1 in every 100 cancers
(1%) diagnosed every year.
 Soft tissue sarcomas are rare but the most common types start
in cartilage or muscle.
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CONTI……
Muscle
Cancer of muscle cells is called
rhabdomyosarcoma or leiomyosarcoma. .
Leukemia – cancers of blood cells
Leukemia is a condition in which the bone
marrow makes too many white blood cells. The
blood cells are not fully formed and so they
don't work properly. The abnormal cells build
up in the blood.
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Leukemia – cancers of blood cells

 Lymphomas and myeloma
 Lymphomas and myeloma are cancers of the lymphatic
system. The lymphatic system is a system of tubes and glands
in the body that filters body fluid and fights infection.
 Lymphomas.
 The abnormal lymphocytes start to collect in the lymph nodes
or other places such as the bone marrow or spleen. They can
then grow into tumors.
 Lymphomas make up about 5 out of every 100 cancer cases
(5%) in the UK.
 You can find out about lymphomas.
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Myeloma
 Myeloma is also known as multiple myeloma. It is a
cancer that starts in plasma cells. Plasma cells are a type of
white blood cell made in the bone marrow. They
produce antibodies, also called immunoglobulin, to help
fight infection.
 Plasma cells can become abnormal, multiply
uncontrollably, and only make a type of antibody that
doesn't work properly to fight infection
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Brain and spinal cord cancers

 Cancer can start in the cells of the brain or spinal cord. The
brain controls the body by sending electrical messages along
nerve fibers. The fibers run out of the brain and join together
to make the spinal cord, which also takes messages from the
body to the brain.
 The brain and spinal cord form the central nervous system.
The brain is made up of billions of nerve cells called neurons.
It also contains special connective tissue cells called glial cells
that support the nerve cells.
 The most common type of brain tumor develops from glial
cells and is called glioma. Some tumors that start in the brain
or spinal cord are non cancerous (benign) and grow very
slowly. Others are cancerous and are more likely to grow and
spread.
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Benign and cancerous (malignant)

tumors
 Tumors (lumps) can be benign or cancerous (malignant).
Benign means it is not cancer.
 Benign tumors
 Usually grow quite slowly
 Don't spread to other parts of the body
 Usually have a covering made up of normal cells
 Benign tumors are made up of cells that are quite similar to
normal cells. They will only cause a problem if they:
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Contu..........)
grow very large
become uncomfortable or painful
are visible and unpleasant to look at
press on other body organs
take up space inside the skull (such as a brain
tumor)
release hormones that affect how the body
works
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Malignant tumors
are made up of cancer cells. They:
usually grow faster than benign tumors
spread into surrounding tissues and cause
damage
may spread to other parts of the body in
the bloodstream or through the lymph
system to form secondary tumors. This is
called metastasis
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Esophageal Cancer
A disease in which malignant (cancer) cells
form in the tissues of the esophagus
The most common types of esophageal cancer
are:
Squamous cell carcinoma : It begins in flat
cells lining the esophagus
Adenocarcinoma. It begins in cells that make
and release mucus and other fluids.
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Clinical manifestations:

 Difficulty
swallowing (dysphasia)
• Weight loss without trying
• Chest pain, pressure or burning
• Worsening indigestion or heartburn
• Coughing or hoarseness
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Etiology:
 Age
 Smoking
 Alcohol
 Gastro esophageal reflux disease
 Barrett’s esophagus
 Obesity
 Diet
 Achalasia
 Human papilloma virus (HPV) infection
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Diagnosis
Physical exam and history
Chest x-ray :
Barium swallow
Endoscopy
Biopsy
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Treatment:
Chemotherapy
Esophageal dilatation
Radiation therapy
Surgery (Esophagectomy)
 Colorectal cancer
bowel cancer
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colon cancer,
Colorectal cancer, also known as
bowel cancer, colon cancer, or
rectal cancer, is any cancer that
affects the colon and the rectum.
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Adenocarcinoma
 Adenocarcinoma start in the gland cells in the lining of the
bowel wall. The gland cells normally produce mucus. This is a
slimy substance that makes it easier for the poo (also called
feces or stool) to pass through the bowel. Adenocarcinoma is
the most common type of bowel cancer.
 There are 2 rare types of Adenocarcinoma:
 mutinous tumors
 signet ring tumors
 They are treated in the same way as the most common types
of Adenocarcinoma of the bowel.
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Rare types of bowel cancer

 Squamous cell tumors
 Squamous cells are the skin cells that make up the
bowel lining, together with the gland cells. They are
treated in the same way as cancer of the anus.
 Carcinoid tumors
 Carcinoid is a type of slow growing tumors called
neuroendocrine tumors. They grow in hormone
producing tissue, usually in the digestive system.
 Carcinoid is treated differently to the most common
types of bowel cancer.
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Conti..
 Sarcomas

Sarcomas are cancers of the supporting cells

of the body, such as bone or muscle. Most
sarcomas in the bowel are called
leiomyosarcoma. This means they are
sarcomas that started in smooth muscle.
Sarcomas are treated differently to
Adenocarcinoma of the bowel.
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Lymphomas
Lymphomas are cancers of the
lymphatic system. They are treated
very differently to other bowel
cancers.
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Etiology:
 Inflammatory bowel disease
 Obesity
 Smoking
 Alcohol
 Age
 Family history
 Infections Human papilloma virus (HPV)
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Clinical manifestation:
 The symptoms of bowel (colorectal) cancer can include:
 bleeding from the back passage (rectum) or blood in your poo
 a change in your normal bowel habit
 a lump that your doctor can feel in your back passage or
tummy (abdomen), more commonly on the right side
 a feeling of needing to strain in your back passage (as if you
need to poo), even after opening your bowels
 losing weight
 pain in your abdomen or back passage
 tiredness and breathlessness caused by a lower than normal
level of red blood cells (anemia)
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Conti…
Sometimes cancer can block the bowel.
This is called a bowel obstruction. The
symptoms include:
griping pains in the abdomen
feeling bloated
constipation and being unable to pass
wind
being sick Gastric Carcinoma
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Gastric cancer
 Also called Gastric Cancer or malignant tumor of the stomach
 Definition:
 A disease in which malignant (cancer) cells form in the lining of the
stomach.
 Or
 A disease in which the cells forming the inner lining of the stomach
become abnormal and start to divide uncontrollably, forming a mass
called a tumor.
 Most common areas affected are pylorus and antrum
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S/S
 Abdominal pain begins periumbical and travels to right lower
quadrant.
 Fever due to infection
 Nausea, vomiting, loss of appetite

 Rebound tenderness

 Rigidity of the abdomen

 Right lower quadrant pain that improves with flexing the

right hip suggests perforation
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Etiology:
Exact cause unknown
 Risk factors:
Family History
 Smoking
 Atrophic gastritis
 Type A Blood Group
 High Alcohol Consumption
 Partial Gastrectomy
 Helicobacter Pylori Infection
 Pernicious anemia

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Clinical Manifestations:
 Weakness and fatigue
 Nausea and vomiting
 Weight loss
 Dysphasia
 Heart burn & Indigestion
 Epigastric or retrosternal pain not relived with medications
 Feeling full or bloated after a small meal
 Blood in vomiting or blood in stool
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Diagnostic Findings:
Physical exam: which reveals Enlarged
lymph nodes (lymphadenopathy)
Biopsy
Endoscopy
Chest X-Ray
Computed Tomography (CT) Scans
Blood tests
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Complications:
Anemia
Malnutrition
Hemorrhage
GI Obstruction
GI perforation

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Treatment:
 Antiemetic to control nausea and vomiting
 Analgesics to relive pain
 Radiotherapy
 Chemotherapy
 Vitamin supplements: Cyanocobalamin(vitamin B12
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Surgical Management
Surgery is the most common
treatment for gastric cancer
Gastrectomy
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Nursing Management:
 Monitor nutritional intake and weigh patient regularly.
 Monitor CBC and serum vitamin B12 levels to detect anemia
 Administer analgesics as ordered.
 Administer Parenteral Nutrition, if ordered.
 Maintain Nasogastric suction to remove fluids and gas in the
stomach and prevent painful distention.
 Eat small, frequent meals rather than three large meals.
 Encourage follow-up visits with the health care provider and
routine blood studies and other testing to detect complications.
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References
 Smeltzer. S. C., Bare. B.G., Hinkle. J. L & Cheever. K. H.
(2011). Textbook of Medical – Surgical Nursing. Vol -I (12th
Ed.). Wolters Kluwer. New Delhi.
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Any questions?