Lung CA

Overview

Leading cause of cancer worldwide

Major complication = a/w obstruction/hypoxia!!

Prognosis poor if tumor cannot be removed

Tx often palliative

Most primary cases from bronchial epithelium

Classified by histologic type:

Small Cell

Non-small Cell -all have similar responses to tx

Lung CA

Assessment

• Observe skin and mucous membranes for color
• How many words can they say between breaths?
• Ask about:
• Cough
• Hoarseness
• Smoking hx
• Exposure to inhalation irritants
• SOB
• Activity tolerance
• Frothy or bloody sputum
• Pain in the arms or chest
• Difficulty swallowing

Breast CA

S/S:

• Painless lump, node or thickening
• Unequal symmetry
• "Peau d'orange" - puckering of nipple
• Nipple discharge
• Ecchymosis
• Axillary swelling
• Pain

Breast CA

Tx:

Local Tx:

• Lumpectomy - breast conservation
• Simple mastectomy - breast tissue only
• Modified radical mastectomy - breast tissue, axillary nodes
• Radical mastectomy - breast tissue, pectoral muscles, axillary nodes, fat, adjacent tissue
• Radiation Therapy

Systemic Tx:

• Chemo
• Hormone therapy
• Combo therapy
• Stem cell transplantation - being explored now

Breast CA

Nursing Care

• Psychological support
• Assess for lymphedema - lymph backing up
• NO BP or venipunctures in affected arm
• Pain MGMT

Reproductive CA

Main symptom = POST MENOPAUSAL BLEEDING

Dx tests:

• CA-125 tumor marker
• CXR
• IV pyelography
• Barium enema
• Pelvic CT
• Liver and bone scans
• Functional D&C

Endometrial CA

Tx:

Radiation:

• External - teletherapy (hold telephone OUTSIDE body)
• Internal - Brachytherapy

Surgery:

Total hysterectomy

Radical hysterectomy

Often asymptomatic

• Classic sx = painless vaginal bleeding
• Leg, flank, pelvic, or chest pain
• unexplained wt loss
• Hematuria
• Rectal bleeding
• Cough

Cervical CA

Dx tests, MGMT

Tests:

• Pap
• Colposcopic
• Enocervical curettage - take tissue

Mgmt:

• Local ablation
• Laser therapy
• Cryotherapy
• Radiation
• Chemo
• Conization
• Surgery

Ovarian CA

S/S:

• Vague abdominal discomfort
• Dyspepsia
• Indigestion
• Gas
• Distention

Ovarian CA

Dx tests:

• Ovarian antibody CA-125
• US
• IV pyelography
• Barium enema
• Upper GI series

Ovarian CA

RF vs Reduced risks assoc. with

RF:

• Nulliparity - no children
• Heredity
• Weight
• LATE menopause

Reduced risk assoc with:

• Oral contraceptive use
• Early menopause
• Increased fiber, decreased fat diet

• Rare, men 20-54 y/o
• Early detection with TSE
• One or both testicles
• Increased risk for males with cryptorchidism or HIV
• Leukemia, lymphoma, and metastatic carcinomas can invade testes

Dx tests:

• DRE
• PSA blood test

Risk Factors:

• Age > 65 y/o
• Family hx
• Race - Af Americans
• Genome changes

Assessment:

• Hesitancy
• CHange in urine stream size
• Pain in back or legs
• Hx of UTIs