#1

1. Review risk factors, screening procedures and warning signs of cancer.

RISK FACTORS
(Lewis pg 293-294) (more from Ill. Study Guide For NCLEX)
Chemical Agents: sun, smoke, dyes, asbestos – alter DNA; most often affect liver, lung, & kidneys
Physical Agents: radiation, sunlight, chronic irritation or infection, tobacco use
Viruses: incorporate into genetic cell structure (oncogenic) Ebstein Barr, AIDS
Genetic & familiar factors: DNA damage occurs in cells where chrom. patterns are abnormal - Wilms’ tumor, acute leukemias, etc
Dietary factors: long term ingestion of fats/oils from animal sources, alcoholic bevs., salt cured/smoked meat and nitrate containing foods (and from lecture… charred meats)
Hormonal Agents: disturbances in the body’s endogenous hormones or administration of exogenous hormones (diethylstilbestrol, prolonged ERT, oral contraceptives)
Idiopathic: arise from unknown causes


SCREENING PROCEDURES

Screening
(National Cancer Institute website)
http://www.cancer.gov/cancerinfo/pdq/screening/overview#Section_2

>Screening is a means of detecting disease early in asymptomatic people.
>Positive results of examinations, tests, or procedures used in screening are usually not diagnostic but identify persons at increased risk for the presence of cancer who warrant further evaluation.
>Diagnosis is confirmation of disease by biopsy or tissue examination in the work-up following positive screening tests. (Following a positive screening result, cancer can often be ruled out by procedures other than biopsy or tissue examination.)

Detection
>Direct or assisted visual observation is the most widely available examination for the detection of cancer. It is useful in identifying suspicious lesions in the skin, retina, lip, mouth, larynx, external genitalia, and cervix.
>The second most available detection procedure is palpation to detect lumps, nodules, or tumors in the breast, mouth, salivary glands, thyroid, subcutaneous tissues, anus, rectum, prostate, testes, ovaries, and uterus and enlarged lymph nodes in the neck, axilla, or groin.
>Internal cancers require procedures and tests such as endoscopy, x-rays, magnetic resonance imaging, or ultrasound. Laboratory tests, such as the Pap smear or the fecal occult blood test have been employed for detection of specific cancers.

See Lewis pg 300 Table 15-7
ACS Recommendations for Early Detection of Cancer in Asymptomatic People


WARNING SIGNS "CAUTION"

Change in bladder or bowel habits
A sore that does not heal
Unusual bleeding or discharge from any body orifice
Thickening or a lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness