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-Alterations in tumor suppression genes like BRCA1 & BRCA2 can increase a persons risk of developing breast and ovarian cancer.
-Benign neoplasms don't have the ability to mestasize but malignant do
-RISK FACTORS (if one is exposed to them, they can be more likely to develop cancer)
-Environmental: chemical exposure (drugs, tobacco, alcohol)
-Obesity & diet: people who are obese, exposed to nitrates, physical inactivity.
-Cocarcinogenic: tobacco and alcohol used together
-Genetics: BRACA 1 & BRACA 2: Human genes that produce human suppression proteins (help repair DNA)
-Age: most significant risk factor regardless of what you do before. The older you get the more at risk you are to develop cancer
-Immunity: low immunity= more at risk to develop cancer.
-some medications can suppress natural immune response eg steroids.

-As a nurse you have a major role in the prevention and early detection of cancer. Eliminating risk factors reduces the incidence of cancer. Early detection and prompt treatment are responsible for increased survival rates in pt's with cancer. Teach the pts and the public about cancer prevention and early detection, including
-Correct misconceptions about cancer to reduce anxiety
-Avoid communication that may hinder exploration of feelings and meaning, such as providing false reassurances (e.g. "its probably nothing"), redirecting the discussion ("lets discuss this later"), generalizing ( "everyone feels this way" ), and using over technical language as a means of distancing yourself from the pt.
- Monitor CBC, particularly neutrophil, platelet, and RBC counts
-Neutropenia (when ANC falls <1000): more common in chemo pts. Risk factor for life-threatening infection and sepsis. Therefore, hand hygiene is important. If a pt is neutropenic there will be a delay in treatment or modification (i.e lower dosage). WBC growth factors such as filgrastim (Neupogen), pegfilgrastim (Neulasta) are used to reduce the duration of chemo-induced neutropenia.
+neutropenic precautions: masks, private rooms, no fresh flowers, no fresh foods, etc
-Monitor temperature routinely
-Thrombocytopenia can result in spontaneous bleeding or major hemorrhage so avoid invasive procedures and pt should avoid activities that place them at risk of bleeding. <50,000 places pt at risk of trauma bleeding, <20,000= platelet transfusion snd places pt at risk for spontaneous bleeding.
-Anemia: later onset (abt 3-4 mo.). For pts with low hub levels, RBC growth factors (i.e, darbepoetin (Aransep), epoetin (Procrit)) may be given according to clinic guidlines.
Fatigue: help pt recognise that fatigue is a common s/e of chemo. Encourage them to get more active.
-Make sure the pt is well hydrated
-Administer anti-emetic
-Recommend a diet low in fibre and residue before chemo. Also avoid fried, fatty or highly seasoned foods or other foods that are gas producing. Avoid milk because of temporary lactose intolerance
-Maintain skin integrity
-keep oral cavity moist, clean and free from debris
-Small frequent meals of high protein and high calories are better tolerated than large meals.