BRAIN CANCER

- A consequence of an abnormal growth of cells in the brain

Types:
1. Primary
2. Metastatic
Most Common Ca that Spreads in the Brain:
Lung, Breast, Kidney, Malignant melanoma
Cause:?
Assessment:
1. Headache
2. Weakness
3. Clumsiness
4. Difficulty walking
5. Seizures
Non specific:
1. Altered mental status
2. N & V
3. Abnormalities in vision
4. Difficulty in speech
5. Gradual changes in intellectual and emotional capacity
Exams & Test:
1. CT scan
2. X-ray
3. MRI
4. Biopsy ( Stereotaxis or Stereoactic Biopsy)
Treatment:
1. Surgery
2. Radiation
3. Chemotherapy
4.
LIPS or MOUTH CANCER
- refers to cancer that develops in any of the parts that make up the mouth
- A.K.A. oral cancer or oral cavity cancer.
SIGNS and SYMPTOMS
A sore that doesn't heal
A lump or thickening of the skin or lining of your mouth
A white or reddish patch on the inside of your mouth
Loose teeth
Poorly fitting dentures
Tongue pain
Jaw pain or stiffness
Difficult or painful chewing
Difficult or painful swallowing
Sore throat
Feeling that something is caught in your throat

RISK FACTORS
Tobacco use of any kind, including cigarettes, cigars, pipes, chewing tobacco and
snuff, among others
Heavy alcohol use
Excessive sun exposure to your lips
A sexually transmitted virus called human papillomavirus (HPV)
Previous cancer or radiation treatments in the head or neck area
COMPLICATIONS
Speech problems
Difficulty swallowing
Difficulty eating
Coping with changes in your appearance
TEST and DIAGNOSIS
1. Physical exam
2. Biopsy
Mouth cancer stages
1. Using a scope to inspect your throat
2. Imaging tests
2.1 X-rays
2.2 CT scan
2.3 MRI
2.4 PET
TREATMENT
1. Surgery
1.1 Surgery to remove the tumor
1.2 Surgery to remove cancer that has spread to the neck
1.3 Surgery to reconstruct the mouth
2. Radiation
3. Chemotherapy

Laryngeal Cancer
- Is a malignant tumor of the larynx
Diagnosis:
- laryngoscopy and biopsy - it evaluates the throat
Chest radiography, CT scan, MRI - use for staging
Risk Factors:
1. Cigarette smoking
2. Heavy alcohol use
3. Exposure to environmental pollutants
4. Exposure to radiation
Assessment:
1. Persistent hoarseness or sore throat
2. Painless neck mass
3. Feeling of a lump in the throat
4. Burning sensation in the throat
5. Dysphagia
6. Change in voice quality
7. Dyspnea

8. Weakness and weight loss

9. Hemoptysis
10. Foul breath odor
Interventions:
1. Place the patient in fowlers position
2. Monitor respiratory status
3. Monitor for signs of aspiration of fluid and food
4. Administer O2 as prescribed
5. Provide respiratory treatments as prescribed
6. Provide activity as tolerated
7. Provide a high calorie and protein diet
8. Provide nutritional support
9. Administer analgesic as prescribed for pain
Non surgical Treatments:
1. Radiation therapy
2. Chemotherapy
Surgical Interventions:
Goal: To remove the cancer and preserve its normal functioning
Types
1.
2.
3.
4.
stoma

of resection:
Cordal Stripping
Cordectomy
Partial laryngectomy
Total laryngectomy
(tracheostomy- this airway opening is permanent and is referred to as laryngectomy

Pre-op:
1. Discuss self care of the airway, alternate methods of communication, pain control
methods, suctioning, critical care environment and nutritional support
2. Encourage client to verbalize feelings
3. Describe rehab program and information about tracheostomy and suctioning
Post-op:
1. Monitor v/s
2. Monitor respiratory status
3. Place the client in a high fowlers position
4. Maintain mechanical ventilator support or a tracheostomy collar with humidification
5. Monitor pulse oximetry
6. Maintain surgical drains in the neck area if present
7. Observe hemorrhage and edema in the neck
8. Provide oral hygiene
9. Assess gag and cough reflex and the ability to swallow
10. Increase activity as tolerated
11. Assess the color, amount, and consistency of sputum
12. Provide stoma and laryngectomy care

ESOPHAGEAL CANCER

is cancer that occurs in the esophagus a long hollow tube that runs from your
throat to your stomach
occurs in the cells that line the inside of the esophagus.

SIGNS and SYMPTOMS

Difficulty swallowing
Losing weight without trying
Chest pain
Fatigue
TYPES of ESOPHAGEAL CANCER
According to the type of cells that are involved:
1. Adenocarcinoma
2. Squamous cell carcinoma
3.
RISK

FACTORS
Alcohol
Bile reflux
Chewing tobacco
Difficulty swallowing caused by an esophageal sphincter that won't relax (achalasia)
Drinking very hot liquids
Eating a diet low in fruits and vegetables
Eating foods preserved in lye
Gastroesophageal reflux disease (GERD)
Obesity
Precancerous changes in the cells of the esophagus (Barrett's esophagus)
Radiation treatment to the chest or upper abdomen
Smoking

TEST
1.
2.
3.

and DIAGNOSIS
Endoscopy
X-rays
Biopsy

TREATMENT
1. Surgery
1.1 Surgery to remove very small tumors
1.2 Surgery to remove a portion of the esophagus (esophagectomy).
1.3 Surgery to remove part of your esophagus and the upper portion of your stomach
(esophagogastrectomy)
2. Chemotherapy
3. Radiation Therapy
INTESTINAL TUMORS
- Malignant lesions that develop in the cells lining the bowel wall or develop as
edematous polyps in the colon or rectum
RISK FACTORS
1. Age older than 50 years old
2. Familial history
3. Previous colorectal polyps or history of cancer
4. History of chronic inflammatory bowel disease
5. History of ovarian or breast cancer
ASSESSMENT

1.
2.
3.
4.
5.
6.
7.

Blood in the stool (most common manifestation)

Anorexia, vomiting and weight loss
Anemia
Abnormal stools
Guarding or abdominal distention/mass (late sign)
Cachexia (late sign)
Masses noted on barium enema, colonoscopy CT scan and sigmoidoscopy

General Interventions
1. Monitor for signs of complications
a. bowel perforation w/ peritonitis
- low bp, rapid weak pulse, distended abdomen, elevated temp
b. abscess or fistula formation
c. hemorrhage
d. complete intestinal obstruction
vomiting, pain, constipation, abdominal distention
-Note for bowel sounds
GASTRIC CANCER
- cancer that occurs in the stomach the muscular sac located in the upper middle of
your abdomen, just below your ribs.
- A.K.A gastric cancer
SIGNS and SYMPTOMS
1. Early symptoms:
a. Indigestion
b. Abdominal discomfort
c. Full feeling
d. Epigastric, back, retrosternal pain
2. Late symptoms:
a. Weakness and fatigue
b. Anorexia and weight loss
c. Nausea and vomiting
d. A sensation of pressure in the stomach
e. Dysphagia and obstructive symptoms
f. Iron deficiency anemia
g. Palpable epigastric mass
RISK

FACTORS
A diet high in salty and smoked foods
A diet low in fruits and vegetables
Eating foods contaminated with a flatoxin fungus
Family history of stomach cancer
Infection with Helicobacter pylori
Long-term stomach inflammation (chronic gastritis)
Pernicious anemia
Smoking
Stomach polyps

INTERVENTIONS
1. Monitor v/s
2. Monitor hgb and hct
3. Monitor weight
4. Assess nutritional status

5. Administer pain medication as ordered

6. Prepare the client for chemotherapy and radiation therapy
7. Prepare the client for surgical resection of the tumor
SURGICAL INTERVENTIONS (for GASTRIC CA)
1. Billroth I (gastroduodenostomy)
2. Billroth II (gastrojejunostomy)
3. Total gastrectomy (esophagojejunostomy)
POST-OP INTERVENTIONS
1. Monitor v/s
2. Place patient in Fowlers position
3. Administer analgesic, anti-emetic as ordered
4. Monitor I & O
5. NPO for 1-3 days
6. Monitor NGT suction
7. Do not remove or irrigate NGT;(assist only)
Monitor for possible complications:
1. hemorrhage
2. dumping syndrome
3. diarrhea
4. hypoglycemia
5. Vitamin B12 deficiency
Pancreatic Cancer
- Most pancreatic tumors are highly malignant, rapidly growing adenocarcinomas
originating from the epithelium of the ductal system
Risk Factors:
1. Increased age
2. History of DM
3. Alcohol use
4. History of previous pancreatitis
5. Smoking
6. Ingestion of a high fat intake
7. Exposure to environmental chemicals
Assessment:
1.Nausea and vomiting
2.Jaundice
3.Unexplained wt loss
4. Clay colored stools
5. Glucose intolerance
6. Abdominal pain
7. ERCP visualization of of the pancreatic duct and biliary sytem and collection of tissue and
pancreas
INTERVENTIONS
1. Radiation
2. Chemotherapy
3. Whipple procedure
Monitor for blood glucose levels

Gallbladder Cancer

Gallbladder cancer is cancer that begins in the gallbladder

Assessment:
Abdominal pain, particularly in the upper right portion of the abdomen
Abdominal bloating
Itchiness
Fever
Loss of appetite
Losing weight without trying
Nausea
Yellowing of the skin and whites of the eyes (jaundice)
Risk factors
1. Sex
2. Age
3. Gallstone
4. Other gallbladder diseases