Textbook of Medical-Surgical Nursing 3e

Chapter 11

Oncology: Nursing management in cancer care

K E Y T E R M S

L E A R N I N G O B J E C T I V E S

Cancer is not a single disease with a single cause; rather, it is a group of distinct diseases with different causes, manifes- tations, treatments and prognoses. Cancer nursing practice covers all age groups and nursing specialties and is carried out in a variety of healthcare settings, including the home, the community, acute care institutions and rehabilitation centres. The scope, responsibilities and goals of cancer nursing, also called oncology nursing, are as diverse and complex as those of any nursing specialty. Nurses need to identify their own reactions to cancer and set realistic goals to meet the chal- lenges inherent in caring for patients with cancer because many people associate cancer with pain and death. In addition, the cancer nurse must be prepared to support the patient and chemotherapy, targeted therapy, haemopoetical stem cell transplantation and other therapies in treating cancer  7 Describe the special nursing needs of patients receiving chemotherapy  8 Describe the nursing care of patients with cancer using the nursing process  9 Identify potential complications for the patient with cancer and discuss associated nursing care 10 Describe the concept of palliative care in providing care for patients with advanced cancer 11 Discuss the role of the nurse in the assessment and management of common oncological emergencies. On completion of this chapter, you should be able to:  1 Compare the structure and function of the normal cell and the cancer cell  2 Differentiate between benign and malignant tumours  3 Identify agents and factors that have been found to be carcinogenic  4 Describe the significance of health education and preventive care in decreasing the incidence of cancer  5 Differentiate between the purposes of surgical procedures used in cancer treatment, diagnosis, prophylaxis, palliation and reconstruction  6 Describe the roles of surgery, radiation therapy,

hyperplasia malignant metaplasia metastasis myelosuppression nadir neoplasia neutropenia oncology palliation radiation therapy staging stomatitis

alopecia anaplasia apoptosis benign biological response modifier (BRM) therapy biopsy brachytherapy cancer

carcinogenesis chemotherapy control cure

targeted therapies thrombocytopenia tumour-specific antigen (TSA) vesicant xerostomia

cytokines dysplasia extravasation grading graft-versus-host disease (GVHD)

family through a wide range of physical, emotional, social, cultural and spiritual crises. Epidemiology of cancer Although cancer affects people of all ages, most cancers occur in people older than 65 years of age. Overall, the incidence of cancer is higher in men than in women and higher in industrialised sectors and nations. Cancer remains the leading cause of death in Australia accounting for 28% of all deaths. In 2005 there were 100,514 new cases diagnosed, the first time this figure has reached six figures. The estimated five most common cancers diagnosed in Australia in 2012 were prostate

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