MRS. DAPHNY B. HATUD R.N. M.A.

CARCINOGENESIS
 The

process through which normal cells are transformed into malignant or cancer cells

STAGES

INITIATION
 Occurs

when a carcinogen damages

DNA

PROMOTION
 Occurs

with additional assaults to the cell, resulting in further genetic damage

MALIGNANT CONVERSION
 Genetic

event results in malignant conversion

PROGRESSION
are increasingly malignant in appearance  It develop into an invasive cancer with metastasis to distant body parts
 Cells

CARCINOMA IN SITU
 The

earliest stage of cancer

 Specific

segments of DNA  It contribute to the transformation of normal cells malignant cells

ONCOGENES

PROLIFERATION
 Also

known as cell growth, the growth or production of cells by multiplication of parts

CYTOKINE
A

substance secreted by immune system cells  It send messages to other immune cells

ANEUPLOID
 Tumor

cells that do not have the normal 46 chromosomes in a human cell  Aneuploid tumors often have a worse prognosis

SARCOMA
A

cancer of supporting or connective tissue such as cartilage, bone, muscle or fat

PHEOCHROMOCYTOMA
A

catecholamine secreting tumor of the chromaffin cells of the sympathetic nervous system  Usually found in the adrenal medulla  Rare

ADENOCARCINOMA
 Cancer

that arises from glandular

tissues

HEAD AND NECK TUMORS

PATHOPHYSIOLOGY

> Irritated mucosa tougher mucosa (squamous metaphasia) occurs by increasing the mucosal thickness (acanthosis or hyperplasia) or by developing a keratin layer (keratosis) > Changes @ the gene level enhance the growth of abnormal epithelial cells that become malignant white patchy lesions (leukoplakia) or red, velvety patches (erythroplasia) > Spread (metastasis) into the mucosa, muscle & bone systemic spread through the blood & lymphatic system distant metastasis to the lungs or liver

DIAGNOSIS
in situ early stage & well differentiated  Moderately differentiated if progressing  Poorly differentiated - Final
 Carcinoma

ETIOLOGY


Risk factors: > chewing tobacco > Hardwood dust > Pipe smoking >Poor oral hygiene > Marijuana > Voice abuse > Chronic laryngitis > exposure to chemicals

Manifestation
 Hoarseness

of the true vocal cord  Mouth sores  Lump in the neck for 3 4 weeks or longer
 Lesions

DIAGNOSTIC MEASURES

LABORATORY TEST
blood count  Bleeding time  Urinalysis  Blood chemistry reveals low protein  Renal & liver function test
 Complete

RADIOGRAPHIC STUDIES
   

X-ray Computed tomography MRI SPECT (Single photon emission computerized tomography scan) PET (Positron emission computerized tomography scan)

DIRECT & INDIRECT LARYNGOSCOPY

 Laryngoscopy  Nasopharyngoscopy  Esophagoscopy  Bronchoscopy

TUMOR MAPPING BIOPSIES

 Identify

tumor location

BIOPSY
 Confirm

the diagnosis

TUMOR STAGING
 Tumor

staging by the TNM (tumor, nodes, metastasis) method

NURSING DIAGNOSIS

Risk for aspiration  Anxiety  Disturbed body image  Acute pain or chronic pain  Imbalance nutrition : less than body requirements  Impaired skin integrity  Ineffective coping  Impaired adjustment  Deficient knowledge


MANAGEMENT

Non surgical management

 Radiation

therapy  Chemotherapy

Side effects of radiation

 Hoarseness  Sore

throat  Difficulty in swallowing  Skin is red & tender  Xerostomia (dry mouth)

Surgical Management
 Laryngectomy

Types: > Cordal stripping > Cordectomy excission of a vocal cord >Partial or total laryngectomy

COMPLICATIONS OF HEAD & NECK SURGERY

 Airway

obstruction  Hemorrhage  Wound breakdown  Tumor recurrence

MALIGNANCIES IN THE REPRODUCTIVE SYSTEM

ENDOMETRIAL (UTERINE CANCER)

ENDOMETRIAL CANCER
A

reproductive cancer  Most common type

PATHOPHYSIOLOGY

 Arises

from the glandular part of the endometrium and may be preceded by endometrial overgrowth  Initial growth is w/n the uterine cavity myometrium cervix

Spread outside the uterus occurs through: Lymphatic spread ovaries, pelvic, inguinal, para aortic lymph nodes  By blood lungs, liver or bones  By transtubal or intra abdominal spread peritoneal cavity


GRADE
 Grade

11- cancers are identified by endometrial glands and well differentiated  Grade 3- have a solid growth pattern 3and are poorly differentiated

Risk factor (Endometrial)

 Age

5050-70 y.o.  Family history  Diabetes mellitus  Hypertension

 Obesity  Uterine

polyps  Late menopause  Nulliparity  Smoking

Risk factor (Cervical)

      

African American Native American/American Indian Multiparity Below 18 y.o. @first coital Below 18 @ first pregnancy Multiple sex partner Smoking

 Infection

with herpes simplex virus  Infection with human papilloma virus  Infection with cytomegalovirus (CMV) HIV/AIDS  Lower socio economic status  Sexual partner had a previous partner who developed cervical cancer

SYMPTOMS

 Post

menopausal bleeding  Watery, bloody vaginal discharge  Low back or abdominal pain  Palpable uterine mass

DIAGNOSTIC TEST

 

 

CA 125 Tumor marker Chest X-ray XIntravenous Pylography or excretory Urography Barium enema Computed Tomography Liver & bone scans

   

Dilatation and curettage Endometrial biopsy Proctosigmoidoscopy Ultrasonography Endoscopic examination of the uterus

MANAGEMENT

NON SURGICAL MANAGEMENT



RADIATION THERAPY a. Intracavitary

radiation (Brachytherapy) takes 35 60 min. b. External Radiation in combination w/surgery

 used when the risk for distant spread exceeds 20%  HORMONE THERAPY for stage 1 & 11 and for palliative treatment for stage 1V
 CHEMOTHERAPY

SURGICAL MANAGEMENT


TOTAL ABDOMINAL HYSTERECTOMY (TAH) BILATERAL SALPINGO OOPERECTOMY RADICAL HYSTERECTOMY W/BILATERAL PELVIC LYMPH NODE DISSECTION for stage 11

PSYCHOSOCIAL PREPARATION need to discuss their concerns  Provide emotional support  Create a good atmosphere  Include family members/S.O. in discussions  Inform the client for possible side effects of medication
 Client

CERVICAL CANCER

PATHOPHYSIOLOGY

 Normal

cells pre malignant changes changes to function transformation to cancers

STAGES OF CERVICAL CANCER

 STAGE

1 carcinoma is confined in the cervix  STAGE 11- extends beyond the cervix 11but not extend to the pelvic wall - vagina is involve

Pre invasive lesions

 Begin

in the transformation zone  Also called as Cervical Intraepithelial Neoplasia (CIN)

CLASSIFICATION OF CIN

  

CIN 1 MILD CIN 11 MODERATE CIN 111 SEVERE TO CARCINOMA IN SITU

MANIFESTATION

 Painless

vaginal bleeding  Watery, blood tinged vaginal discharge that becomes dark & foul smelling  Leg pain (along the sciatic nerve)  Swelling of the legs (late symptom)

SIGNS OF METASTASIS
 Weight

loss  Pelvic pain  Painful urination  Hematuria  Rectal bleeding  Chest pain  Coughing

DIAGNOSTIC PROCEDURES

examination to view the transformation zone Colposcopy a procedure in which application of a 30% acetic acid solution is applied to the cervix  Pap smear  Endocervical curettage scrapping of the endocervix
 Colposcopic

MANAGEMENT

NON - SURGICAL

Loop electrosurgical excision procedure

 Transmits

a painless electrical current used to cut away or peel off affected tissue

Laser Therapy
A

laser beam is directed to the abdominal tissues

Cryotherapy
A

prone is placed against the cervix to cause freezing of the tissues and subsequent necrosis

Radiation Therapy
 For

invasive cancer  Effective as a radical hysterectomy

Chemotherapy
 For

locally advance carcinomas, unresectable recurrent tumors, or widely metastatic disease

SURGICAL

Conization


Used to treat clients with microinvasive cervical cancer, especially when presentation of fertility is desired Done when the lesion cannot be visualized by colposcopic examination

Hysterectomy
 Done

if the client does not desire childbearing

Pelvic Exenteration
 Performed

for recurrent cancers

PSYCHOSOCIAL PREPARATION

 Assess

the client for manifestations of depression daily  Emotional support  Assess the need for sexual counseling

Complications of Conization
 Hemorrhage  Uterine

perforation  Incompetent cervix  Cervical canal narrowing  Preterm labor

OVARIAN CANCER

PATHOPHYSIOLOGY

 Tumor

grows rapidly, spread quickly & are often bilateral metastasize by direct extension into nearby organs or through blood & lymph circulation to distant sites abdomen by seeding free floating cancer cells

RISK FACTORS
 Age

over 40 y.o.  Family history  Diabetes Mellitus  Nulliparity  Above 30 y.o. @ first pregnancy

 Breast

cancer  Colorectal cancer  Infertility  Gene mutations

STAGING OF OVARIAN CANCER

STAGE 1
 Growth

is limited to ovaries

STAGE 11
 Growth

involves one or both ovaries with pelvic extensions

STAGE 111
 Tumor

involves one or both ovaries with peritoneal implants outside the pelvis or positive retroperitoneal or inguinal nodes; superficial liver metastasis but with histologically proven malignant extension to small bowel or omentum

STAGE 1V
 Growth

involving one or both ovaries with distant metastasis to the lungs & liver

MANIFESTATION
 Abdominal

pain or swelling  Abdominal discomfort  Premenstrual tension  Heavy menstrual flow  Abdominal mass

DIAGNOSTIC TEST
Complete blood count  Urinalysis  Liver studies if ascites occurs  Ultrasonography  Intravenous pyelography (IVP)


Computed tomography  Radiography  Barium enema study  Upper GI radiographic series



MANAGEMENT

NON SURGICAL

Chemotherapy
Most common agents used: - Cisplatin - Carboplatin - Paclitaxel (Taxol)

RADIATION THERAPY
 Used

after surgery

SURGICAL

Total Abdominal Hysteretomy & Bilateral Salpingo - oopherectomy

VULVAR CANCER

PATHOPHYSIOLOGY

 Vulvar

atypia or mild dysplasia (Vulvar Intraepithelial Neoplasia) VIN 1  moderate dysplasia (VIN 11)  severe dysplasia or carcinoma in Situ (VIN 111)  lesions become invasive  spread to the urethra, vagina, anus  through the lymphatic system  inguinal, femoral & deep iliac pelvic nodes

RISK FACTORS
 Herpes

Simplex Type 11  Human Papillomavirus

MANIFESTATIONS
 Irritation  Sore

that will not heal  Bleeding (late symptom)  Multifocal lesions on the labia (lesions are whitish & reddish)

DIAGNOSTIC TEST
 Pap

smear  Colposcopic examination of the vulva  Toluidine blue test identify abnormal cells for biopsy  Biopsy (Keyes Dermal Punch) a device that removes a disk of tissue

MANAGEMENT

NON SURGICAL

Laser Therapy

Radiation therapy
 Used

after surgery

SURGICAL MANAGEMENT

Vulvectomy
 To

remove vulvar lesions

TYPES OF VULVECTOMY

Simple Vulvectomy
 Removal

of the vulva, labia majora, labia minora, possibly the clitoris

Skinning Vulvectomy
 The

removal of superficial vulvar skin without removal of the clitoris & replacement of removed skin with split thickness graft

Radical Vulvectomy
 Removal

of the entire vulva skin, labia, clitoris, subcutaneous tissues and possibly inguinal & femoral node dissection

VAGINAL CANCER

PATHOPHYSIOLOGY

 Vaginal

cancer is an extension of cervical, endometrial, or vulvar cancers  Spread depends on the location of the tumor  Upper vaginal lesions spread in the same manner as cervical cancer  Lower lesions spread similarly to vulvar cancer

Risk Factors
 Repeated

pregnancies  Vaginal Trauma  Sexually Transmitted Diseases

Manifestations papsmear - only indication Late symptoms: - Pain - Foul smelling vaginal discharge - Painless vaginal bleeding - Pruritus - Urinary symptoms
 Abnormal

Diagnostic Test
 Pelvic

examination  Colposcopic examination  Biopsy

MANAGEMENT

Non - surgical
 Laser

therapy  Staining of the abnormal tissues with iodine solution  Topical chemotherapy  Intracavitary radiation

Complications of Radiation
 Vaginal

stenosis  Adhesions  Vaginal discharges

Surgical
 Partial

or Total vaginectomy  Radical hysterectomy or pelvic exenteration

FALLOPIAN TUBE CANCER

Fallopian Tube Cancer

 Rarest

of gynecologic cancers  Results from pelvic inflammatory disease and chronic salpingitis

Risk factors
 Nulliparity  Infertility

PATHOPHYSIOLOGY

 Initial

lesion is confined to the lumen of the tube invades the serosa spreads intraperitonially bowel, omentum & peritoneum. Lymphatic spread is to the para aortic & retroperitoneal nodes

Manifestations
 Postmenopausal

bleeding  Abdominal pain  Watery vaginal discharges  Leukorrhea

Late Manifestations:  Lower abdominal pain  Feelings of pressure

Diagnostic Examination
 Pap

smear  Vaginal Ultrasonography  Computed Tomography  Laparoscopy

Management
 Total

abdominal hysterectomy  Bilateral Salpingo oopherectomy with omentectomy (removal of the connective tissues covering these organs)  Chemotherapy (before or after surgery)

PROSTATE CANCER

TYPES OF PROSTATIC CANCER

ADENOCARCINOMAS
 Arise

from the epithelial cells of the prostate

NONEPITHELIAL CARCENOMAS
 TYPES: -

Ductal carcinomas Transitional cell carcinomas Squamous cell carcinomas Sarcomas

Common sites of metastasis

 Nearby

lymph nodes  Bone marrow  Bones of the pelvis  Sacrum  Lumbar spine

Common organ sites of metastasis

 Lungs  Liver  Adrenals  kidneys

GLEASON GRADING SYSTEM

1 Normal prostate tissue cells Up to 5 Abnormal cells

Etiology
 Castrated

before

 History

puberty  Aging men  Family history  Heavy metal exposure

of vasectomy  Sexually transmitted disease  Cytomegalovirus  Herpes type 2

Manifestations
 Difficulty

in urination  Recurrent bladder infections  Urinary retention  Painless hematuria  Bone pain

Screening Procedures
 Digital

rectal examination (DRE) prostate that is found stony hard is suspected malignant  Prostate specific antigen (PSA) a glycoprotein produced solely by the prostate

Diagnostic test
Biopsy  Prostatic ultrasonography  Radiographic and blood studies  Computed Tomography of the pelvis and abdomen  Magnetic resonance imaging  Bone scan  Liver function test


NURSING DIAGNOSIS

 Anxiety  Acute

or chronic pain  Impaired urinary elimination  Risk for sexual dysfunction  Dysfunctional grieving  Potential for metastasis

CANCER OF THE PENIS

PATHOPHYSIOLOGY

 Epidermoid

(squamous) carcinomas developing from the squamous cells.  Tumors tend to grow slowly and can develop anywhere on the penis but most commonly occur on the foreskin or the glans.  When the cancer is confined to the skin of the penis it is called carcinoma in situ (CIS).  Other types of penile cancers include melanomas, basal cell cancer, and sarcomas

Manifestations
 Painless,

wartlike growth or ulcer on the glans under the prepuce (foreskin) and may be mistaken for a venereal wart  Reddened lesion with plaque

MANAGEMENT

biopsy  Penectomy TYPES  Partial Penectomy the distal portion of the corpus cavernosum and the corpus spongiosum is amputated  Total Penectomy- an incision is made from Penectomythe pubic bone, which encircles the penis & extends into the perineum

 Excisional

Preventive measures
 Circumcision  Personal

hygiene

RENAL CELL CARCINOMA

PATHOPHYSIOLOGY

 Also

known as adenocarcinoma of the kidney  The healthy tissue of the kidney is damage and replaced by cancer cells

Staging Renal Tumor

Stage 1 Tumors up to 2.5 are situated within the capsule of the kidney; the renal vein, perinephric fat, and adjacent lymph nodes have o tumor Stage 11 - Tumors are larger than 2.5 cm & extend beyond the capsule but are within Gerotas fascia; the renal vein and lymph nodes are not involved Stage 111 Tumors extend into the renal vein, lymph nodes or both Stage 1V Tumors include invasion of adjacent organs beyond Gerotas fascia or metastasize to distant tissues

Systemic effects
Paraneoplastic syndromes: syndromes: - Anemia - Erythrocytosis - Hypercalcemia - Liver dysfunction
-

Hormonal effects Increased sedimentation rate Hypertension

Manifestations
Flank pain  Gross hematuria  Palpable renal mass  Renal bruit heard during auscultation  Hematuria late sign


Muscle wasting  Weakness  Poor nutritional status  Weight loss  Breast enlargement


Diagnostic Assessment
Urinalysis  Surgical exploration  IV Urogram with Nephrograms  Sonography  CT  Magnetic resonance imaging


MANAGEMENT

NON SURGICAL
 Radiofrequency  Chemotherapy

ablation

SURGICAL


Nephrectomy

GASTRIC CARCINOMA

GASTRIC CARCINOMA
A

malignant neoplasm in the stomach  Mostly Adenocarcinoma  It develops in the mucosal cells that form the innermost lining of any portion or all of the stomach  Other types include: lymphomas and sarcomas

PATHOPHYSIOLOGY

 Result

from atrophic gastritis or intestinal metaplasia  Gastric cancers spread by direct extension through the gastric wall and into regional lymphatics  The intramural lymphatics readily allow horizontal spread within the gastric wall  Extramural lymphatics carry tumor deposits to lymph nodes.

 Direct

invasion to the extramural lymphatics carry tumor lymph nodes.  Hematogenous spread via the portal vein the liver and via the systemic circulation lungs and bones  Peritoneal seeding of cancer cells from the gastric serosa omentum, peritoneum, ovary, & pelvic cul-de-sac cul-de For the advance gastric cancer, there is invasion of the stomach muscle or beyond

Etiology
 Infection

with H. pylori  Pernicious anemia  Gastric polyps  Chronic atropic gastritis  Achlorhydria absence of secretion of hydrochloric acid

 Ingestion

of pickled foods  Salted fish, meat  Nitrates from processed foods  High consumption of salt  Genetic factor  Gastric surgery like Billroth 11 procedure  Smoking, drinking alcoholic beverage

MANIFESTATIONS

EARLY GASTRIC CANCER: CANCER:

 Indigestion

(heartburn)  Abdominal discomfort  Feeling of fullness  Epigastric or back pain

ADVANCED GASTRIC CANCER

Nausea and vomiting  Obstructive symptoms  Iron deficiency anemia  Palpable epigastric mass


Enlarged lymph nodes  Weakness and fatigue  Progressive weight loss  Distant metastasis


Signs of distant metastasis

Virchows (sentinel or signal) nodes (enlarged supraclavicular lymph nodes, especially on the left)  Blumers shelf, resulting from peritoneal seeding that produces a firm mass palpable on rectal or vaginal examination  Sister Mary Joseph nodes (subcutaneous periumbilical deposits)  Krukenbergs tumor (metastatic ovarian nodules)


Laboratory Assessment
hematocrit and hemoglobin values  Stool positive for occult blood  Hypoalbuminemia  Elevated carcinogenic antigen
 Low

Radiographic Assessment
 Double

contrast upper gastrointestinal (GI) series  Computed Tomography scan

Other Diagnostic Assessments

 Esophagogastroduodenoscopy  Endoscopic

(EGD)

ultrasound (EUS)

MANAGEMENT

NON SURGICAL
 Chemotherapy  Radiation

therapy (Intraoperative radiotherapy)

SURGICAL
 Total

or subtotal gastrectomy  Laparoscopic surgery

Nursing Interventions
 Auscultate

the lungs  Monitor for the return of bowel sounds  Inspect the operative site for signs of infection or bleeding  Nutrition therapy

ENDOCRINAL NEOPLASM

TYPES OF THYROID CANCER

PAPILLARY CARCINOMA
common type of thyroid cancer  Occurs most often in younger women
 Most

FOLLICULAR CARCINOMAS
 About

25% of all thyroid cancers  Occur most often in older clients  Cancer invades blood vessels and spread to bones and lung tissue = dyspnea & dysphagia

MEDULLARY CARCINOMA
 Accounts

for 5% to 10% of all thyroid

cancers  Most common in clients older than 50 years of age  This tumor often occurs as part of multiple endocrine neoplasia (MEN) type 11

ANAPLASTIC CARCINOMA
A

rapid growing, aggressive tumor that directly invades nearby structures Manifestations: - Stridor - Hoarseness - Dysphagia

Management
 Total

thyroidectomy with nodal neck dissection  Thyroid hormone therapy

NEUROLOGIC AND SKIN TUMORS

BRAIN TUMORS
 Arise

anywhere within the brain structures and are named according to the cell or tissue from which they originate

PATHOPHYSIOLOGY


Regardless of origin, the tumor expands and invades, infiltrates, compresses, and displaces normal brain tissue

Cerebral edema / brain tissue inflammation Increased intracranial pressure Focal neurologic deficit Obstruction of the flow of the CSF Pituitary dysfunction

COMPLICATIONS
 Ischemia  Hemorrhage  Seizure  Hydrocephalus

CLASSIFICATION
1st Classified as:  Benign  Malignant

LOCATION OF TUMORS
2nd classification is based on their location:  SUPRATENTORIAL above the tentorium cerebelli  INFRATENTORIAL- beneath the INFRATENTORIALtentorium, the area of the brainstem structures and cerebellum

3rd Classification
 Depends

on the cellular, histologic, or anatomic origin of the tumor

Two types of cell in the nervous system

 Neurons

are responsible for nerve impulse conduction  Neuroglial cells provide support, nourishment, and protection for neurons

Four specific types of cells

Neuroglial cells: - Astrocytes - Oligodendroglia - Ependymal cells - Microglia

GLIOMAS
 Are

malignant tumors.  Arise from the neuroglial cells of the brain and brainstem

Types of glioma

a. Astrocytoma
may be found anywhere within the cerebral hemispheres  The most common


b. Oligodendrogliomas
 Located

within the frontal lobes of the

brain  Are slow growing tumors

c. Glioblastoma
 Highly

malignant, grade 3 or higher  Rapidly growing

d. Ependymomas
 Arise

from the lining of the ventricles and are difficult to treat surgically

MENINGIOMAS
 Arise

from the coverings of the brain (the meninges)  Most common benign tumor

PITUITARY TUMORS
cause endocrine dysfunction  Most common type of pituitary tumor is the adenoma  Adenomas are subdivided into chromophobe, secretory, nonsecretory adenomas
 May

Symptoms of Pituitary Tumors

 Visual

disturbances  Hypopituitary signs (loss of body hair, diabetes DI, sterility, visual field defects, and headache)

ACOUSTIC NEUROMAS
 Arise

from the sheath of Schwann cells in the peripheral portion of cranial nerve VIII  Also referred to as cerebellar pontine angle (CPA)

COMMON SYMPTOMS OF ACOUSTIC NEUROMAS

 Hearing  Tinnitus  Dizziness

loss or vertigo

METASTATIC TUMORS
called as secondary tumors  Metastatic cells from the lungs, breast, colon, pancreas, and kidney
 Also

ETIOLOGY OF BRAIN TUMORS

 Genetic

changes  Heredity  Errors in fetal development  Ionizing radiation

 Electromagnetic

fields  Environmental hazards  Diet  Viruses  Injury

CLINICAL MANIFESTATIONS

 Headache  Nausea

and Vomiting  Visual symptoms  Seizures  Changes in mentation or personality  Papilledema (swelling of the optic disk)

Diagnostic Test
Computed Tomography  Magnetic Resonance Imaging  Skull films  Electroencephalogr aphy (EEG)


Lumbar puncture  Myelography  Brain scan  Positron emission tomography (PET)  Laboratory test


MANAGEMENT

NONSURGICAL
   

 

Radiation therapy Drug therapy Chemotherapy Other drugs (Analgesics, Dexamethasone, Phenytoin,Histamine blockers, Metoclopramide) Radiosurgery Gamma Knife

SURGICAL MANAGEMENT
 Craniotomy

POSTOPERATIVE COMPLICATIONS OF CRANIOTOMY

 Increased

Intracranial pressure  Hematomas (Subdural hematoma, Epidural hematoma, Subarachnoid hemorrhage)  Hypovolemic shock  Hydrocephalus


Respiratory complications (Atelectasis, Hypoxia, Pneumonia, Neurogenic pulmonary edema)

Wound infection  Meningitis  Fluid and Electrolyte Imbalances (dehydration, Hyponatremia)  Seizures  Cerebrospinal fluid (CSF) leak  Cerebral edema


POST OP CARE
 Positioning  Monitoring

the dressing  Monitoring laboratory values  Ventilating the client  Drug therapy

SKIN TUMORS

Skin cancer


, the uncontrolled growth of skin cells, is one of the most commonly diagnosed forms of cancer. Several different types of skin cancer exist.

Basal cell carcinoma

   

is the most common type of skin cancer. It is a slow growing cancer that normally appears in patients aged 40 or over. usually occurs on areas of the body or scalp that are regularly exposed to the sun. People with light skin, hair, and eye color are at greater risk of developing basal cell skin cancer, as are those who have been overexposed to xrays. rays.

Manifestations


A skin lesion that has a pearl-like or waxy pearlappearance and is flat or slightly raised The lesion could be white or light pink, fleshfleshcolored, or brown, and may contain blood vessels that are visible either in the lesion or nearby skin. A sore that wont heal or a lesion that looks like a scar, but is not related to a skin injury. injury.

Squamous cell carcinoma



  

Occurs in the middle layer of the epidermis, or epidermis, skin. More aggressive than basal cell carcinoma. It often begins after age 50 Occur in normal skin or in a burned or injured area.

Melanoma


is not as common, but more deadly than other skin cancer forms. Four types of melanoma exist, and they vary according to the location on the body where they are likely to occur, the age group they affect, and the groups of people most likely affected.

Preventive Measures


 

Avoiding the suns strongest rays, basically from 10 a.m. to 4 p.m. Use a sunscreen daily that has a sun protection factor (SPF) of 15 or higher. Wearing sunglasses and wide-brimmed hats. wideSpending time outdoors, but in the shade

Causes of skin cancer

 

   

Sun exposure Ultraviolet radiation has the potential to greatly damage their skin cells. Synthetic tanning devices like tanning beds Exposure to toxins Reactions to chemicals Intolerance to certain medication.

Treatment
      

Excision Cryosurgery Mohs surgery Chemotherapy Radiation Electrodessication Curettage.

SARCOMAS