Pathophysiology - Cancer

Breast Cancer

• Found most in upper outer quadrant of the breast
• Adenocarcinomas; most common, arise from epithelial tissues

Incidence

• Increase with age; women older than 40
• Hereditary: first degree relative with breast cancer, past breast cancer
• Menarche before age 12, menopause after age 55
• Nulliparity/parity after age 35
• High-fat diet, obesity
• Longer exposure to estrogen

Diagnostic evaluation: 

• yearly mammogram starting age 40 and continue for as long as a woman is in good health
• Clinical breast exam every 3 years in 20’s and 30’s and yearly for age 40 and over
• Monthly self-breast exam performed immediately after menstruation, use the clock to describe location of the mass

Mastectomy

• Simple mastectomy
• Removal of mammary tissue of the breast
• Partial mastectomy
• Removal of about 1/3 portion of the breast
• Radical mastectomy
• Removal of breast, pectoral muscles and axillary nodes
• Modified radical mastectomy
• Removal of breast, axillary and apical nodes and preservation of pectoral muscles
• Extended radical mastectomy
• Removal of internal mammary nodes, breast, pectoral muscles, and axillary nodes

Nursing Care

Semi-fowler’s position, arms and hands elevated (promotes drainage and prevents edema)

Prostate Cancer

• African-American men and men with a strong family of one or more first degree relatives, father, and brother diagnosed at an early age

Diagnostic test

• Should begin testing both  prostate specific antigen (PSA), blood test and digital rectal examination at age 45, age 40 for men at even higher risk

Skin Cancer

• Very common among Caucasians (white-skinned) due to exposure to UV radiation because of lesser amount of melanin in the skin
• Carcinoma- malignant neoplasm of epithelial tissue

Cervical Cancer

• Yellowish, blood-tinged, foul-smelling vaginal discharge
• Flank pain, leakage of feces/urine
• Multiple sex partners

Diagnostic Test

• Cervical cancer screening 3 years after having vaginal intercourse but no later than when they are 21 years old unless a woman had a total hysterectomy

Treatment

• Radium
• Interferes with DNA replication and mitosis
• Destroys cells in the bone marrow (bone marrow depression)
• Unstable substance, disintegrates spontaneously and produces harmful radiation
• Stored in lead containers that function as barrier
• Radiology department is responsible for handling by the use of forceps, not the nurse
• Nursing care
• Isolation
• Strict bed rest
• Flat in bed
• If used in the skin, assess for redness and irritation, wash with water only