ADULT HEALTH THEORY III EXAM 2
Cancer
Defect in cell proliferation – more cells than normal.
Defect in differentiation of more immature cells.
Malignant usually comes back.
Malignant tumors invade adjacent tissues and spread → benign tumors do NOT
metastasize Benign tumors do not usually recur
Risk factors
1. Older age #1
2. Genetics
3. Smoking
4. Sun exposure/tanning beds
5. Diet high in fat/red meat
6. Low in fiber
Diagnostic
1. Biopsy (most reliable)
2. MRI
3. CT
4. PET scan
5. Ultrasound
Preventatives:
1. SPF of at least 15, exercise, rest, no stress
2. Avoid smoking, drinking, self-tanning, sun exposure.
3. Healthy diet: whole grains, fruits, veggies, fiber.
4. Regular physical exams, self-examination.
Warning Signs of Cancer
“CAUTION”
C – change in bowel or bladder habits
A – any sore that does not heal
U – unusual bleeding or discharge
T – thickening or lump in breast or elsewhere
I – indigestion
O – obvious change in wart or mole
N – nagging cough or hoarseness
NEED REGULAR SCREENING
REMOVAL OF AT RISK TISSUES
Screening
Colonoscopy → start 50yr, every 10 years.
, o IF you are at risk for it, start early.
Mammograms → start age 40 and every year after that.
Digital rectal exam >55 q1 year + PSA age >70 q2 years.
Pap Smears → start at ages 21-29 and every 3 years
o Age 30-65 every 5 years unless abnormal then every 6 months.
Pelvic exams → age 50, q1 year for cervical cancer
Breast & Testicular exam → age 15-50
o FIRST MENSTRUATION
o FOR BOYS WHEN VOICE CHANGES.
Clinical breast exam → q3 years starting at 20-39 or q1 year >40
Benign vs Malignant
Benign → Encapsulated, no metastasis, no recurrence, slight vascularity, growth mode:
expansive, cells fairly normal, localized.
Malignant → Metastasis, recurring, moderate to mild vascularity, growth is infiltrated or
expansive, abnormal cells, large and fast growing.
Grading
1. Grade I – cells differ slightly from normal cells and are well differentiated (mild
dysplasia). 2. Grade II – cells are more abnormal and are moderately differentiated
(moderate dysplasia) 3. Grade III – Cells are very abnormal and poorly differentiated
(severe dysplasia) 4. Grade IV – Immature cells (anaplasia) undifferentiated; cell of
origin is difficult to determine. 5. Grade V – Not assessable (worst) cells cannot be
assessed.
Staging
Stage 0 – carcinoma in SITU
Stage 1 – tumor limited to tissue of origin, localized tumor growth
Stage 2 – limited local spread
Stage 3 – extensive local and regional spread
Stage 4 – Distant metastasis
Skin Cancer
If you have a mole with asymmetry, changing colors, diameter of >6mm, change in
appearance, it starts bleeding out of nowhere
Melanoma → deadliest form of skin cancer. Involving moles. Highly
metastatic. A – Asymmetry
B – Border irregularity
C – Color variation- mix of colors
D – Diameter. Anything over 6mm
E – Evolving, changing in size shape and color
Tissue biopsy is required to diagnose skin cancer.
AVOID SUN EXPOSURE (outdoor occupation, frequent sunburns) AND TANNING
BEDS!!! SPF with strength of at least 30, 15 minutes before going in the sun.
, Cervical Cancer
HPV #1 tested cause. Even with condoms, HPV can be spread. NEED PAP SMEAR for
women at 21, then every 3 years. Usually localized to pelvis metastasis.
Risk factors → Multiple sex partners (guys are carriers), smoking, sexual activity before 18,
long term oral contraceptives, smoking, history of STDs
S/S → bloating, urinary frequency, increased abd. Girth, vaginal bleeding, smelly vaginal
discharge, pelvic/lower back/groin pain, urine/feces leaking from vagina
Interventions → laser therapy (visible lesion boundaries), cryosurgery (freeze impacted
tissue off), conization (cone-shaped area of cervix removed, women retain reproductive
capacity, long term care needed)
Hysterectomy
For microinvasive cancers, usually a vaginal approach. Radical hysterectomy if cancer
spreads beyond the cervix but not the pelvic wall.
Post-Op → ROM early ambulation, no sex 3-6 weeks, monitor vaginal bleeding (>1-soaked
pad/hour call HCP) compression socks, I’s/O’s, bowel sounds, limit stair climbing for a month,
no baths, no sitting for long times, no lifting
Pelvic Exenteration
Removal of all pelvic contents (bowel, vagina, bladder) for recurrent cancer with no cancer
outside of pelvis and no lymph nodes impacted.
NO SEXUAL INTERCOURSE AFTER ANTERIOR/TOTAL EXENTERNATION!!!!
Colorectal Cancer
3rd most common. High greasy fat food diet, alcohol use, obesity, smoking.
DIVERTICULITIS. Risk factors – IBD, DIVERTICULITIS, family history, inactivity, alcohol,
smoking S/S – Bloody stool with history of Diverticulitis, change in bowels, abd pain,
bloating, losing weight.
Screening – fecal occult test. If positive, need a biopsy. Bowel cleansing for colonoscopy.
Liquid diet 24-48 hours before + 4L MiraLAX.
Leukemia vs Lymphoma
Cancer
Defect in cell proliferation – more cells than normal.
Defect in differentiation of more immature cells.
Malignant usually comes back.
Malignant tumors invade adjacent tissues and spread → benign tumors do NOT
metastasize Benign tumors do not usually recur
Risk factors
1. Older age #1
2. Genetics
3. Smoking
4. Sun exposure/tanning beds
5. Diet high in fat/red meat
6. Low in fiber
Diagnostic
1. Biopsy (most reliable)
2. MRI
3. CT
4. PET scan
5. Ultrasound
Preventatives:
1. SPF of at least 15, exercise, rest, no stress
2. Avoid smoking, drinking, self-tanning, sun exposure.
3. Healthy diet: whole grains, fruits, veggies, fiber.
4. Regular physical exams, self-examination.
Warning Signs of Cancer
“CAUTION”
C – change in bowel or bladder habits
A – any sore that does not heal
U – unusual bleeding or discharge
T – thickening or lump in breast or elsewhere
I – indigestion
O – obvious change in wart or mole
N – nagging cough or hoarseness
NEED REGULAR SCREENING
REMOVAL OF AT RISK TISSUES
Screening
Colonoscopy → start 50yr, every 10 years.
, o IF you are at risk for it, start early.
Mammograms → start age 40 and every year after that.
Digital rectal exam >55 q1 year + PSA age >70 q2 years.
Pap Smears → start at ages 21-29 and every 3 years
o Age 30-65 every 5 years unless abnormal then every 6 months.
Pelvic exams → age 50, q1 year for cervical cancer
Breast & Testicular exam → age 15-50
o FIRST MENSTRUATION
o FOR BOYS WHEN VOICE CHANGES.
Clinical breast exam → q3 years starting at 20-39 or q1 year >40
Benign vs Malignant
Benign → Encapsulated, no metastasis, no recurrence, slight vascularity, growth mode:
expansive, cells fairly normal, localized.
Malignant → Metastasis, recurring, moderate to mild vascularity, growth is infiltrated or
expansive, abnormal cells, large and fast growing.
Grading
1. Grade I – cells differ slightly from normal cells and are well differentiated (mild
dysplasia). 2. Grade II – cells are more abnormal and are moderately differentiated
(moderate dysplasia) 3. Grade III – Cells are very abnormal and poorly differentiated
(severe dysplasia) 4. Grade IV – Immature cells (anaplasia) undifferentiated; cell of
origin is difficult to determine. 5. Grade V – Not assessable (worst) cells cannot be
assessed.
Staging
Stage 0 – carcinoma in SITU
Stage 1 – tumor limited to tissue of origin, localized tumor growth
Stage 2 – limited local spread
Stage 3 – extensive local and regional spread
Stage 4 – Distant metastasis
Skin Cancer
If you have a mole with asymmetry, changing colors, diameter of >6mm, change in
appearance, it starts bleeding out of nowhere
Melanoma → deadliest form of skin cancer. Involving moles. Highly
metastatic. A – Asymmetry
B – Border irregularity
C – Color variation- mix of colors
D – Diameter. Anything over 6mm
E – Evolving, changing in size shape and color
Tissue biopsy is required to diagnose skin cancer.
AVOID SUN EXPOSURE (outdoor occupation, frequent sunburns) AND TANNING
BEDS!!! SPF with strength of at least 30, 15 minutes before going in the sun.
, Cervical Cancer
HPV #1 tested cause. Even with condoms, HPV can be spread. NEED PAP SMEAR for
women at 21, then every 3 years. Usually localized to pelvis metastasis.
Risk factors → Multiple sex partners (guys are carriers), smoking, sexual activity before 18,
long term oral contraceptives, smoking, history of STDs
S/S → bloating, urinary frequency, increased abd. Girth, vaginal bleeding, smelly vaginal
discharge, pelvic/lower back/groin pain, urine/feces leaking from vagina
Interventions → laser therapy (visible lesion boundaries), cryosurgery (freeze impacted
tissue off), conization (cone-shaped area of cervix removed, women retain reproductive
capacity, long term care needed)
Hysterectomy
For microinvasive cancers, usually a vaginal approach. Radical hysterectomy if cancer
spreads beyond the cervix but not the pelvic wall.
Post-Op → ROM early ambulation, no sex 3-6 weeks, monitor vaginal bleeding (>1-soaked
pad/hour call HCP) compression socks, I’s/O’s, bowel sounds, limit stair climbing for a month,
no baths, no sitting for long times, no lifting
Pelvic Exenteration
Removal of all pelvic contents (bowel, vagina, bladder) for recurrent cancer with no cancer
outside of pelvis and no lymph nodes impacted.
NO SEXUAL INTERCOURSE AFTER ANTERIOR/TOTAL EXENTERNATION!!!!
Colorectal Cancer
3rd most common. High greasy fat food diet, alcohol use, obesity, smoking.
DIVERTICULITIS. Risk factors – IBD, DIVERTICULITIS, family history, inactivity, alcohol,
smoking S/S – Bloody stool with history of Diverticulitis, change in bowels, abd pain,
bloating, losing weight.
Screening – fecal occult test. If positive, need a biopsy. Bowel cleansing for colonoscopy.
Liquid diet 24-48 hours before + 4L MiraLAX.
Leukemia vs Lymphoma
