Medical-surgical nursing General Care Plans Cancer Care


The term cancer refers to several disease entities, all of which have in common the proliferation of abnormal cells. To varying degrees, these cells have lost their ability to reproduce in an organized fashion, function normally, and die a natural death (apoptosis). As a result they may develop new functions not characteristic of their site of origin, spread and invade uncontrollably (metastasize), and cause dysfunction and death of other cells.


Lung cancer

Lung cancer is the most common cause of cancer death among men and women in the United States, accounting for about 14% of all cancer diagnoses (American Cancer Society, 2013b). An estimated 159,480 deaths from lung cancer were expected in 2013, accounting for about 27% of all cancer deaths.

Both incidence and death rates from lung cancer began declining for men over the past two decades, but these rates did not start declining for women until the mid-2000s. The primary risk factor for lung cancer is cigarette smoking, and the risk increases with the amount and length of time someone smokes. Cigarette smoking is estimated to be responsible for 85% of all lung cancers.

Despite treatment advances in surgery, chemotherapy, and radiation therapy, the cure rate remains low. Although exposure to known carcinogens such as second-hand smoke, radon, arsenic, asbestos, and air pollution (to name a few) may cause lung cancer, the single most important risk factor for lung cancer is smoking.

Nervous system tumors

These tumors may be primary or secondary tumors of the central nervous system (CNS), which includes the brain and spinal cord. They are classified according to their cell of origin and graded according to their malignant behavior. Although histologically the tumor may be benign, the enclosed nature of the CNS may result in tumor effects causing significant damage or even death. The National Cancer Institute (NCI) estimated 22,910 new cases of primary malignant brain and central nervous system (CNS) tumors would be diagnosed in the United States in 2012. Among children, brain tumors are the most frequent cause of solid tumor cancer–related deaths.

There are relatively few known risk factors for brain and CNS cancers. Patients with exposure to radiation and vinyl chloride and those with certain genetic syndromes may be at higher risk. The primary CNS tumor may be diagnosed because of symptoms related to changes in functions of neurons, spinal cord or brain compression, or symptoms resulting from obstruction of the flow of cerebrospinal fluid. Surgery, radiation, and chemotherapy are commonly used treatments, while biologic therapy and hyperthermia therapy are being explored through clinical trials.

Head and neck cancers

Head and neck cancers include tumors of the tonsils, larynx, pharynx, tongue, and oral cavity. Incidence is greatest in men older than age 50, and incidence rates are double in men compared to women. By far the greatest risk factors are tobacco consumption through smoking or smokeless tobacco and alcohol consumption. However, infection with cancer-causing HPV, especially HPV-16, is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers that involve the tonsils or the base of the tongue. In fact, the incidence of oropharyngeal cancers caused by HPV infection is increasing in the United States, while the incidence of oropharyngeal cancers related to other causes is decreasing.

Breast cancer

With the exception of skin cancer, breast cancer is the most commonly occurring cancer in women, accounting for one in three cancer diagnoses (American Cancer Society, 2013a). Although Caucasian women have higher incidence rates, African American women have higher mortality rates associated with breast cancer (American Cancer Society, 2013a). Most women with breast cancer will have some type of surgery.

Surgery is often combined with other treatments such as radiation therapy, chemotherapy, hormone therapy, and/or targeted therapy. The 5-year relative survival rate is lower among women diagnosed with breast cancer before age 40 (84%) compared to women diagnosed at 40 years of age or older (90%). This may be due to tumors diagnosed in younger women being more aggressive and/or less responsive to treatment.

Last word

Tumors are classified as seminomas and no seminomas, depending on their cellular line of differentiation, with many consisting of a mixed cellular type. No seminomas tend to grow and metastasize more aggressively.

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