Cancer Nursing: Principles And Practice

TITLE......Page 4
COPYRIGHT......Page 5
CONTENTS......Page 6
PREFACE......Page 36
THE EDITORS......Page 37
CONTRIBUTORS......Page 38
PART I: THE CANCER PROBLEM......Page 44
CHAPTER 1 BIOLOGY OF CANCER......Page 46
RESEARCH MODELS OF TUMOR DEVELOPMENT......Page 47
PROPERTIES OF CANCER AND TRANSFORMED CELLS......Page 50
MUTATIONS......Page 51
MECHANISMS TO REPAIR DNA DAMAGE......Page 52
ONCOGENES......Page 53
TUMOR SUPPRESSOR GENES......Page 55
THE CELL CYCLE......Page 56
EVENTS OF THE CELL CYCLE......Page 57
CHARACTERISTICS OF CELLS UNDERGOING APOPTOSIS......Page 58
METASTASIS......Page 59
FACTORS CONTRIBUTING TO METASTASIS......Page 60
THE METASTATIC CASCADE......Page 62
CONCLUSION......Page 63
REFERENCES......Page 64
CHAPTER 2 IMMUNOLOGY......Page 66
CELLS OF THE IMMUNE SYSTEM......Page 67
SOLUBLE MEDIATORS OF IMMUNE RESPONSE......Page 70
MECHANISMS OF ADAPTIVE IMMUNITY......Page 71
HUMORAL IMMUNE RESPONSE......Page 73
CELL-MEDIATED IMMUNE RESPONSE......Page 74
CELL-MEDIATED CYTOTOXICITY......Page 75
AGING......Page 76
IMPLICATION FOR NURSING PRACTICE......Page 77
REFERENCES......Page 78
CHAPTER 3 EPIDEMIOLOGY......Page 80
STUDY DESIGNS......Page 81
DEFINING THE POPULATION......Page 87
TOBACCO......Page 88
DIET......Page 89
VIRUSES AND OTHER BIOLOGICAL AGENTS......Page 93
RADIATION......Page 94
DRUGS......Page 95
SEX......Page 97
ETHNICITY AND RACE......Page 98
SOCIOECONOMIC FACTORS......Page 99
NOCTURNAL LIGHT EXPOSURE,......Page 101
BIOBEHAVIORAL FACTORS AND STRESS......Page 102
REFERENCES......Page 104
PART II: PREVENTION, DETECTION, AND DIAGNOSIS......Page 112
CHAPTER 4 CULTURAL DIVERSITY AMONG INDIVIDUALS WITH CANCER......Page 114
EPIDEMIOLOGY......Page 115
ETHNICITY AND CANCER......Page 117
AFRICAN AMERICANS......Page 118
ASIAN AND PACIFIC ISLANDERS......Page 120
HISPANICS......Page 123
AMERICAN INDIANS/ALASKAN NATIVES......Page 126
CANCER, POVERTY, AND ETHNICITY......Page 130
CULTURALLY APPROPRIATE PUBLIC/PATIENT DUCATION......Page 131
CLINICAL TRIALS AND CANCER RESEARCH......Page 132
CONCLUSION......Page 134
REFERENCES......Page 135
CHAPTER 5 DYNAMICS OF CANCER PREVENTION......Page 138
LIFESTYLE INTERVENTIONS......Page 139
MEDICAL INTERVENTIONS......Page 143
TOBACCO......Page 151
CANCER PREVENTION CHALLENGES......Page 152
NURSING IMPLICATIONS......Page 153
REFERENCES......Page 154
CHAPTER 6 SCREENING AND DETECTION FOR ASYMPTOMATIC INDIVIDUALS......Page 158
DEFINITIONS......Page 159
FAMILY HISTORY......Page 160
PAST MEDICAL HISTORY/LIFESTYLE FACTORS......Page 161
ABSOLUTE RISK......Page 162
EXPLANATION OF RISK WITH CLINICAL MODELS......Page 163
PRINCIPLES OF CANCER RISK COMMUNICATION......Page 164
ORAL COMMUNICATION OF RISK......Page 165
DOCUMENTATION OF RISK ASSESSMENT......Page 166
NEGATIVE PREDICTIVE VALUE......Page 167
IMPLEMENTING CANCER SCREENING......Page 168
DEVELOPMENT OF SCREENING GUIDELINES......Page 170
FOLLOW-UP......Page 171
ADMINISTRATIVE CONSIDERATIONS......Page 172
PRACTICE CONSIDERATIONS......Page 173
INTERACTIONS WITH THE MEDIA......Page 174
CONCLUSION......Page 175
REFERENCES......Page 176
CHAPTER 7 GENETIC RISK AND HEREDITARY CANCER SYNDROMES......Page 178
VOCABULARY OF HEREDITARY CANCER SYNDROMES FOR ONCOLOGY NURSES......Page 179
IDENTIFYING HIGH-RISK INDIVIDUALS AND FAMILIES......Page 180
ETHICAL, LEGAL, AND SOCIAL IMPLICATIONS OF PREDISPOSITION GENETIC TESTING FOR HEREDITARY CANCER SYNDROMES......Page 182
ETHICAL PRINCIPLES......Page 183
GENETIC INFORMATION NONDISCRIMINATION ACT OF 2008......Page 186
IDENTIFYING THE OPTIMAL FAMILY MEMBER TO TEST AND INTERPRETATION OF TEST RESULTS......Page 187
HEREDITARY BREAST AND OVARIAN CANCER SYNDROMES......Page 188
IDENTIFYING INDIVIDUALS AT HIGH RISK OF HBOC......Page 190
BREAST CANCER RISK: GAIL MODEL AND CLAUS MODEL......Page 191
HORMONAL PREVENTION OF BRCA1/2 BREAST CANCER......Page 192
CHEMOPREVENTION OF OVARIAN CANCER......Page 193
LYNCH SYNDROME......Page 194
FAMILIAL ADENOMATOUS POLYPOSIS......Page 196
COWDEN SYNDROME......Page 200
FUTURE DIRECTION OF NURSING PRACTICE AND RESEARCH......Page 201
REFERENCES......Page 202
APPENDIX 7-1: CANCER GENETICS RESOURCES: AN ORGANIZATIONAL GUIDE......Page 207
CHAPTER 8 DIAGNOSTIC EVALUATION, CLASSIFICATION, AND STAGING......Page 209
THE DIAGNOSTIC APPROACH......Page 210
TUMOR MARKERS......Page 212
ANALYTICAL TECHNIQUES......Page 213
GENETIC TESTING......Page 215
TUMOR IMAGING......Page 216
INVASIVE DIAGNOSTIC TECHNIQUES......Page 227
BASIC TERMINOLOGY......Page 230
TUMOR CLASSIFICATION SYSTEM......Page 231
STAGING THE EXTENT OF THE DISEASE......Page 232
GRADING......Page 234
FUTURE TRENDS......Page 236
REFERENCES......Page 237
PART III: TREATMENT......Page 242
CHAPTER 9 QUALITY OF LIFE AS AN OUTCOME OF CANCER CARE......Page 244
USING QUALITY OF LIFE INFORMATION IN CANCER CARE......Page 245
TREATMENT vs SUPPORTIVE CARE ONLY......Page 246
USING QUALITY OF LIFE QUESTIONNAIRES IN CLINICAL PRACTICE......Page 247
CONCEPTUAL MODEL OF QUALITY OF LIFE?......Page 248
SCOPE OF QUALITY OF LIFE FOR RESEARCH AND CLINICAL PRACTICE......Page 249
CHOOSING INSTRUMENTS TO MEASURE QUALITY OF LIFE......Page 251
STATUS AND EVALUATION QUESTIONS......Page 252
CLINICAL SIGNIFICANCE......Page 253
DATA COLLECTION IN REAL TIME......Page 254
COGNITIVE IMPAIRMENT......Page 255
END OF LIFE......Page 256
FAMILY CAREGIVERS......Page 257
REFERENCES......Page 258
CHAPTER 10 PRINCIPLES OF CANCER CLINICAL TRIALS......Page 262
TYPES OF CLINICAL TRIALS......Page 263
PHASES OF CLINICAL TRIALS......Page 264
RESEARCH TEAM MEMBERS......Page 266
SPECIAL EXCEPTION (COMPASSIONATE USE/COMPASSIONATE EXCEPTION)......Page 267
INFORMED CONSENT......Page 268
FEDERAL OVERSIGHT AGENCIES......Page 269
NCI CANCER CENTERS PROGRAM......Page 270
EVALUATING A CLINICAL TRIAL......Page 271
FUTURE TRENDS......Page 272
REFERENCES......Page 273
CHAPTER 11 SURGICAL THERAPY......Page 275
INTRODUCTION......Page 276
DIAGNOSIS......Page 277
STAGING OF DISEASE......Page 278
RESECTION FOR CURE......Page 279
RECONSTRUCTION......Page 280
SURGERY AS ANCILLARY INTERVENTION......Page 281
ENVIRONMENTAL FACTORS......Page 282
LONG-TERM OUTCOMES......Page 283
POSTOPERATIVE TEACHING AND COUNSELING......Page 284
TRENDS IN SURGICAL ONCOLOGY......Page 285
SENTINEL NODE BIOPSY AND MAPPING......Page 286
ONCOLOGIC EMERGENCIES......Page 287
NUTRITIONAL SUPPORT......Page 288
REFERENCES......Page 289
CHAPTER 12 PRINCIPLES OF RADIATION THERAPY......Page 292
HISTORY OF RADIATION THERAPY......Page 293
APPLIED RADIATION PHYSICS......Page 294
NEUTRON-BEAM THERAPY......Page 296
NEGATIVE PI-MESON THERAPY......Page 297
CELLULAR RESPONSE TO RADIATION......Page 298
HIGH-DOSE-RATE BRACHYTHERAPY......Page 301
RADIOSENSITIZERS AND RADIOPROTECTORS......Page 302
COMBINED MODALITY THERAPY......Page 304
HYPERTHERMIA......Page 305
CHRONIC LOW-DOSE EXPOSURE......Page 306
TOTAL-BODY RADIATION SYNDROME......Page 307
RADIATION-INDUCED MALIGNANCIES......Page 308
REFERENCES......Page 309
CHAPTER 13 RADIATION TREATMENT PLANNING......Page 312
OVERVIEW......Page 313
TREATMENT SIMULATORS......Page 314
RESPIRATORY GATING......Page 317
ELECTRONIC PORTAL IMAGING......Page 318
IMAGING FOR TARGET DEFINITION......Page 319
METHODS OF TREATMENT DELIVERY......Page 322
PRINCIPLES OF EXTERNAL BEAM RADIATION DOSING/DOSIMETRY......Page 329
DOSE DELIVERY OF RADIATION......Page 331
TISSUE COMPENSATION......Page 332
IMMOBILIZATION DEVICES......Page 333
POSITIONING DEVICES......Page 335
LINEAR ACCELERATOR......Page 336
MACHINE DESIGN......Page 337
PROTON THERAPY......Page 338
STEREOTACTIC RADIOSURGERY......Page 339
IMAGE-GUIDED CYBERKNIFE RADIOSURGERY......Page 340
BRACHYTHERAPY......Page 342
PARTIAL BREAST IRRADIATION......Page 344
HYPOFRACTIONATED WHOLE BREAST IRRADIATION......Page 347
HIGH-INTENSITY FOCUSED ULTRASOUND......Page 348
SELECTIVE INTERNAL RADIATION THERAPY......Page 350
CONCLUSION......Page 351
REFERENCES......Page 352
CHAPTER 14 RADIATION THERAPY: TOXICITIES AND MANAGEMENT......Page 355
RADIOBIOLOGY......Page 356
TISSUE AND ORGAN RESPONSE TO RADIATION......Page 358
ACUTE EFFECTS......Page 359
ROLE OF THE RADIATION THERAPY NURSE......Page 360
SKIN REACTION (RADIODERMATITIS)......Page 361
FATIGUE......Page 366
WEIGHT LOSS......Page 368
MYELOSUPPRESSION......Page 369
ACUTE RADIATION TOXICITIES AND MANAGEMENT: SITE SPECIFIC......Page 370
BRAIN......Page 371
HEAD AND NECK......Page 373
CHEST AND LUNG......Page 378
ABDOMEN AND PELVIS......Page 379
EXTREMITY......Page 381
LATE EFFECTS OF RADIATION: SITE SPECIFIC......Page 382
CENTRAL NERVOUS SYSTEM......Page 383
HEAD AND NECK......Page 386
HEART......Page 387
ABDOMEN AND PELVIS......Page 388
REPRODUCTIVE SYSTEM......Page 389
SECONDARY MALIGNANCIES......Page 390
CONCLUSION......Page 391
REFERENCES......Page 392
CHAPTER 15 CYTOTOXIC CHEMOTHERAPY: PRINCIPLES OF THERAPY......Page 395
HISTORICAL PERSPECTIVE......Page 396
CLINICAL TRIALS......Page 397
TUMOR CELL KINETICS......Page 398
THE EFFECTS OF CYTOTOXIC CHEMOTHERAPY ON TUMOR CELLS......Page 399
CYTOTOXIC DRUG-SELECTION CRITERIA......Page 400
THEORETICAL BASIS FOR CYTOTOXIC DRUG RESISTANCE......Page 402
TYPES OF DRUG RESISTANCE......Page 403
TUMOR CELL DEATH AND CYTOTOXIC DRUG RESISTANCE......Page 405
THERAPEUTIC STRATEGIES......Page 406
PHARMACOLOGY OF CHEMOTHERAPEUTIC DRUGS......Page 409
PHARMACOKINETICS OF ANTINEOPLASTIC DRUGS......Page 410
DRUG INTERACTIONS IN THE PATIENT RECEIVING CHEMOTHERAPY......Page 413
ANTINEOPLASTIC DRUGS......Page 416
HORMONAL THERAPY......Page 426
REFERENCES......Page 428
CHAPTER 16 CHEMOTHERAPY: PRINCIPLES OF ADMINISTRATION......Page 433
PROFESSIONAL QUALIFICATIONS......Page 434
HANDLING HAZARDOUS DRUGS......Page 435
PATIENT AND FAMILY EDUCATION......Page 438
SAFE PRACTICE CONSIDERATIONS......Page 439
PRE-CHEMOTHERAPY PATIENT ASSESSMENT......Page 442
DOSE CALCULATION......Page 443
ROUTES OF ADMINISTRATION......Page 444
VASCULAR ACCESS DEVICES......Page 460
GENERAL MANAGEMENT......Page 462
COMPLICATION MANAGEMENT......Page 466
CONCLUSION......Page 469
REFERENCES......Page 471
APPENDIX 16A: ORAL CHEMOTHERAPY AND HORMONAL AGENTS......Page 474
APPENDIX 16B: INTRAVENOUS CHEMOTHERAPY AGENTS......Page 478
CHAPTER 17 CHEMOTHERAPY TOXICITIES AND MANAGEMENT......Page 501
PRETREATMENT EVALUATION: RISK ANALYSIS......Page 502
SELF-CARE......Page 503
GRADING OF TOXICITIES......Page 504
SYSTEMIC TOXICITIES......Page 508
ORGAN TOXICITIES......Page 530
REFERENCES......Page 543
CHAPTER 18 PRINCIPLES AND TECHNIQUES OF BLOOD AND MARROW TRANSPLANTATION......Page 547
HEMATOPOIESIS AND TRANSPLANT IMMUNOLOGY......Page 548
AUTOLOGOUS TRANSPLANTATION......Page 549
SOURCES OF STEM CELLS......Page 550
PATIENT EVALUATION......Page 551
TRANSPLANT COURSE......Page 552
SITE OF CARE DELIVERY......Page 553
REFERENCES......Page 554
CHAPTER 19 COMPLICATIONS OF HEMATOPOIETIC CELL TRANSPLANTATION......Page 556
PROPHYLAXIS OF INFECTIONS......Page 557
VENO-OCCLUSIVE DISEASE/SINUSOIDAL OBSTRUCTION SYNDROME......Page 558
BLOOD PRODUCT SUPPORT......Page 559
ACUTE GRAFT-vs-HOST DISEASE......Page 560
GASTROINTESTINAL COMPLICATIONS......Page 562
NEUROLOGICAL COMPLICATIONS......Page 563
CARDIAC COMPLICATIONS......Page 564
CHRONIC GRAFT-vs-HOST DISEASE......Page 565
OPHTHALMOLOGICAL COMPLICATIONS......Page 566
ENDOCRINE COMPLICATIONS......Page 567
SECONDARY GRAFT FAILURE......Page 568
REFERENCES......Page 569
CHAPTER 20 BIOTHERAPY......Page 573
INNATE IMMUNITY......Page 574
ADAPTIVE IMMUNITY......Page 575
INTERLEUKIN 2......Page 576
INDICATIONS FOR THE USE OF IL-2......Page 577
METHODS OF ADMINISTRATION......Page 578
IL-2 SYSTEMIC SIDE EFFECTS: NURSING AND MEDICAL MANAGEMENT......Page 579
THE INTERFERONS......Page 585
INTERFERON-α: INDICATIONS FOR USE......Page 586
INTERFERON-α: SIDE EFFECTS AND MEDICAL AND NURSING MANAGEMENT......Page 588
IMIQUIMOD......Page 591
IMMUNOADJUVANTS......Page 592
CANCER VACCINE STRATEGIES......Page 593
CURRENT STATUS/FUTURE DIRECTIONS......Page 594
ADOPTIVE CELLULAR TRANSFER THERAPY......Page 598
REFERENCES......Page 599
CHAPTER 21 TARGETED THERAPY......Page 604
RECEPTOR KINASE PATHWAYS......Page 605
HUMAN EPIDERMAL RECEPTORS......Page 606
MITOGEN-ACTIVATED PROTEIN KINASE......Page 609
MONOCLONAL ANTIBODIES......Page 610
ANTI-EGFR MONOCLONAL ANTIBODIES......Page 611
ANTI-EGFR TKI......Page 612
MULTITARGETED TKI......Page 613
DERMATOLOGIC......Page 614
INFUSION REACTIONS......Page 617
OCULAR TOXICITIES......Page 618
PULMONARY INTERSTITIAL LUNG DISEASE......Page 619
CARDIAC TOXICITIES......Page 620
DIARRHEA......Page 621
DOSE MODIFICATIONS......Page 622
REFERENCES......Page 623
CHAPTER 22 GENE THERAPY......Page 627
GENE THERAPY DEFINED......Page 628
GENE TRANSFER METHODS......Page 629
ADENOVIRAL VECTORS......Page 630
THE SEVERE COMBINED IMMUNODEFICIENCY DISEASE PROTOCOL......Page 632
CANCER GENE THERAPY......Page 633
ASSESSING CLINICAL BENEFITS......Page 636
SAFETY ISSUES......Page 637
EMERGING ETHICAL ISSUES IN GENE THERAPY......Page 638
PROVIDER OF GENETIC SERVICES......Page 639
CONCLUSION......Page 640
REFERENCES......Page 641
CHAPTER 23 HEMATOPOIETIC THERAPY......Page 643
HEMATOPOIESIS......Page 644
TRANSFUSION THERAPY......Page 651
RED BLOOD CELL THERAPY......Page 652
PLATELET THERAPY......Page 658
PLASMA THERAPY......Page 659
TRANSFUSION REACTIONS AND COMPLICATIONS......Page 661
REFERENCES......Page 665
CHAPTER 24 COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES IN INTEGRATIVE ONCOLOGY......Page 669
HISTORICAL PERSPECTIVE......Page 670
CAM UTILIZATION......Page 672
FDA: REGULATION OF DIETARY SUPPLEMENTS AND DEVICES......Page 673
THE ROLE OF EVIDENCE IN CLINICAL PRACTICE......Page 674
INTEGRATIVE ONCOLOGY: EFFICACY AND SAFETY OF COMMONLY USED MODALITIES......Page 678
PROGRAMS FOR HEALTHCARE PROFESSIONALS......Page 687
LOCATING RELIABLE INFORMATION......Page 688
METHODOLOGICAL CHALLENGES......Page 690
ROLE OF ONCOLOGY NURSING......Page 692
REFERENCES......Page 694
PART IV: CANCER SYMPTOM MANAGEMENT......Page 698
CHAPTER 25 EVIDENCE-BASED ONCOLOGY NURSING......Page 700
A FRAMEWORK: IMPLEMENTATION OF EVIDENCE-BASED PRACTICE......Page 701
OBTAINING EVIDENCE......Page 702
EVALUATING THE EVIDENCE AND DETERMINING CLINICAL RECOMMENDATIONS......Page 705
EVALUATING THE CONTEXT WHERE A CHANGE IS BEING CONTEMPLATED......Page 706
REFERENCES......Page 708
CHAPTER 26 CANCER-RELATED DISTRESS......Page 710
HISTORICAL PERSPECTIVE......Page 711
BARRIERS TO IDENTIFICATION AND TREATMENT......Page 712
CLINICIAN BARRIERS......Page 713
GERIATRIC PATIENTS WITH CANCER......Page 714
SUCCESSFUL ADAPTATION......Page 715
MILD DISTRESS......Page 716
MODERATE DISTRESS......Page 717
SEVERE DISTRESS......Page 718
THERAPEUTIC APPROACHES AND NURSING CARE......Page 720
COGNITIVE-BEHAVIORAL STRATEGIES......Page 721
CONCLUSION......Page 722
REFERENCES......Page 723
CHAPTER 27 CANCER PAIN MANAGEMENT......Page 728
NOCICEPTIVE PAIN......Page 729
BREAKTHROUGH PAIN......Page 730
ASSESSMENT TOOLS......Page 732
FREQUENCY OF PAIN ASSESSMENT......Page 734
PHARMACOLOGICAL MANAGEMENT OF PAIN......Page 735
OPIOID ANALGESICS......Page 736
OPIOID ANTAGONISTS......Page 739
ROUTES OF OPIOID ADMINISTRATION......Page 740
NONOPIOID ANALGESICS......Page 743
SPINAL OPIOIDS......Page 746
EPIDURAL INFUSIONS......Page 748
NEUROLYTIC BLOCKS......Page 749
NONPHARMACOLOGICAL MANAGEMENT OF PAIN......Page 750
REFERENCES......Page 751
CHAPTER 28 INFECTION......Page 756
DEFINITIONS......Page 757
INCIDENCE......Page 759
NORMAL ANATOMY, PHYSIOLOGY, AND SCIENTIFIC PRINCIPLES......Page 760
PATHOPHYSIOLOGY......Page 766
PHYSICAL EXAMINATION......Page 767
DIAGNOSTIC STUDIES......Page 768
PREVENTION......Page 773
MANAGEMENT......Page 774
CONCLUSION......Page 783
REFERENCES......Page 784
CHAPTER 29 BLEEDING......Page 788
AGGREGATION......Page 789
COAGULATION......Page 790
PATHOPHYSIOLOGY OF BLEEDING......Page 791
PLATELET ABNORMALITIES......Page 792
HYPOCOAGULATION......Page 793
TREATMENT EFFECTS......Page 794
PATIENT/FAMILY HISTORY......Page 797
COMPLETE BLOOD COUNT AND PERIPHERAL BLOOD SMEAR......Page 798
PREVENTION OF BLEEDING......Page 802
MANAGEMENT OF BLEEDING......Page 805
BLOOD COMPONENT THERAPY......Page 807
REFERENCES......Page 811
CHAPTER 30 CANCER-RELATED FATIGUE......Page 815
DEFINITION......Page 816
EVALUATION OF THE PATIENT WITH CANCER-RELATED FATIGUE......Page 817
EXERCISE......Page 820
PSYCHOEDUCATIONAL AND SELF-MANAGEMENT INTERVENTIONS......Page 821
STRUCTURED REHABILITATION......Page 822
CORRECTION OF ANEMIA LESS THAN 10 G/DL......Page 825
PHARMACOLOGICAL MEASURES......Page 826
COMPLEMENTARY THERAPIES......Page 827
CONCLUSION AND FUTURE DIRECTIONS......Page 828
REFERENCES......Page 829
CHAPTER 31 HYPERSENSITIVITY REACTIONS TO ANTINEOPLASTIC DRUGS......Page 835
INCIDENCE......Page 836
RISK FACTORS......Page 837
PATHOPHYSIOLOGY......Page 839
CHEMOTHERAPY DRUGS FREQUENTLY ASSOCIATED WITH HYPERSENSITIVITY REACTIONS......Page 840
BIOTHERAPY DRUGS FREQUENTLY ASSOCIATED WITH HYPERSENSITIVITY REACTIONS AND CYTOKINE RELEASE SYNDROMES......Page 842
PREVENTION......Page 843
NURSING CARE AND MANAGEMENT......Page 845
REFERENCES......Page 847
CHAPTER 32 ORAL MUCOSITIS......Page 850
ETIOLOGY AND RISK FACTORS......Page 851
PATHOGENESIS OF ORAL MUCOSITIS......Page 854
CLINICAL MANIFESTATIONS......Page 855
ASSESSMENT AND GRADING......Page 856
RECOMMENDED FOR PRACTICE......Page 857
EFFECTIVENESS NOT ESTABLISHED......Page 858
REFERENCES......Page 859
CHAPTER 33 NUTRITIONAL DISTURBANCES......Page 861
RISK FACTORS......Page 862
NORMAL NUTRITIONAL PHYSIOLOGY......Page 864
CANCER-INDUCED ALTERATIONS IN NUTRIENT INTAKE......Page 865
CANCER-INDUCED CHANGES IN ENERGY BALANCE......Page 867
CLINICAL MANIFESTATIONS......Page 869
NUTRITIONAL ASSESSMENT......Page 870
PHYSICAL EXAMINATION......Page 873
NUTRITION-RELATED SYMPTOM ASSESSMENT......Page 875
NUTRITIONAL PRESCRIPTION......Page 876
NUTRITIONAL STRATEGIES......Page 879
ENTERAL AND PARENTERAL NUTRITION......Page 881
PHYSICAL ACTIVITY......Page 882
CONCLUSION......Page 883
REFERENCES......Page 884
CHAPTER 34 PARANEOPLASTIC SYNDROMES......Page 888
SCOPE OF THE PROBLEM......Page 889
CLINICAL MANIFESTATIONS......Page 891
SCOPE OF THE PROBLEM......Page 892
CLINICAL MANIFESTATIONS......Page 894
THERAPEUTIC APPROACHES AND NURSING CARE......Page 895
SCOPE OF THE PROBLEM......Page 896
PATHOPHYSIOLOGY......Page 897
THERAPEUTIC APPROACHES AND NURSING CARE......Page 898
CLINICAL MANIFESTATIONS......Page 899
CANCER ANOREXIA-CACHEXIA SYNDROME......Page 900
MUSCULOSKELETAL/RHEUMATIC PARANEOPLASTIC SYNDROMES......Page 902
REFERENCES......Page 903
CHAPTER 35 MALIGNANT EFFUSIONS......Page 906
PHYSIOLOGIC ALTERATIONS......Page 907
ASSESSMENT......Page 908
THERAPEUTIC APPROACHES AND NURSING CARE......Page 909
SCOPE OF THE PROBLEM......Page 912
PHYSIOLOGIC ALTERATIONS......Page 913
THERAPEUTIC APPROACHES AND NURSING CARE......Page 914
PHYSIOLOGIC ALTERATIONS......Page 916
ASSESSMENT......Page 917
FUTURE TRENDS......Page 918
REFERENCES......Page 920
CHAPTER 36 SEXUAL AND REPRODUCTIVE DYSFUNCTION......Page 922
PHYSIOLOGICAL ALTERATIONS......Page 923
SURGERY......Page 924
RADIATION THERAPY......Page 929
CHEMOTHERAPY......Page 930
TARGETED THERAPIES......Page 933
ASSESSMENT STRATEGIES......Page 934
INTERVENTION STRATEGIES......Page 937
FERTILITY CONSIDERATIONS AND PROCREATIVE ALTERNATIVES......Page 938
SEXUAL DYSFUNCTION IN SPECIAL POPULATIONS......Page 942
MEDICAL MANAGEMENT OF COMMONLY ASSOCIATED CANCERS......Page 944
EFFECTS OF TREATMENT AND MALIGNANCY ON THE FETUS......Page 947
CONCLUSION......Page 948
REFERENCES......Page 949
PART V: ONCOLOGIC EMERGENCIES......Page 956
CHAPTER 37 CARDIAC TAMPONADE......Page 958
NORMAL ANATOMY AND PHYSIOLOGY......Page 959
CLINICAL MANIFESTATIONS......Page 960
DIAGNOSTIC TESTS......Page 963
MANAGEMENT......Page 965
REFERENCES......Page 969
CHAPTER 38 DISSEMINATED INTRAVASCULAR COAGULATION......Page 971
ETIOLOGY AND RISK FACTORS......Page 972
PATHOPHYSIOLOGY......Page 973
CLINICAL MANIFESTATIONS......Page 974
PHYSICAL EXAMINATION......Page 975
DIAGNOSTIC TESTS......Page 976
MANAGEMENT......Page 977
CONCLUSION......Page 979
REFERENCES......Page 980
CHAPTER 39 HYPERCALCEMIA OF MALIGNANCY......Page 982
ETIOLOGY AND RISK FACTORS......Page 983
NORMAL CALCIUM HOMEOSTASIS......Page 984
REGULATION OF NORMAL CALCIUM HOMEOSTASIS......Page 985
ETIOLOGY OF HYPERCALCEMIA OF MALIGNANCY......Page 987
CLINICAL MANIFESTATIONS OF HYPERCALCEMIA......Page 990
GASTROINTESTINAL EFFECTS......Page 991
BLOOD CHEMISTRY MEASUREMENTS......Page 992
GRADING HYPERCALCEMIA IN MALIGNANT DISEASE......Page 993
PRINCIPLES OF ANTIHYPERCALCEMIC TREATMENT......Page 994
ANTIRESORPTIVE THERAPY: BISPHOSPHONATES......Page 998
OTHER ANTIHYPERCALCEMIC THERAPIES......Page 1001
OVERVIEW......Page 1002
PATIENT AND CAREGIVER EDUCATION......Page 1004
REFERENCES......Page 1005
CHAPTER 40 SEPTIC SHOCK......Page 1007
INCIDENCE......Page 1008
ETIOLOGY AND RISK FACTORS......Page 1009
CLINICAL MANIFESTATIONS......Page 1010
DIAGNOSTIC STUDIES......Page 1012
PREVENTION AND DETECTION......Page 1013
MANAGEMENT......Page 1014
CONCLUSION......Page 1019
REFERENCES......Page 1020
CHAPTER 41 SPINAL CORD COMPRESSION......Page 1022
ANATOMY OF THE SPINAL CORD......Page 1023
ETIOLOGY......Page 1024
SITE OF COMPRESSION......Page 1025
MOTOR WEAKNESS AND MOTOR LOSS......Page 1026
PLAIN FILMS AND BONE SCANS......Page 1027
MEDICAL MANAGEMENT......Page 1028
SYMPTOM MANAGEMENT......Page 1033
CONCLUSION......Page 1035
REFERENCES......Page 1036
CHAPTER 42 SUPERIOR VENA CAVA SYNDROME......Page 1038
RISK FACTORS......Page 1039
NORMAL ANATOMY AND PHYSIOLOGY......Page 1040
SIGNS AND SYMPTOMS......Page 1041
ASSESSMENT......Page 1042
MANAGEMENT......Page 1043
REFERENCES......Page 1046
CHAPTER 43 SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE......Page 1048
NORMAL PHYSIOLOGY AND SCIENTIFIC PRINCIPLES......Page 1049
PATHOPHYSIOLOGY......Page 1051
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1052
REFERENCES......Page 1055
CHAPTER 44 TUMOR LYSIS SYNDROME......Page 1057
ETIOLOGY AND RISK FACTORS......Page 1058
PHYSIOLOGICAL ALTERATIONS......Page 1060
ASSESSMENT......Page 1062
MEDICATIONS......Page 1064
DIALYSIS......Page 1066
SPECIFIC ELECTROLYTE MANAGEMENT......Page 1067
SPECIAL CONSIDERATIONS IN THE ELDERLY......Page 1068
CONCLUSION......Page 1070
REFERENCES......Page 1071
PART VI: THE CARE OF INDIVIDUALS WITH SPECIFIC CANCERS......Page 1074
CHAPTER 45 AIDS-RELATED MALIGNANCIES......Page 1076
INTRODUCTION......Page 1077
HIV DISEASE AND CANCER......Page 1078
ASSESSMENT AND DIAGNOSIS......Page 1079
NURSING CARE......Page 1080
PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA......Page 1081
KAPOSI SARCOMA......Page 1082
ASSESSMENT AND DIAGNOSIS......Page 1083
THERAPEUTIC APPROACHES......Page 1084
EPIDEMIOLOGY......Page 1086
ASSESSMENT......Page 1087
NON-AIDS-DEFINING MALIGNANCIES......Page 1088
ANAL CANCER......Page 1089
CLINICAL TRIALS AND HIV......Page 1090
REFERENCES......Page 1091
CHAPTER 46 BONE AND SOFT TISSUE SARCOMAS......Page 1095
ETIOLOGY......Page 1096
PATHOPHYSIOLOGY......Page 1097
PHYSICAL EXAMINATION......Page 1098
DIAGNOSTIC STUDIES......Page 1099
PROGNOSTIC INDICATORS......Page 1101
CLASSIFICATION AND STAGING......Page 1102
BONE......Page 1103
METASTATIC SARCOMA......Page 1111
RADIOTHERAPY......Page 1112
CHEMOTHERAPY......Page 1113
OSTEOSARCOMA......Page 1114
CHONDROSARCOMA......Page 1116
EWING’S SARCOMA......Page 1117
SOFT TISSUE SARCOMAS......Page 1118
LIMITATIONS OF MOBILITY......Page 1120
REFERENCES......Page 1121
CHAPTER 47 BLADDER CANCER......Page 1123
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1124
DIAGNOSTIC STUDIES......Page 1125
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1126
NON–MUSCLE-INVASIVE CANCER/SUPERFICIAL......Page 1127
MUSCLE-INVASIVE CANCER......Page 1129
METASTATIC DISEASE......Page 1131
REFERENCES......Page 1132
CHAPTER 48 BREAST CANCER......Page 1134
HORMONAL FACTORS......Page 1135
FAMILY HISTORY......Page 1137
RACE, ETHNICITY, AND SOCIOECONOMIC STATUS......Page 1138
RISK ASSESSMENT TOOLS......Page 1139
PREVENTION......Page 1140
NURSING IMPLICATIONS......Page 1142
GENETIC COUNSELING PROGRAMS......Page 1143
CELLULAR CHARACTERISTICS......Page 1144
HISTORY......Page 1145
PHYSICAL EXAMINATION......Page 1146
DIAGNOSTIC STUDIES......Page 1147
PROGNOSTIC INDICATORS......Page 1153
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1155
BREAST SURGERY......Page 1157
BREAST RECONSTRUCTION......Page 1160
NIPPLE–AREOLAR CONSTRUCTION......Page 1163
NURSING IMPLICATIONS......Page 1164
SYSTEMIC ADJUVANT THERAPY......Page 1165
METASTATIC BREAST CANCER......Page 1170
ENDOCRINE THERAPY......Page 1171
TARGETED THERAPY......Page 1173
MALES......Page 1174
YOUNG WOMEN......Page 1175
AFRICAN AMERICAN WOMEN......Page 1176
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1178
FUTURE TRENDS......Page 1179
REFERENCES......Page 1180
CHAPTER 49 CENTRAL NERVOUS SYSTEM CANCERS......Page 1189
GENETIC FACTORS......Page 1190
IMMUNOSUPPRESSION AND VIRAL FACTORS......Page 1191
ANATOMY AND PHYSIOLOGY......Page 1192
FOCAL EFFECTS......Page 1197
GENERALIZED EFFECTS OF INCREASED INTRACRANIAL PRESSURE......Page 1198
DISPLACEMENT OF BRAIN STRUCTURES......Page 1199
PHYSICAL EXAM......Page 1201
DIAGNOSTIC STUDIES......Page 1202
GLIOMAS......Page 1204
VESTIBULAR SCHWANNOMAS (ACOUSTIC NEUROMAS)......Page 1207
BRAIN METASTASES......Page 1208
SURGERY......Page 1210
RADIATION THERAPY......Page 1212
CHEMOTHERAPY......Page 1215
EPIDEMIOLOGY......Page 1216
ANATOMY AND PHYSIOLOGY......Page 1217
EXTRADURAL TUMORS......Page 1218
PATTERN OF SPREAD......Page 1219
ASSESSMENT......Page 1220
SURGERY......Page 1221
CHEMOTHERAPY......Page 1222
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1223
CONCLUSION......Page 1225
REFERENCES......Page 1226
CHAPTER 50 CERVICAL CANCER......Page 1231
ETIOLOGY......Page 1232
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1233
SQUAMOUS INTRAEPITHELIAL LESIONS......Page 1234
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1235
PATHOPHYSIOLOGY......Page 1237
CLASSIFICATION AND STAGING......Page 1239
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1240
STAGES IB2 AND IIA......Page 1241
STAGES IIB, III, AND IVA—LOCALLY ADVANCED DISEASE......Page 1242
RECURRENT OR PERSISTENT DISEASE......Page 1243
REFERENCES......Page 1245
CHAPTER 51 COLON, RECTAL, AND ANAL CANCERS......Page 1248
EPIDEMIOLOGY AND ETIOLOGY......Page 1249
FAMILIAL/GENETIC AND LIFESTYLE FACTORS......Page 1251
PRIMARY PREVENTION......Page 1254
SECONDARY PREVENTION AND SCREENING......Page 1255
CELLULAR CHARACTERISTICS......Page 1259
PROGRESSION OF DISEASE AND PATTERNS OF SPREAD......Page 1261
CLINICAL MANIFESTATIONS......Page 1263
PHYSICAL EXAMINATION......Page 1264
PROGNOSTIC INDICATORS......Page 1265
CLASSIFICATION AND STAGING......Page 1266
SURGERY......Page 1267
RADIATION THERAPY......Page 1270
CHEMOTHERAPY......Page 1271
ADVANCED OR METASTATIC DISEASE CHEMOTHERAPY AND TARGETED THERAPY......Page 1274
BOWEL OBSTRUCTION......Page 1277
FISTULA......Page 1278
PROGRESSIVE DISEASE......Page 1279
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1280
CELLULAR CHARACTERISTICS......Page 1281
PATIENT AND FAMILY HISTORY......Page 1282
CLASSIFICATION AND STAGING......Page 1283
SURGERY......Page 1284
RADIATION THERAPY......Page 1286
STOMA AND COLOSTOMY MANAGEMENT......Page 1287
SEXUAL DYSFUNCTION......Page 1288
INTRODUCTION......Page 1289
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1290
PROGRESSION OF DISEASE......Page 1291
SURGERY......Page 1292
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1294
CONCLUSION......Page 1295
REFERENCES......Page 1296
CHAPTER 52 ENDOCRINE MALIGNANCIES......Page 1301
ETIOLOGY......Page 1302
PATHOPHYSIOLOGY......Page 1303
ASSESSMENT......Page 1304
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1305
PARATHYROID TUMORS......Page 1307
ASSESSMENT......Page 1308
PITUITARY TUMORS......Page 1309
PATHOPHYSIOLOGY......Page 1310
ASSESSMENT......Page 1311
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1312
ADRENAL TUMORS......Page 1314
ADRENOCORTICAL TUMORS......Page 1315
PHEOCHROMOCYTOMA......Page 1317
MULTIPLE ENDOCRINE NEOPLASIA......Page 1319
MULTIPLE ENDOCRINE NEOPLASIA 1......Page 1320
MULTIPLE ENDOCRINE NEOPLASIA 2......Page 1321
REFERENCES......Page 1322
CHAPTER 53 ENDOMETRIAL CANCER......Page 1324
ETIOLOGY......Page 1325
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1326
CELLULAR CHARACTERISTICS......Page 1327
PROGRESSION OF DISEASE AND PATTERNS OF SPREAD......Page 1328
CLASSIFICATION AND STAGING......Page 1329
EARLY-STAGE DISEASE......Page 1330
ADVANCED OR RECURRENT DISEASE......Page 1333
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1334
REFERENCES......Page 1335
CHAPTER 54 ESOPHAGEAL CANCER......Page 1338
EPIDEMIOLOGY......Page 1339
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1340
PROGRESSION OF DISEASE......Page 1341
PATIENT AND FAMILY HISTORY......Page 1342
DIAGNOSTIC STUDIES......Page 1343
BARRETT’S ESOPHAGUS......Page 1344
LOCAL AND LOCOREGIONAL ESOPHAGEAL CANCER......Page 1346
NONRESECTABLE OR METASTATIC DISEASE......Page 1354
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1356
REFERENCES......Page 1357
CHAPTER 55 GALLBLADDER AND BILE DUCT CANCER......Page 1359
ETIOLOGY......Page 1360
CLINICAL MANIFESTATIONS......Page 1361
ASSESSMENT......Page 1362
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1363
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1366
EPIDEMIOLOGY......Page 1367
ETIOLOGY......Page 1368
ASSESSMENT......Page 1369
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1371
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1373
REFERENCES......Page 1374
CHAPTER 56 HEAD AND NECK MALIGNANCIES......Page 1377
NASAL FOSSA AND PARANASAL SINUSES......Page 1378
OROPHARYNX......Page 1379
LARYNX......Page 1381
TOBACCO AND ALCOHOL......Page 1382
CARCINOMA OF THE LIP......Page 1383
SKULL BASE MALIGNANCIES......Page 1384
NASAL CAVITY, PARANASAL SINUSES, AND NASOPHARYNGEAL MALIGNANCIES......Page 1385
PROGRESSION OF DISEASE......Page 1386
IMAGING......Page 1387
CLASSIFICATION AND STAGING......Page 1388
SURGERY......Page 1390
RADIATION THERAPY......Page 1391
TARGETED THERAPIES......Page 1393
FUTURE TREATMENT AND MANAGEMENT STRATEGIES......Page 1394
TREATMENT STRATEGIES FOR SPECIFIC HEAD AND NECK CANCERS......Page 1395
SWALLOW THERAPY......Page 1397
SPEECH......Page 1398
ORAL CARE......Page 1399
XEROSTOMIA......Page 1400
PAIN MANAGEMENT......Page 1402
NUTRITIONAL MANAGEMENT......Page 1403
ENTERAL THERAPY......Page 1404
QUALITY-OF-LIFE ISSUES......Page 1405
MULTIDISCIPLINARY CARE......Page 1406
REFERENCES......Page 1407
CHAPTER 57 LEUKEMIA AND MYELODYSPLASTIC SYNDROMES......Page 1412
ETIOLOGY......Page 1413
PATHOBIOLOGY......Page 1414
CLASSIFICATION AND STAGING......Page 1416
ASSESSMENT......Page 1420
THERAPEUTIC APPROACHES AND NURSING MANAGEMENT......Page 1423
TREATMENT STRATEGIES FOR ACUTE MYELOGENOUS LEUKEMIA......Page 1424
TREATMENT STRATEGIES FOR ACUTE PROMYELOCYTIC LEUKEMIA......Page 1426
TREATMENT STRATEGIES FOR ACUTE LYMPHOCYTIC LEUKEMIA......Page 1427
TREATMENT STRATEGIES FOR CHRONIC MYELOGENOUS LEUKEMIA......Page 1429
TREATMENT STRATEGIES FOR CHRONIC LYMPHOCYTIC LEUKEMIA......Page 1431
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1434
REFERENCES......Page 1439
CHAPTER 58 LIVER CANCER......Page 1442
HEPATOCELLULAR CARCINOMA......Page 1443
CELLULAR CHARACTERISTICS......Page 1445
PROGRESSION OF DISEASE......Page 1446
PHYSICAL EXAMINATION......Page 1447
DIAGNOSTIC STUDIES......Page 1448
CLASSIFICATION AND STAGING......Page 1449
HEPATOCELLULAR CARCINOMA......Page 1450
LIVER METASTASES......Page 1452
POSTOPERATIVE CARE......Page 1453
PALLIATIVE TREATMENTS......Page 1455
HEPATOCELLULAR CARCINOMA AND TARGETED THERAPIES......Page 1459
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1460
REFERENCES......Page 1461
CHAPTER 59 LUNG CANCER......Page 1467
EPIDEMIOLOGY......Page 1468
TOBACCO......Page 1469
CANNABIS......Page 1470
OTHER FACTORS......Page 1471
SECONDARY PREVENTION......Page 1472
BRONCHOSCOPIC PROCEDURES......Page 1474
CELLULAR CHARACTERISTICS......Page 1475
PROGRESSION OF DISEASE......Page 1476
SYMPTOMS RELATED TO EXTRAPULMONARY SPREAD......Page 1477
PARANEOPLASTIC SYNDROMES: SIGNS AND SYMPTOMS INDIRECTLY RELATED TO THE TUMOR......Page 1478
REVIEW OF SYSTEMS......Page 1479
DIAGNOSTIC STUDIES......Page 1480
NON-SMALL CELL LUNG CANCER......Page 1483
SURGERY......Page 1484
RADIATION......Page 1487
CHEMOTHERAPY......Page 1488
BIOTHERAPY......Page 1491
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1492
COUGH......Page 1493
REFERENCES......Page 1494
CHAPTER 60 LYMPHOMAS......Page 1501
LYMPHOID TISSUES AND THE IMMUNE SYSTEM......Page 1502
CLINICAL MANIFESTATIONS......Page 1505
LABORATORY TESTS......Page 1506
RADIOGRAPHIC TESTS......Page 1507
ETIOLOGY......Page 1508
CLASSICAL HODGKIN’S LYMPHOMA......Page 1510
RADIATION THERAPY......Page 1511
CHEMOTHERAPY......Page 1512
STEM CELL TRANSPLANT......Page 1513
EPIDEMIOLOGY......Page 1514
INTERNATIONAL WORKING FORMULA......Page 1515
SMALL LYMPHOCYTIC LYMPHOMA/CHRONIC LYMPHOCYTIC LEUKEMIA......Page 1516
FOLLICULAR LYMPHOMA......Page 1519
MALT LYMPHOMA......Page 1520
MANTLE CELL LYMPHOMA......Page 1521
DIFFUSE LARGE B-CELL LYMPHOMA......Page 1522
BURKITT’S LYMPHOMA......Page 1523
AIDS-RELATED LYMPHOMA......Page 1524
LYMPHOBLASTIC LYMPHOMA: PRECURSOR B-CELL OR T-CELL LYMPHOBLASTIC LEUKEMIA/LYMPHOMA......Page 1525
POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER......Page 1526
CUTANEOUS T-CELL LYMPHOMA......Page 1528
ANAPLASTIC LARGE CELL LYMPHOMA......Page 1531
PERIPHERAL T-CELL LYMPHOMA, UNSPECIFIED......Page 1532
TARGETED THERAPY......Page 1533
HEMATOPOIETIC STEM CELL TRANSPLANTATION......Page 1536
NEW THERAPIES......Page 1537
TREATMENT-RELATED COMPLICATIONS......Page 1540
CHRONIC COMPLICATIONS OF THERAPY......Page 1541
THYROID DYSFUNCTION......Page 1542
REPRODUCTIVE CHANGES......Page 1544
NURSING IMPLICATIONS......Page 1545
REFERENCES......Page 1546
CHAPTER 61 MULTIPLE MYELOMA......Page 1556
RISK FACTORS......Page 1557
PATHOPHYSIOLOGY......Page 1558
ROLE OF CYTOKINES......Page 1559
SKELETAL INVOLVEMENT......Page 1560
BONE MARROW INVOLVEMENT......Page 1561
RENAL INSUFFICIENCY......Page 1562
METABOLIC SYNDROMES......Page 1563
ASSESSMENT......Page 1564
PROGNOSTIC FACTORS......Page 1565
CLASSIFICATION AND STAGING......Page 1566
PRIMARY CONVENTIONAL TREATMENT (PATIENTS INELIGIBLE FOR TRANSPLANT)......Page 1567
PRIMARY TREATMENT (PATIENTS ELIGIBLE FOR TRANSPLANT)......Page 1571
CONVENTIONAL AND NOVEL THERAPIES FOR RELAPSED AND REFRACTORY MYELOMA......Page 1575
RADIATION THERAPY......Page 1576
BISPHOSPHONATES......Page 1577
SYMPTOM MANAGEMENT AND NURSING CARE......Page 1578
NEUROLOGICAL SYMPTOMS......Page 1579
PROTECTIVE MECHANISMS......Page 1580
GENITOURINARY SYMPTOMS......Page 1581
REFERENCES......Page 1582
CHAPTER 62 OVARIAN CANCER......Page 1589
REPRODUCTIVE AND HORMONAL......Page 1590
ENVIRONMENTAL......Page 1592
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1593
CA-125......Page 1594
PROTEOMICS......Page 1595
BIOLOGY......Page 1596
ASSESSMENT......Page 1597
CLASSIFICATION AND STAGING......Page 1598
SURGERY......Page 1599
TREATMENT OF EPITHELIAL OVARIAN CANCER......Page 1600
INTRAPERITONEAL CHEMOTHERAPY......Page 1606
PRIMARY TREATMENT OF OTHER OVARIAN TUMORS......Page 1608
ASCITES......Page 1609
INTESTINAL OBSTRUCTION......Page 1610
MALNUTRITION......Page 1611
LYMPHEDEMA......Page 1612
PLEURAL EFFUSION......Page 1613
STRESS AND SUPPORT......Page 1614
PATIENT RESOURCES......Page 1615
REFERENCES......Page 1617
CHAPTER 63 PANCREATIC CANCER......Page 1623
ETIOLOGY......Page 1624
GENETICS......Page 1625
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1626
PRECURSORS TO DUCTAL ADENOCARCINOMA......Page 1627
PROGRESSION OF DISEASE......Page 1628
CLINICAL MANIFESTATIONS......Page 1629
BODY OF PANCREAS......Page 1630
DIAGNOSTIC STUDIES......Page 1631
THERAPEUTIC APPROACHES AND NURSING CARE......Page 1634
SURGERY......Page 1636
CHEMOTHERAPY......Page 1642
RADIATION THERAPY......Page 1644
SYMPTOM MANAGEMENT AND NURSING CARE......Page 1645
FUTURE TRENDS......Page 1647
REFERENCES......Page 1648
CHAPTER 64 PROSTATE CANCER......Page 1652
ETIOLOGY......Page 1653
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1654
CELLULAR CHARACTERISTICS......Page 1656
CLINICAL MANIFESTATIONS......Page 1657
DIAGNOSTIC STUDIES......Page 1658
ACTIVE SURVEILLANCE, WATCHFUL WAITING, OR PERIODIC OBSERVATION FOR EARLY-STAGE PROSTATE CANCER......Page 1659
SURGERY......Page 1662
RADIATION THERAPY......Page 1669
HORMONAL THERAPY......Page 1670
CHEMOTHERAPY......Page 1672
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1673
REFERENCES......Page 1674
CHAPTER 65 RENAL CANCER......Page 1677
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1678
PATHOPHYSIOLOGY......Page 1679
ASSESSMENT......Page 1680
CLASSIFICATION AND STAGING......Page 1681
SURGERY......Page 1682
TARGETED THERAPY......Page 1683
RADIATION......Page 1688
REFERENCES......Page 1689
CHAPTER 66 SKIN CANCER......Page 1693
EPIDEMIOLOGY......Page 1694
GENOTYPIC FACTORS......Page 1695
ENVIRONMENTAL FACTORS......Page 1697
PRIMARY PREVENTION......Page 1700
SECONDARY PREVENTION......Page 1706
NORMAL SKIN STRUCTURES......Page 1708
MALIGNANT CHANGE......Page 1709
CLINICAL MANIFESTATIONS......Page 1710
PATIENT AND FAMILY HISTORY......Page 1712
PHYSICAL EXAMINATION......Page 1713
PROGNOSTIC INDICATORS......Page 1714
NONMELANOMA SKIN CANCERS......Page 1715
NONMELANOMA SKIN CANCERS......Page 1716
MALIGNANT MELANOMA......Page 1719
REFERENCES......Page 1723
CHAPTER 67 STOMACH CANCER......Page 1726
EPIDEMIOLOGY......Page 1727
ETIOLOGY......Page 1728
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1729
CLINICAL MANIFESTATIONS......Page 1730
DIAGNOSTIC STUDIES......Page 1731
PROGNOSIS......Page 1732
SURGERY......Page 1733
RADIATION THERAPY......Page 1734
CHEMOTHERAPY......Page 1735
REFERENCES......Page 1736
CHAPTER 68 TESTICULAR GERM CELL CANCER......Page 1739
ETIOLOGY......Page 1740
PREVENTION, SCREENING, AND EARLY DETECTION......Page 1741
PATHOPHYSIOLOGY......Page 1742
DIAGNOSTIC STUDIES......Page 1743
CLASSIFICATION AND STAGING......Page 1744
NONSEMINOMA TUMORS......Page 1746
SEMINOMAS......Page 1749
SALVAGE CHEMOTHERAPY......Page 1750
NURSING CARE......Page 1751
DISEASE PROGRESSION......Page 1754
FOLLOW-UP CARE AND SURVIVORSHIP......Page 1755
REFERENCES......Page 1756
CHAPTER 69 VULVAR AND VAGINAL CANCER......Page 1762
ETIOLOGY......Page 1763
PATHOPHYSIOLOGY......Page 1764
ASSESSMENT......Page 1765
CLASSIFICATION AND STAGING......Page 1767
THERAPEUTIC APPROACHES AND NURSING CARE: VIN......Page 1768
THERAPEUTIC APPROACHES AND NURSING CARE: INVASIVE DISEASE......Page 1769
SYMPTOM MANAGEMENT AND SUPPORTIVE CARE......Page 1771
FUTURE TRENDS......Page 1772
ETIOLOGY......Page 1773
PATHOPHYSIOLOGY......Page 1774
ASSESSMENT......Page 1775
THERAPEUTIC APPROACHES AND NURSING CARE: VAIN......Page 1776
THERAPEUTIC APPROACHES AND NURSING CARE: INVASIVE DISEASE......Page 1777
FUTURE TRENDS......Page 1779
REFERENCES......Page 1780
PART VII: DIMENSIONS OF CANCER SURVIVORSHIP......Page 1784
CHAPTER 70 CANCER SURVIVORSHIP: A CRITICAL ASPECT OF CARE......Page 1786
QUALITY OF LIFE AND CANCER SURVIVORS......Page 1787
DEPRESSION......Page 1788
MEANING AND APPRAISAL......Page 1789
RURAL CANCER SURVIVORS......Page 1790
ELDERLY AND CANCER SURVIVORSHIP......Page 1791
NUTRITION AND EXERCISE......Page 1792
RETURNING TO WORK......Page 1793
CANCER SURVIVORSHIP RESEARCH......Page 1794
REFERENCES......Page 1795
CHAPTER 71 LATE EFFECTS OF CANCER TREATMENT......Page 1798
MEDICAL LATE EFFECTS......Page 1799
IDENTIFYING LATE EFFECTS IN CANCER SURVIVORS......Page 1805
BREAST CANCER SURVIVORS......Page 1806
PROSTATE CANCER SURVIVORS......Page 1807
SECONDARY MALIGNANCIES IN CANCER SURVIVORS......Page 1810
MODELS OF SURVIVORSHIP CARE DELIVERY......Page 1813
RESOURCES......Page 1814
REFERENCES......Page 1819
CHAPTER 72 FAMILY AND CAREGIVER ISSUES......Page 1823
BARRIERS TO HELPING FAMILIES OF PATIENTS WITH CANCER......Page 1824
STRESS AND COPING THEORY......Page 1825
EMOTIONAL WELL-BEING......Page 1826
SOCIAL WELL-BEING......Page 1828
PHYSICAL WELL-BEING......Page 1829
PRACTICAL STRATEGIES FOR HELPING PATIENTS AND FAMILY MEMBERS......Page 1830
ASSESSMENT ISSUES......Page 1831
INTERVENTIONS TO HELP PATIENTS AND FAMILY MEMBERS......Page 1832
REFERENCES......Page 1836
CHAPTER 73 SPIRITUAL RESPONSES TO CANCER......Page 1840
WHY ADDRESS SPIRITUALITY?......Page 1841
CANCER SCREENING AND PREDIAGNOSIS......Page 1842
LIVING WITH CANCER......Page 1843
DYING WITH CANCER......Page 1846
PROVIDING SPIRITUAL CARE......Page 1847
INDIVIDUAL APPROACHES......Page 1848
CONCLUSION......Page 1851
REFERENCES......Page 1852
PART VIII: PALLIATIVE CARE AND END OF LIFE......Page 1856
CHAPTER 74 PRINCIPLES AND ISSUES IN PALLIATIVE CARE......Page 1858
HISTORICAL PERSPECTIVES......Page 1859
MODELS OF PALLIATIVE CARE......Page 1860
OUTPATIENT SERVICES......Page 1861
EXTENDED CARE SERVICES......Page 1862
ACCESS TO CARE......Page 1863
ECONOMICS......Page 1864
PROFESSIONALS AS BARRIERS......Page 1865
CHALLENGES FOR THE FUTURE OF PALLIATIVE CARE......Page 1867
OUTCOME MEASUREMENT......Page 1868
REFERENCES......Page 1869
CHAPTER 75 CARE DURING THE FINAL DAYS OF LIFE......Page 1872
MANAGEMENT OF SPECIFIC SYMPTOMS......Page 1873
AFTER-DEATH CARE......Page 1879
PALLIATIVE SEDATION......Page 1880
REFERENCES......Page 1881
PART IX: PROFESSIONAL ISSUES FOR THE CANCER NURSE......Page 1886
CHAPTER 76 THE ADVANCED ONCOLOGY PRACTICE NURSE......Page 1888
ADVANCED PRACTICE NURSING DEFINED......Page 1889
ONCOLOGY CLINICAL NURSE SPECIALIST PRACTICE FRAMEWORK......Page 1891
ONCOLOGY ADVANCED PRACTICE NURSING EDUCATION......Page 1892
LEVELS OF REGULATION......Page 1893
AUTHORITY TO PRACTICE AS AN ADVANCED PRACTICE NURSE......Page 1894
REIMBURSEMENT FOR SERVICES......Page 1897
IMPLEMENTING ADVANCED ONCOLOGY NURSING PRACTICE: WORKING COLLABORATIVELY......Page 1898
CHALLENGES FOR THE FUTURE......Page 1899
CONCLUSION......Page 1900
REFERENCES......Page 1901
APPENDIX A: ONCOLOGY CLINICAL NURSE SPECIALIST PRACTICE COMPETENCIES......Page 1903
APPENDIX B: ONCOLOGY NURSE PRACTITIONER COMPETENCIES......Page 1907
CHAPTER 77 LEGAL ISSUES......Page 1911
CHEMOTHERAPY MEDICATION ERRORS......Page 1912
HYPERSENSITIVITY AND INFUSION-RELATED REACTIONS......Page 1914
VESICANT EXTRAVASATION......Page 1916
RESPONDING TO ERRORS AND ADVERSE EVENTS......Page 1917
COMPLAINTS AND LITIGATION......Page 1918
PAIN MANAGEMENT......Page 1920
REFERENCES......Page 1921
INDEX......Page 1924