Oncological emergencies

Anaphylaxis 656 Disseminated intravascular coagulation 658 Malignancy induced hypercalcaemia 660 Spinal cord compression 664 Superior vena cava obstruction 668 Syndrome of inappropriate antidiuretic hormone 670 Tumour lysis syndrome 672 Anaphylaxis is a severe systemic allergic reaction with multi-system involvement. Onset is normally immediate, but there can be a delay of hours....

Skin and mucosal alterations

Hair loss (alopecia) 636 Scalp cooling (scalp hypothermia) 638 Oral mucositis and related problems 640 Oral mucositis: managing the process and symptoms 644 Oesophagitis 646 Oral care in advanced cancer 647 Malignant wounds 648 Lymphoedema 650 Hair loss can be a distressing side effect of cancer treatment; it impacts on body image and feelings of attractiveness, creates anxiety and causes a visual reminder of the disease and treatment. Alopecia is not a major side effect for most people, but a small group of patients will become extremely distressed by it....

Psychological reactions to cancer

Introduction 592 Adjustment, stress reactions, and disorders 594 Supporting the cancer patient through periods of adjustment 596 Psychological assessment 598 Depression 600 Suicide and suicidal ideas 602 Treatment of depression 604 Anxiety 606 Anxiety management 608 Pharmacological treatment of anxiety 610 Assessment and support of the anxious patient ...

Cancer-related fatigue

Causes and assessment 534 Management 536 Fatigue is one of the most common and distressing symptoms experienced by people with cancer. It is characterized by a lack of energy, being tired, weak, worn out, or exhausted, and is unrelieved by rest or sleep. This results in feeling less able to do mental or physical tasks. It can severely restrict activities, and this can lead to social isolation and impact on relationships. All patients should be informed of the likelihood of fatigue, and given self-care information, before it becomes a major impediment to their quality of life....

Thrombosis

Venous thrombosis 512 Venous thromboembolic disease (VTE) includes thrombosis of superficial and deep veins (DVT), usually of the leg, thigh, and pelvis, pulmonary embolus (PE) and thrombosis associated with central venous catheters (CVCs). Venous thrombosis can have a profound impact on a cancer patient's quality of life. It is a well recognized, major complication of cancer and the second leading cause of death in hospitalized patients with cancer. It remains an under-diagnosed and under-treated condition....

Blood product support

Blood products 502 The nurses' role in blood product transfusions 508 The introduction of safe, reliable blood products has enabled the development of intensive chemotherapy programmes for a variety of malignancies. This has led to significantly improved remission rates. It must be remembered however that blood product use is not without risks, and that these are a very expensive resource. The pool of acceptable donors is also diminishing because of more stringent screening. Blood products should only be used in appropriate situations in consultation with national and local guidelines. (See British Committee for Standards in Haematology, BCSH...

Lung cancer

Introduction 452 Management of non-small cell lung cancer (NSCLC) 456 Management of small cell lung cancer (SCLC) 458 Mesothelioma 460 Nursing management issues 462 Lung cancer is a mainly preventable disease, the main cause being cigarette smoking. It was relatively rare until the 20th century, but is now the leading cause of cancer death in the UK, Europe, and the USA. This is despite changes in treatment modalities, diagnostic procedures, and recent falling smoking rates amongst many sectors of society....

Endocrine cancers

Introduction and types of endocrine cancers 362 Endocrine tumours arise from glands that secrete endocrine hormones. This includes the pituitary, thyroid, parathyroid, and adrenal glands as well as the gonads and the islets of Langerhans in the pancreas. Endocrine tumours are rare, and are benign in most cases. Benign tumours can still cause significant morbidity, but they are not covered in this book (...

Cancer of unknown primary (CUP)

Introduction and prognosis 358 Treatment and nursing management 359 • Common oncological problem representing up to 15% of all referrals. • The primary site of a carcinoma remains undetected even after postmortem examination in around 20–25% of these cases. • Normally arises due to the unusual metastatic potential of the tumour but occasionally there has been regression of the primary (well recognized in melanoma)....

Colorectal cancer

Introduction 344 Treatment approaches to colorectal cancer 346 Care of the patient with a stoma 350 Nursing management issues 354 • Colorectal cancer is the third commonest cancer in UK (fourth worldwide) with over 34,000 UK cases diagnosed annually. • It affects men and women almost equally....