Modalities in Cancer
A tumor manifests as an enlarging space-occupying mass composed of more primitive cells. All health workers should be aware of the early indicators of possible malignancies. These table will help in having a quick look for routes of administration of chemotherapy, Diagnostic/ Biopsy Surgeries for cancer and curative surgeries for cancer.
| Route | Typical Cancer |
| Oral
Intravenous Intra-arterial Isolated limb perfusion Inactivity
|
Hodgkin’s Lymphoma, Leukemia
(maintenance phase) Most solid tumors, Leukaemia’s, Lymphomas Hepatic tumors (primary and metastatic) Cancers confined to limb
Brain tumors Brain tumors, Prophylaxis for acute lymphocytic leukemia Bladder tumors |
Table 1. Routes of Chemotherapy Administration
Table 2. Curative Surgeries for Cancer
| Surgery type | Description | Purpose/Use |
| Local Incision
Wide local incision Wide excision Extended radical incision |
Removal of all identifiable tumor with small margin of normal tissues
Removal of identifiable tumor plus immediate tissue or adjacent tissue Removal of tumor surrounding tissue, adjacent structures, and usual lymph channels draining the area Removal of tumor, surrounding tissue, lymphatic’s, adjacent organs , and all tissue sin the region |
Small, localized tumors
Small tumors with only local tissue invasion Small to moderate-size tumors with known local invasion Tumor infiltrate in a wide area but with known distant metastasis |
Table 3. Diagnostic Tests
| Diagnostic Test | Definition |
| Blood tests | Helps in monitoring the effects of chemotherapy. Hemoglobin and erhythrocyte counts may be low which is a general sign of cancer. |
| Tumor Markers | These are substances produced by malignant tumors which is circulating in the blood or other body fluid.
Examples: Carcinoembrynic Antigen (CEA) – for colon cancer Prostate Specific Antigen (PSA) – Prostate Cancer |
| X-ray, ultrasound, magnetic resonance imaging (MRI) and computed tomography | These are ways to examine changes in tissues or organs |
| Cytologic Tests | These are done for individuals to confirm diagnosis. Biopsies of suspicious masses is the main activity in this testing. |
Table 4. Diagnostic/ Biopsy Surgeries for cancer
| Biopsy type | Description | Problem/ limitations |
| Needle
Incisional Excisional Staging |
Aspirating cells in a fluid or in a very soft tissue
Boring a “core” of solid tissue by using a long needle or making a punch, scrape, or bite. Removing a wedge of suspected tissue from a larger mass, leaving some tumor cells in the tissue. Remove a wedge of suspected tissue from a larger mass, leaving some tumor cells in the tissue. Completely removing an entire lesion without removing any adjacent normal tissue. Performing multiple needle or incisional biopsies in tissues where metastasis is suspected or likely. |
Sample error- may biopsy only cancerous cells in a tissue or organ.
Sample size may not be adequate for accurate testing. Procedure may spread cancer by seeding it into surrounding tissues. Procedure may damage healthy tissue. Sample error Tumor seeding Damage to healthy tissue Tumor seeding Leaving micro metastasis Damage to healthy tissues Tumor seeding Sample error Damage to healthy tissues |
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
