ONCO NI DEAN • Obvious change in wart or mole

• Nagging cough or hoarseness - continuous

Oncology - study of cancer • Unexplained Anemia - bleeding somewhere
• Sudden Weight Loss
Cell
↓ Dx
Stress 1. Biopsy - confirmatory test
Infection 2. TNM scoring
Surgery 3. Staging
↓ 4. BSE
Inflammation - Regular menses - 7 days after mens
↓ - Irregular - same date each month
Neoplasm WHEN: During bath
IPAPEA
Theories: - Inspection: symmetry
Failure of Immune Response - ↓ immune - Palpation: 1st dominant side of breast
system • Upper outer quadrant; movement: clockwise
Cellular derangement 5. TSE - usually left portion is smaller
Cell - same date each month
↓ WHEN: After warm bath
Carcinogens (Killer triad) - Inspection: 2 hands
↓ - Palpation: outer to inner
Abn cells • Watery - ↓ sperm count
(cancerous) 6. Mammogram - annually
• Age: 35 y/o and above
Killer triad - smoking, asbestos, tobacco (2nd hand • History of breast cancer: 30 y/o
smoking) Mx:
a. Painful
NEOPLASM (TUMOR) b. No GIT prer - x NPO
c. Avoid: deodorant, powder
BENIGN MALIGNANT
7. Guaiac (hidden) stool exam - annually
SURVIVAL ↑ ↓ - specimen: stool, presence of blood in stool
• 3 days prior:
PROGNOSIS ↑ ↓ - No RBC-containing foods/Fe - False positive
result
PAIN ✔ X early stage - No to Vit C → False positive result
✔ late stage - No to Vit K → False Negative result
• 2.5 cm/1 inch
CAPSULE ✔, smooth X • Colorectal cancer
• 40 year old
SPREAD Localize, Metastasize
enlarges 8. Digital Rectal Exam - annually
- possible for prostate cancer
• Gloves: clean + lubricant, Px: left side lying
WARNING SIGNS (3 OR MORE S/SX) = CANCER • 40-50 year old above
• Change in bowel and bladder habits 9. Pap smear - annually
- prolonged constipation (6 days) → diarrhea - possible for cervical cancer
- presence blood in stools, ribbon-like stool, goat- - 18 y/o - sexually active
like stool - 50 year old
• A sore that does not heal
- steroids (3 days) x healing = cancer Class I - Normal
• Unusual bleeding or discharge Class II - Inflammation
- epistaxis Class III - Doubtful
- melema (UGI bleeding) Class IV- Probable
- hematochezia (LGI bleeding) Class V - Possible
• Thickening of lump
- steroids (3 days) → biopsy
Tx CELL CYCLE SPECIFIC
1. Radiation Therapy - kills cancer cells
G0
Brachytherapy
Internal G1 DOC: Asparaginase
Teletherapy S/E: Anaphylaxis
External Antidote: Epinephrine
1a. Brachytherapy - pt. is radioactive
Sources: S a. Antimetabolites -
Methotrexate
1. Sealed: implant (imbedded in body)
b. 5FU
2. Unsealed - IV, Oral S/E: Ataxia
Mx
1. Shield - lead apron + dosimeter badge (amount G2 Bleomycin
of radiation that you have received) S/E: Pulmonary Fibrosis
2. Time: 30 mins/shift
• Room: away Mitosis Vinyl Alkaloids, Vincristine
S/E: Peripheral Neuritis
• Task: organize
• Rotational → shifting
3. Distant: 6 ft CELL CYCLE NON SPECIFIC
4. Bedside: lead container + lead forcep Alkylating agents - Cisplatin
5. Other S/E: hearing loss
a. Unsealed: flush 2-3x
Death – Duration of radiation in room: 48-72 hrs Cyclophosphamide Cytoxan
b. Sealed: dislodge S/E: Hematuria
• Seen: lead container + lead forcep
Antitumor antibiotics Doxorubicin
• unseen: call the radiologist, close the door S/E: CHF
- Gyger monitor → detect where the implant
1b. Teletherapy - pt not Radioactive Hormonal Agent Tamoxifen
Cx. S/E: osteoporosis
1. Burn
2. Cover the unaffected area with lead 3. Combination Therapy (RT + CT)
3. Diet: ↑ CHON Primary - kill cancer cell
4. Clothes: loose/nonrestrictive Secondary - kill fast-forming cell + cancer cell
5. Wash: H2O • Bone marrow (RM) - RBC, WBC, Platelets
6. Avoid sunlight exposure a. Anemia - normal: 4-6M
- Rest
2. Chemotherapy - kills cancer cells - O2 therapy
Route: IV, Oral - Blood transfusion: pack RBC
Types: - Apogen - artificial erythropoietin
1. Cell cycle specific - 1 cycle b. Leukopenia - normal: 10,000-15,000
2. Cell cycle non-specific - any cycle except for G0 Risk for infection
Cell Cycle: - Isolate
1. Interphase - cellular enlargement - Hand washing
G0 - resting phase - Wear mask
G1 - ↑ size, DNA synthesis -. Avoid fresh fruits/vegetables
S - ↑ size, RNA synthesis - Prophylactic antibiotics
G2 - pre-mitosis c. Thrombocytopenia = normal: 150,000-400,000
2. Mitosis - cell division - Needle: small
Prophase - Razor: electric
Metaphase - Thermometer: axillary
Anaphase - Non contact sports
Telophase • Stomatitis
- Alkaline solution: H2O + Na
- Ice chips
- Lidocaine
 S/sx
• Nausea & Vomiting a. Mass - unilateral, pea shaped
- Antiemetics b. Feeling of heaviness in testes
- Dry crackers c. Pain (late sign) - groin
• Burns Dx
- ↑ CHON 1. TSE
- Loose clothes 2. UTZ
• Alopecia - (3-6 months) Mx
- emotional support - DOC: Cisplatin
- wig - Surgery: Orchiectomy
8. Infertility/Sterility
IMPOTENT STERILITY
- Egg cell bank
- Counselling Uniteral X X
9. UTI
- ↑ OFI
Bilateral X ✔
DISORDERS:
1. Breast cancer: 99% women, 1% men 3. Cervical cancer
R/F: R/F
a. Hx of estrogen replacement therapy 1. Multiple sexual partners
B. Early menarche 2. Hx of HPV
c. Late menopause 3. Poor perineal hygiene
d. Nullipara - x pregnant S/sx
S/sx Early stage
1. Peau d’ orange “orange peel skin” 1. Thin, watery discharge
2. Discharge - pus 2. Bleeding often after coitus
3. Necrosis Late stage
4. Dimpling 1. Thick discharge
Dx 2. Foul smelling odor
1. BSE 3. Pain - back
2. Mammogram Mx
Mx DOC: Asplatin
1. DOC: Tamoxifen 2. Surgery
2. Surgery a. Conization - cone-shaped
a. Lumpectomy b. Hysterectomy - x uterus
b. Mastectomy - removal of breast c. TAHBSO
c. Partial mastectomy - lump + 2-3 cm of normal
tissue 4. Colorectal
d. Radical mastectomy - breast, lymph node, R/F
pectoralis muscle - Hx of polyp
e. Modified radical mastectomy - breast, lymph - Hx of IBD
node • Crohn’s disease } Severe Diarrhea
Post op: • Ulceration
1. Elevate the arm of the affected side - prevent Diet: ↓ fiber
lymphedema Age: 40 y/o
2. Jackson’s Pratt - hemovac (blood evacuation) - S/Sx
drainage - Change of bowel habit
- N/V • Obstruction in abdominal = N/V
2. Testicular cancer - Abdominal pain - late
- curable Dx
R/F 1. Guaiac stool exam
a. 20-40 y/o 2. Colonoscopy - q10yrs
b. Down syndrome Mx:
c. Caucasian 1. DOC: 5fu - Fluorouracil
2. Surgery: Abdominal resection + colostomy

5. Lung cancer
Prevention - avoid: smoking
Screening - 40 y/o and above
R/F:
Killer Triad
S/sx:
DTB (Fever)
Lung Cancer (No fever)
1 Nagging cough
2 Hemoptysis
3 Weight loss
4 Anorexia
Mx:
DOC: Bleomycin
Surgery:
Lobectomy: Unaffected side
Pneumonectomy: Affected side

6. Hodgkin’s lymphoma - lymph nodes

R/F: OGK
S/sx
- Enlarged lymph node
- Night sweats
- Pruritus
- Fever
- Presence of Reed-sternberg cell - urine
Mx:
1. DOC: Adriamycin S/E: Alopecia, Diarrhea, Red-
orange urine
2. Surgery - Incision

7. Multiple Myeloma - cancer of the bone marrow

and soft tissues
R/F: unknown
S/sx
1. Fracture - brittle bones
2. Bone pain
3. Pancytopenia
4. Hypercalcemia - renal calculi
Mx
1. Ambulate
2. ↑ OFI
3. BT - whole blood