| Foreword |
xv |
| Acknowledgments |
xvii |
| Section I. Foundations |
1
|
| Chapter 1. Biology of Cancer |
3
|
| Introduction |
3 |
| Models of Cancer Development |
3 |
| Structure and Function of DNA and Chromosomes |
5 |
| Self-Sufficiency in Growth Signals |
9 |
| Tumor Suppressor Genes |
12 |
| Sustained Angiogenesis |
15 |
| Tissue Invasion and Metastasis |
15 |
| Conclusion |
16 |
| References |
16 |
| Chapter 2. Staging and Performance Status |
19
|
| Introduction |
19 |
| Types of Cancer |
19 |
| Confirming a Diagnosis of Cancer |
20 |
| Nursing Implications of Cancer Staging and Performance Status |
26 |
| Conclusion |
27 |
| References |
27 |
| Chapter 3. Cancer Epidemiology and Prevention |
35
|
| Introduction |
35 |
| Epidemiologic Terms and Concepts |
35 |
| Risk Factors and Risk Assessment |
40 |
| Primary Cancer Prevention |
47 |
| Conclusion |
52 |
| References |
52 |
| Chapter 4. Genetic Risk for Developing Cancer |
55
|
| Introduction |
55 |
| The Genetic Basis of Cancer |
55 |
| Indications for Genetic Assessment |
57 |
| Standards for Genetic Testing |
57 |
| Provision of Cancer Genetic Education and Counseling |
58 |
| Common Cancer Genetic Predisposition Syndromes |
68 |
| Nursing Implications |
75 |
| Conclusion |
76 |
| References |
76 |
| Chapter 5. Cancer Detection Measures |
81
|
| Introduction |
81 |
| Principles of Secondary Cancer Prevention |
81 |
| Lung Cancer |
84 |
| Breast Cancer |
85 |
| Cervical Cancer |
91 |
| Endometrial and Ovarian Cancers |
95 |
| Colorectal Cancer |
99 |
| Oral Cancers |
105 |
| Testicular Cancer |
106 |
| Prostate Cancer |
108 |
| Skin Cancer |
110 |
| Nursing Implications |
113 |
| Conclusion |
115 |
| References |
115 |
| Chapter 6. Cultural Differences in Cancer Care |
119
|
| Introduction |
119 |
| Evidence-Based Cultural Care |
119 |
| Culturally Competent Nursing Care in Oncology |
121 |
| Conclusion |
131 |
| References |
132 |
| Section II. Treatment Options |
137
|
| Chapter 7. Pharmacogenomics |
139
|
| Introduction |
139 |
| History |
139 |
| Pharmacogenetics and Pharmacogenomics |
140 |
| Pharmacodynamics and Pharmacokinetics |
141 |
| P450 Cytochromes |
141 |
| Non-CYP Metabolizers |
142 |
| Drug Transport Genes |
144 |
| Nursing Implications |
145 |
| Conclusion |
146 |
| References |
146 |
| Chapter 8. Surgery |
149
|
| Introduction |
149 |
| Cancer Surgery Rationale |
150 |
| Staging |
151 |
| Types of Cancer Operations |
151 |
| Perioperative Nursing Considerations |
154 |
| Selected Cancers in Surgical Oncology |
156 |
| Conclusion |
169 |
| References |
169 |
| Chapter 9. Radiation Therapy |
173
|
| Introduction |
173 |
| The Science Behind Radiation Therapy |
173 |
| Clinical Uses of Radiation Therapy |
175 |
| External Beam Radiation Therapy |
175 |
| Internal Radiation Therapy: Radioactive Source Therapy |
180 |
| Radiation Safety |
182 |
| Side Effects |
183 |
| The Nursing Role in Radiation Oncology |
185 |
| Conclusion |
185 |
| References |
191 |
| Chapter 10. Chemotherapy |
195
|
| Introduction |
195 |
| Chemotherapy and the Cell Cycle |
195 |
| Mechanism of Action |
197 |
| Response to Chemotherapy |
203 |
| Chemotherapy Treatment Approaches |
207 |
| Routes of Chemotherapy |
209 |
| Administration |
211 |
| Conclusion |
214 |
| References |
214 |
| Chapter 11. Biologics and Targeted Therapies |
217
|
| Introduction |
217 |
| Historical Perspective |
217 |
| Immune System |
218 |
| Definition and Classification of Biologic Therapy |
219 |
| Maximum Tolerated Dose Versus Optimal Biologic Dose |
220 |
| Cytokines |
220 |
| Hematopoietic Growth Factors |
220 |
| Interferons |
230 |
| Interleukins |
231 |
| Monoclonal Antibodies |
232 |
| Hematologic Monoclonal Antibodies |
234 |
| Solid Tumor Monoclonal Antibodies |
240 |
| Small Molecules—Tyrosine Kinase Inhibitors |
246 |
| Tyrosine Kinase Inhibitors for Hematologic Malignancies |
246 |
| Tyrosine Kinase Inhibitors for Solid Tumors |
250 |
| Proteasome Inhibitors |
253 |
| Immunomodulatory Agents |
254 |
| Histone Deacetylase Inhibitors |
256 |
| Vaccines |
257 |
| Conclusion |
260 |
| References |
261 |
| Chapter 12. Hormonal Therapy |
269
|
| Introduction |
269 |
| Breast Cancer |
277 |
| Endometrial Cancer |
278 |
| Ovarian Cancer |
279 |
| Prostate Cancer |
280 |
| Side Effects of Hormonal Therapy |
282 |
| The Role of Supplements in Hormone-Sensitive Cancers |
282 |
| Treatments on the Horizon |
282 |
| Conclusion |
284 |
| References |
284 |
| Chapter 13. Clinical Trials |
287
|
| Introduction |
287 |
| Definition |
287 |
| A Brief History of Clinical Trials |
288 |
| Types of Cancer Clinical Trials |
291 |
| Phases of Cancer Clinical Trials |
291 |
| Elements of a Clinical Trial Protocol |
293 |
| Ethical, Legal, and Regulatory Issues |
294 |
| Conduct of Cancer Clinical Trials in the Oncology Setting |
297 |
| Nursing Implications |
298 |
| Conclusion |
298 |
| References |
301 |
| Chapter 14. Complementary and Alternative Medicine |
303
|
| Introduction |
303 |
| Definitions |
304 |
| Economics of Complementary and Alternative Medicine Use |
305 |
| Ethical and Legal Issues in Complementary and Alternative Medicine Use |
311 |
| Evidence Base |
311 |
| Defining Professional Duty |
312 |
| Nondisclosure |
312 |
| Children |
312 |
| Reporting Adverse Effects |
312 |
| Nursing Implications |
313 |
| Conclusion |
314 |
| References |
314 |
| Chapter 15. Transplantation |
317
|
| Introduction |
317 |
| Hematopoietic and Immunologic Concepts of Transplantation |
317 |
| Evolution of Transplantation |
319 |
| Types of Transplant |
320 |
| Transplant Program Standards |
320 |
| Preparing for Transplantation |
322 |
| Acute Side Effects |
326 |
| Late Complications |
333 |
| Long-Term Issues |
336 |
| Future Directions |
339 |
| Conclusion |
339 |
| References |
340 |
| Section III. Symptom Management |
343
|
| Chapter 16. Alopecia |
345
|
| Introduction |
345 |
| Risk Factors |
346 |
| Definition and Pathophysiology |
346 |
| Assessment |
347 |
| Prevention and Treatment |
347 |
| Patient Education |
348 |
| The Impact of Alopecia: Understanding What Hair Means |
349 |
| Conclusion |
350 |
| References |
350 |
| Chapter 17. Cardiac and Pulmonary Toxicity |
353
|
| Introduction |
353 |
| Risk Factors |
353 |
| Preventive Measures |
354 |
| Pathophysiology |
355 |
| Diagnosis |
357 |
| Treatment |
357 |
| Oncologic Emergency: Superior Vena Cava Syndrome |
358 |
| Oncologic Emergency: Cardiac Tamponade |
358 |
| Conclusion |
359 |
| References |
359 |
| Chapter 18. Cognitive Changes |
361
|
| Introduction |
361 |
| Risk Factors |
361 |
| Pathophysiology |
363 |
| Assessment |
366 |
| Symptom Management |
367 |
| Conclusion |
367 |
| References |
367 |
| Chapter 19. Dermatologic Complications |
371
|
| Introduction |
371 |
| Basic Rationale |
371 |
| Side Effects |
371 |
| Conclusion |
379 |
| References |
379 |
| Chapter 20. Gastrointestinal Symptoms |
383
|
| Introduction |
383 |
| Xerostomia |
383 |
| Mucositis |
386 |
| Dysphagia |
392 |
| Nausea and Vomiting |
395 |
| Constipation |
403 |
| Diarrhea |
407 |
| Conclusion |
414 |
| References |
414 |
| Chapter 21. Genitourinary Symptoms |
421
|
| Introduction |
421 |
| Overview of Urinary Incontinence |
421 |
| Assessment |
422 |
| Pathophysiology of Urinary Incontinence After Prostatectomy |
422 |
| Postprostatectomy Urinary Incontinence |
422 |
| Urinary Incontinence in Patients With Other Cancers |
423 |
| Consequences of Urinary Incontinence |
424 |
| Pelvic Floor Muscle Exercises |
425 |
| Nursing Interventions |
427 |
| Future Research |
428 |
| Conclusion |
428 |
| References |
428 |
| Chapter 22. Hematologic Issues |
433
|
| Introduction |
433 |
| Neutropenia |
433 |
| Anemia |
438 |
| Thrombocytopenia |
441 |
| Conclusion |
445 |
| References |
445 |
| Chapter 23. Hepatic Toxicities |
449
|
| Introduction |
449 |
| Liver Anatomy, Pathology, and Physiology |
449 |
| Liver Laboratory Parameters |
452 |
| Clinical Findings |
454 |
| Tumors |
458 |
| Surgery |
459 |
| Chemotherapy and Targeted Therapy |
460 |
| Liver-Directed Therapies |
463 |
| Graft-Versus-Host Disease and Sinusoidal Obstruction Syndrome |
468 |
| Conclusion |
470 |
| References |
470 |
| Chapter 24. Hypersensitivity |
473
|
| Introduction |
473 |
| Risk Factors |
473 |
| Pathophysiology |
475 |
| Diagnosis |
478 |
| Treatment and Nursing Implications |
481 |
| Prognosis |
483 |
| Conclusion |
484 |
| References |
484 |
| Chapter 25. Pain |
485
|
| Introduction |
485 |
| Definition of Pain |
485 |
| Etiology |
485 |
| Pathophysiology |
486 |
| Pain Assessment |
486 |
| Pain Management |
490 |
| Non-Narcotic Analgesics |
491 |
| Opioids |
492 |
| Adjuvant Analgesics |
497 |
| Interventional Strategies for Pain Management |
500 |
| Complementary and Alternative Medicine Therapies |
503 |
| Conclusion |
504 |
| References |
505 |
| Chapter 26. Peripheral Neuropathy |
511
|
| Introduction |
511 |
| Risk Factors |
511 |
| Pathophysiology |
512 |
| Assessment |
512 |
| Prevention and Treatment |
515 |
| Nursing Implications |
518 |
| Patient Education |
518 |
| Conclusion |
520 |
| References |
520 |
| Section IV. Issues for Cancer Survivors and Their Families |
523
|
| Chapter 27. Sexual and Reproductive Issues |
525 |
| Introduction |
525 |
| Integrating the Components of Sexuality |
527 |
| Effects of Cancer Treatment on Sexuality |
528 |
| Overcoming Physical Handicaps |
529 |
| Issues Related to Infertility After Cancer Treatment |
532 |
| Parenthood During or After Cancer Treatment |
533 |
| Relational Issues |
535 |
| Including Sexuality Assessment in Nursing Practice |
536 |
| Conclusion |
537 |
| References |
538 |
| Chapter 28. Developmental Life Stage Issues |
541
|
| Introduction |
541 |
| Early Adulthood (Ages 20–39) |
542 |
| Middle Adulthood (Ages 40–59) |
543 |
| Young-Old (Ages 60–75) |
545 |
| Old-Old (Age 75 and Older) |
546 |
| Conclusion |
548 |
| References |
548 |
| Chapter 29. Psychosocial Issues |
551
|
| Introduction |
551 |
| Conceptualizing Psychosocial Aspects |
552 |
| Traumatic Events on the Cancer Trajectory |
553 |
| Cancer and Post-Traumatic Stress Disorder |
553 |
| The Psychosocial Impact Along the Cancer Trajectory |
554 |
| Nursing Management of Psychosocial Aspects |
557 |
| Supportive Psychotherapy and Supportive Social Networks |
562 |
| Mitigating and Compounding Distress |
563 |
| Conclusion |
565 |
| References |
565 |
| Chapter 30. Caring for the Adult Childhood Cancer Survivor |
569
|
| Introduction |
569 |
| The Childhood Cancer Survivor Study |
570 |
| Common Adverse Medical Outcomes Associated With Treatment for Childhood Cancer |
571 |
| Depression, Post-Traumatic Stress, and Quality of Life in Adult Childhood Cancer Survivors |
575 |
| Risk-Based Follow-Up Care of Adult Childhood Cancer Survivors |
578 |
| Models of Care for Adult Survivors of Childhood Cancer |
578 |
| Transition of Care |
580 |
| Risk-Based Guidelines Interventions |
581 |
| Conclusion |
582 |
| References |
582 |
| Chapter 31. Ethical Issues |
587
|
| Introduction |
587 |
| Nurse’s Role |
588 |
| Diagnosis—Truth-Telling, Prognosis, Treatment Options, Hope |
589 |
| Caregiver Burden, Moral Distress, and Impact on Treatment Decisions |
590 |
| Advance Care Planning |
592 |
| Role of Ethics Consultants and Ethics Committees |
595 |
| Futility |
598 |
| Pediatric Issues |
601 |
| Treating Vulnerable Populations |
604 |
| Rehabilitation for Patients With a Terminal Cancer Diagnosis |
605 |
| Conclusion |
605 |
| References |
606 |
| Index |
609 |