Professional Documents
Culture Documents
with CANCER
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Breast Cancer
3 Breast Cancer
Most common cancer in American
women- can also occur in men
Fibroademonas – benign, firm
rubbery texture, mobile well defined
Malignant masses – usually fixed,
irregular, hard and poorly defined
Men can develop breast cancer- less
than 1% incidence
Most occur with genetic mutation
of BRCA1 or BRCA 2
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Risk factors for Breast Cancer
Increased age –sporadic not definite
Family history – especially if premenopausal
Early menarche – before age 12 yr
Late menarche – after age 50 yr
Never had children – nuliparity
Late age at first pregnancy/birth – after age
30
High fat diet
Obesity – especially after menopause
5 Risk factors for Breast Cancer
Hard
Painless
Irregular
shape
Non mobile
12 Diagnosis
Mammogram, US, MRI,
BGSI – breast specific gamma imaging
PEM – positron emission mammography
Biopsy
Fine needle aspiration
Axillary lymph node status
exam 6-10 nodes
Hormone receptor status
13 Receptor positive tumors
Poorly differentiated
Frequently recur on visceral sites
Usually unresponsive to
hormonal therapy
15 Treatment
Trastuzumab
DNA derived monoclonal antibody
Inhibits growth of tumor cells HER2 (human
epidermal growth factor receptor 2)
Given with IV taxol as First line treatment for
breast cancer tumors with HER2 protein
20 Hormone Therapy
If estrogen receptors are positive, estrogen
promotes growth of the tumor cells
Tamoxifen (nolvadex)
Anti-estrogen –blocks estrogen receptor sites
of malignant cells
Prevents and treats recurrent breast cancer
Used for 1-2 years to 5 years or longer
May increase the risk of endometrial cancer
21 Stem Cell Transplantation
Autologous
Allogenic
Option for high risk
recurrence
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Post op care
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Hemovac or JP drains – removed after several
days
Only in hospital 1-2 days
Dressing changes
No BP, lab, IV in arm
Be careful to avoid trauma or burns
Restore arm function
◦ Semi fowlers position, arm above heart
◦ Hand exercises –gradually increase to brush hair
and wall climb exercise
Prevent lymphedema
◦ Elevate the arm
◦ Pressure sleeve
24 Follow up
Also called
“undifferentiated
carcinoma”
A fast growing tumor that
tends to arise peripherally
Represents 10% of tumors
52 Bronchoalveolar Cell
Cancer
Found in the terminal
bronchi and alveoli
Is usually slower
growing compared
with other
bronchogenic
carcinoma
Risk factors
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The nurse understands which is the primary risk factor for lung
cancer?
A. Air pollution
B. Cigarette smoking
C. Chronic exposure to asbestos
D. Occupational radiation exposure
Risk factors
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Staging
A – asymptomatic
B – confined
C – near structures
D - metastasis
78 Prostate Cancer
Nonsteroidal antiandrogen –
bicalutamide (casodex)
Sunscreen
Monitor moles for any
changes
Avoid irritants
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2 Malignant Melanoma
UV rays
1/100 Caucasians acquire
it yearly
Melanoma prone families
due to moles (absence of
gene 9p)
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5 Melanoma signs
Superficial spreading melanoma
Most common form (middle age)
Occurs anywhere on the body – often trunk
and lower extremities
Appear circular with irregular borders
Flat or papules
Combination of colors with hues of tan,
brown, and black mixed
May also be gray, blue-black or white
May be a dull pink rose color
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6 Melanoma diagnosis
Biopsy
Thorough skin assessment
Family history
Confirm – chest x ray, CBC,
liver functions, CT scan to
stage the disease
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7 Prognosis
Poor if lesions >1.5 mm thick or
with lymph node involvement for
long term (5 years)
If on hand, foot, or scalp have
better prognosis
Lesions on torso have ^chance
of metastasis to bone, liver,
lungs, spleen and CNS
Men and elderly have poorer
prognosis
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8 Medical Management