Cancer 101

Cancer 101Cancer 101

Monica Schlatter, RN, ND, Monica Schlatter, RN, ND, AOCNPAOCNP

Types of CancerTypes of Cancer AIDS- related malignanciesAIDS- related malignancies

Bone and soft tissue sarcomaBone and soft tissue sarcoma

Bladder and kidney cancerBladder and kidney cancer

Breast cancerBreast cancer

Central nervous system cancersCentral nervous system cancers

Colon and rectal cancerColon and rectal cancer

Endocrine malignanciesEndocrine malignancies

Esophageal, stomach, liver, Esophageal, stomach, liver, gallbladder, and pancreatic gallbladder, and pancreatic cancerscancers

Gynecologic cancerGynecologic cancer

Head and neck malignanciesHead and neck malignancies

LeukemiaLeukemia

Lung cancerLung cancer

Malignant lymphomasMalignant lymphomas

Multiple myelomaMultiple myeloma

Prostate cancerProstate cancer

Skin cancerSkin cancer

Testicular germ cell cancerTesticular germ cell cancer

Types of TreatmentTypes of Treatment ChemotherapyChemotherapy

RadiotherapyRadiotherapy

SurgerySurgery BiotherapyBiotherapy

TransplantationTransplantation

Side Effects of Side Effects of ChemotherapyChemotherapy

Bone Marrow SuppressionBone Marrow Suppression Infection, bleeding, fatigue related to Infection, bleeding, fatigue related to

anemiaanemia FatigueFatigue Gastrointestinal TractGastrointestinal Tract

Nausea/vomiting Nausea/vomiting Diarrhea/constipationDiarrhea/constipation Loss of appetiteLoss of appetite

Side Effects (cont’d)Side Effects (cont’d) HeartHeart

Congestive heart failure (low blood pressure, changes Congestive heart failure (low blood pressure, changes in heart rate)in heart rate)

Brain/nervesBrain/nerves Short term memory lossShort term memory loss Cognitive DysfunctionCognitive Dysfunction Peripheral NeuropathyPeripheral Neuropathy Vision/Hearing effectsVision/Hearing effects DizzinessDizziness

LungsLungs Shortness of breathShortness of breath CoughCough Pain with breathingPain with breathing

Side Effects (cont’d)Side Effects (cont’d)

LiverLiver JaundiceJaundice Unclear thinkingUnclear thinking Pain/Increased abdominal girthPain/Increased abdominal girth

MusculoskeletalMusculoskeletal Sore muscles and jointsSore muscles and joints Fragile bonesFragile bones

Side Effects (cont’d)Side Effects (cont’d) BladderBladder

Bloody urineBloody urine Painful urinationPainful urination

KidneysKidneys Decreased urinationDecreased urination Changes in electrolytes that could affect muscle Changes in electrolytes that could affect muscle

functionfunction HormonesHormones

InfertilityInfertility Symptoms of menopauseSymptoms of menopause Decreased muscle massDecreased muscle mass Difficulty in thermoregulationDifficulty in thermoregulation Decreased libidoDecreased libido

Secondary CancersSecondary Cancers

Side Effects (cont’d)Side Effects (cont’d)

SkinSkin RashRash Increased sensitivityIncreased sensitivity DryDry AlopeciaAlopecia

MouthMouth UlcersUlcers DryDry Poor dentitionPoor dentition

Side Effects of RadiationSide Effects of Radiation

SkinSkin Redness, dryness, desquamationRedness, dryness, desquamation AlopeciaAlopecia

Bone MarrowBone Marrow Possible decrease in white blood cells Possible decrease in white blood cells

and plateletsand platelets GastrointestinalGastrointestinal

MucositisMucositis Dry mouthDry mouth Nausea/vomiting, gastritis, diarrheaNausea/vomiting, gastritis, diarrhea

Side Effects of RadiationSide Effects of Radiation

ReproductiveReproductive InfertilityInfertility Early menopauseEarly menopause

UrinaryUrinary Cystitis, urethritisCystitis, urethritis

CardiovascularCardiovascular Clot formationClot formation PericarditisPericarditis FatigueFatigue

Side Effects of RadiationSide Effects of Radiation

SkeletalSkeletal PainPain Pathological fracturePathological fracture

RespiratoryRespiratory HoarsenessHoarseness PneumonitisPneumonitis

NervousNervous Lhermitte’s SyndromeLhermitte’s Syndrome

Side Effects of Side Effects of BiotherapyBiotherapy

Short term or Infusion- relatedShort term or Infusion- related

Commonly low blood pressure, rash, Commonly low blood pressure, rash, fever/chills, headache, malaise, and sore fever/chills, headache, malaise, and sore jointsjoints

Long termLong term

Increased risk of viral infectionsIncreased risk of viral infections

TransplantationTransplantation

Autologous Hematopoetic Stem Cell Autologous Hematopoetic Stem Cell The use of the patient’s own cells to The use of the patient’s own cells to

“rescue” them following high dose “rescue” them following high dose chemotherapychemotherapy

Used mostly in Multiple myeloma and Used mostly in Multiple myeloma and Lymphomas. Use occasionally in Acute Lymphomas. Use occasionally in Acute Myelogenous LeukemiaMyelogenous Leukemia

All patients require a central lineAll patients require a central line Can be done as an outpatient but many Can be done as an outpatient but many

are admittedare admitted

TransplantationTransplantation

Autologous:Autologous: The patient’s cells are collected then frozenThe patient’s cells are collected then frozen The patient is then given high dose The patient is then given high dose

chemotherapychemotherapy The cells are given about 48 hrs following the The cells are given about 48 hrs following the

chemochemo The cells grow and “engraft” in about 2 The cells grow and “engraft” in about 2

weeksweeks Most patients are discharged back to their Most patients are discharged back to their

oncologists after about a month oncologists after about a month

Side Effects of an Auto Side Effects of an Auto TransplantationTransplantation

The same as those listed for The same as those listed for chemotherapychemotherapy

Bone Marrow HarvestBone Marrow Harvest

TransplantationTransplantation

Allogeneic Hematopoetic Stem CellAllogeneic Hematopoetic Stem Cell The use of someone else’s cells to replace The use of someone else’s cells to replace

the patient’s immune system to generate a the patient’s immune system to generate a “graft versus leukemia/lymphoma” effect“graft versus leukemia/lymphoma” effect

Used mostly in Leukemias and Used mostly in Leukemias and Lymphomas. Used occasionally in Multiple Lymphomas. Used occasionally in Multiple myelomamyeloma

All patients have a central lineAll patients have a central line Most patients are inpatient for up to a Most patients are inpatient for up to a

month with no complicationsmonth with no complications

TransplantationTransplantation

Allogeneic:Allogeneic: The patient is given their “conditioning” The patient is given their “conditioning”

regimen (chemotherapy or chemo with regimen (chemotherapy or chemo with total body irradiation)total body irradiation)

The patient’s donor is then collected a The patient’s donor is then collected a day or two before the cells are to be givenday or two before the cells are to be given

Donor can be the patient’s sibling, or on Donor can be the patient’s sibling, or on occasion, parent, an unknown donor from occasion, parent, an unknown donor from the NMDP (National Marrow Donor the NMDP (National Marrow Donor Program), or a cord blood Program), or a cord blood

Cord Blood Stem CellsCord Blood Stem Cells

Side Effects of an Allo Side Effects of an Allo TransplantationTransplantation

The same as those listed for chemotherapy. The same as those listed for chemotherapy. TBI (total body irradiation) usually causes TBI (total body irradiation) usually causes

nausea/vomiting, mouth sores, diarrhea, nausea/vomiting, mouth sores, diarrhea, fatigue, and alopeciafatigue, and alopecia

Graft vs. Host DiseaseGraft vs. Host Disease Syndrome where the donor cells “attack” the Syndrome where the donor cells “attack” the

host.host. Manifested as a rash, nausea, vomiting, diarrhea, Manifested as a rash, nausea, vomiting, diarrhea,

abdominal cramps, and/or loss of appetiteabdominal cramps, and/or loss of appetite Can affect the eyes, mouth, lungs, liver, kidneys, Can affect the eyes, mouth, lungs, liver, kidneys,

and musclesand muscles