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

  • Intraventricular
  • Intrathecal
  • Intravesical
Hodgkin’s Lymphoma, Leukemia

(maintenance phase)

Most solid tumors, Leukaemia’s,

Lymphomas

Hepatic tumors (primary and metastatic)

Cancers confined to limb

  • Oestrogenic sarcoma
  • Ewing’s sarcoma
  • Rhabdomyosarcoma

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
Human chorionic gonadotropin (hCG) – for testicular cancer
Alpha-fetoprotein  – hepatocellular cancer
CA 125 – ovarian 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.

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