Oncology Basics for the New Nurse

July 8, 2018

Now that I am studying to become an Oncology Certified Nurse, I thought I would share some basics with you all. I honestly cannot remember if I even had an oncology course during nursing school. I know for a FACT I had three different clinical experiences on a pediatric oncology floor, but not sure I learned about the different types of cancer. And while I handle oncology patients every day at work, I still very overwhelmed about all the material. 
I am going to keep it simple and only break this into a three-part segment (maybe?): A brief overview of cancer, treatment options, and individual cancer sites. Now keep in mind...I am (only) a nurse and this is for educational purposes and should not be used for guidance of medical treatment. Now that the awkward disclaimer is over, let's begin!

Cancer at its core is a disease of cells...abnormal cells. Plain and simple. It is caused by genetic alterations and defective cell function characterized by unregulated growth. Since cancer cells adhere poorly to each other there are able to metastasize throughout the body and cause damage to other body systems unrelated to where they originated. 

Carcinogenesis is described as the changing of a normal cell into a cancer cell through initiation, promotion, progression, and metastasis. It may take up to six mutations in a gene to cause cancer. Initiation occurs when a gene is exposed to a carcinogen causing irreversible damage to the DNA. Carcinogens may be chemical, physical agents, or viruses. Probably the most familiar carcinogen is tobacco smoke or UV radiation from the sun. After a gene is exposed to a carcinogen, agents are needed to promote the tumor growth. Promoters can include chemicals, drugs, and your own hormones. As cells continue to become more malignant and less differentiated, they will need to develop their own blood supply through angiogenesis in order to grow. A primary tumor must reach 1 billion cells (1 cm) in size before metastasis is possible. 

Carcinogenesis is affected by both intrinsic and extrinsic factors. Intrinsic factors include age, familial tendencies, chromosomal abnormalities, and hereditary mutations. Most cancer is associated with genetic mutations that occur in a single cell and have accumulated sometime during the individual's life. Extrinsic factors include viral carcinogens, bacterial carcinogens, alcohol, estrogen, asbestos, UV light, radiation, and chemical carcinogens. 

While cancer continues to become more prevalent, it is important to provide education on ways to prevent the incidence. Prevention education might include avoiding carcinogen exposure and prophylactic surgery. 

I hope this brief post provides a little bit more insight on how malignant tumors occur. Make sure to follow me on Instagram (@mightynursemegan) to know when the second post will be up including education of health promotion and a basic rundown on treatment options. 

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