NRS 322 Lecture 5: Topic 5- Cancer

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28 Jul 2015
Topic 5- Cancer
1. Define and discuss the following terms:
Biologic therapy: treatment involving the use of biological agents such as interferons,
interleukins, monoclonal antibodies, and growth factors to modify the relationship
between the host and the tumour
Brachytherapy: “closed” radiation delivery system in which radioactive materials are
implanted or inserted directly into the tumour or close to the tumour
Carcinogens: agents that cause cancer
Carcinoma in situ: a lesion with all the histological features of cancer except invasion
of surrounding areas
Histologic grading: a pathology-based system for grading tumours according to
appearance and other features of cells that are predictive of growth rate and
invasiveness; tumour grade helps determine treatment and prognosis
Nadir: the lowest level of the peripheral blood cell counts that occurs secondary to
destruction of circulating and proliferating progenitor blood cells by chemotherapy
Metastasis: spread of cancer from the initial or primary site to a distant site
Peripherally inserted central venous catheters (PICC): are central venous catheters
inserted into a vein in the arm rather than a vein in the neck or chest; they are single- or
multiple-lumen, nontunnelled catheters that are up to 60 cm in length with gauges
ranging from 24 to 16 – they are inserted at or just above the antecubital fossa (usually
cephalic or basilic vein) and advanced to a position with the tip ending in the distal one
third of the superior vena cava
Central venous catheters: are inserted into a vein in the neck or chest (subclavian or
jugular) or groin (femoral) with the tip resting in the distal end of the superior vena cava;
single-, double-, triple-, or quadruple-lumen catheters and they are inserted with the aid
of local or general anaesthesia
Implanted infusion ports: consist of a central venous catheter connected to an
implanted, single or double subcutaneous injection port; the catheter is placed into the
desired vein and the other end is connected to a port that is surgically implanted in a
subcutaneous pocket on the chest wall – the port consists of a metal sheath with a self-
sealing silicone septum; drugs are injected through the skin into the port – after being
filled, the reservoir slowly releases the medicine into the bloodstream
2. Describe the prevalence, incidence, and death rates of cancer. (Refer to
Canadian Cancer Society web site)
oPrevalence is the total number of people living with a diagnosis of cancer
at a certain point in time. This statistic can be useful in planning healthcare
services for people recently diagnosed with cancer and for cancer
oIn 2009, about 810,045 Canadians diagnosed with cancer in the previous
10 years were alive. This represents about 2.4% of the Canadian
population or 1 out of every 41 Canadians.
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oThe number of newly diagnosed cancer cases in Canada is increasing,
but survival rates are also increasing. These improved survival rates
account for the growing number of Canadian cancer survivors.
Incidence and mortality
oIncidence is the total number of new cases of cancer. Mortality is the
number of deaths due to cancer. To provide the most current cancer
statistics, researchers use statistical methods to estimate the number of
new cancer cases and deaths until actual data become available.
oAn estimated 191,300 new cases of cancer and 76,600 deaths from
cancer will occur in Canada in 2014. (The number of estimated new cases
does not include 76,100 new non-melanoma skin cancer cases.)
oCancer is the leading cause of death in Canada and is responsible for
30% of all deaths.
oIt is estimated that in 2014:
97,700 Canadian men will be diagnosed with cancer and 40,000
men will die from cancer.
93,600 Canadian women will be diagnosed with cancer and 36,600
women will die from cancer.
On average, 524 Canadians will be diagnosed with cancer every
On average, 210 Canadians will die from cancer every day.
oLung, breast, colorectal and prostate cancer are the most common types
of cancer in Canada (excluding non-melanoma skin cancer). Based on
2014 estimates:
These cancers account for over half (52%) of all new cancer cases.
Prostate cancer accounts for about one-quarter (24%) of all new
cancer cases in men.
Lung cancer accounts for 14% of all new cases of cancer.
Breast cancer accounts for about one-quarter (26%) of all new
cancer cases in women.
Colorectal cancer accounts for 13% of all new cancer cases.
3. Discuss the risk factors for the development of cancer.
Tobacco use
Excessive body weight
Lack of physical activity
Unhealthy eating habits
Excessive exposure to the sun
4. Explain the role of the nurse in the prevention and detection of cancer.
The nurse has a prominent role in the prevention and detection of cancer. Early
detection and prompt treatment are directly responsible for increased survival rates
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among patients with cancer. Public education should include the following
1. Reduce or eliminate exposure to carcinogens and cancer promoters, such as
cigarette smoke and sun exposure.
2. Eat a balanced diet that includes fresh fruits, vegetables, omega-3 fatty acids,
and fibre, and reduce intake of cholesterol and saturated fats. Following Eating
Well With Canada's Food Guide helps to ensure a healthy diet (Health Canada,
3. Participate regularly (a minimum of 30 minutes, 5 times per week) in mild to
moderate physical activity such as biking, walking, or running.
4. Maintain a healthy weight for your body type.
5. Limit alcohol use to one or two drinks per day.
6. Get to know your body. Learn and practice self-examination (e.g., breast self-
examination, testicular self-examination). Report any changes to your doctor or
7. Follow cancer screening guidelines (see eTable 18-2, Summary of Canadian
Cancer Society Recommendations for Early Detection of Cancer in
Asymptomatic People, available on the Evolve Web site for this chapter). Early
detection of cancer has a positive effect on prognosis.
8. Know the seven warning signs of cancer.
C  Change in bowel or bladder habits
AA sore that does not heal
U  Unusual bleeding or discharge from any body orifice
T  Thickening or a lump in the breast or elsewhere
I  Indigestion or difficulty in swallowing
O  Obvious change in a wart or mole
N  Nagging cough or hoarseness
When the public is educated about cancer, care should be taken to minimize the
fear that surrounds the diagnosis.
Teaching strategies that address the specific needs of the target audience (e.g.,
the needs of older adults in comparison with those of high school students and of
new immigrants to Canada) are most effective.
Although the general public requires information that supports healthy
behaviours, those at an increased risk of cancer are the target population for
effective cancer control.
These individuals must be motivated to learn to change negative health
behaviours in order to achieve and maintain an optimal state of health.
Nurses can have a definite effect in convincing people that change in lifestyle
patterns will have a positive influence on health.
To be successful, nurses must identify potential challenges and barriers and
develop appropriate strategies to facilitate uptake of information about effective
cancer control.
5. Describe the use of the classification systems for cancer.
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