AIDS	Acquired immunodeficiency syndrome
CDC	Centers for Disease Control and Prevention
HIV	Human immunodeficiency virus
STD	Sexually transmitted disease
TB	Tuberculosis

Understanding cancer, immune system, and skin disorders gives meaning to the required care. Refer to Chapter 10 while you study this chapter.

Cancer

Cells reproduce for tissue growth and repair. Cells divide in an orderly way. Sometimes cell division and growth are out of control. A mass or clump of cells develops. This new growth of abnormal cells is called a tumor. Tumors are benign or malignant (Fig. 43-1, p. 694).

• Benign tumors do not spread to other body parts. They can grow to a large size but rarely threaten life. They usually do not grow back when removed.

• Malignant tumors (cancer) invade and destroy nearby tissues. They can spread to other body parts (Fig. 43-2, p. 694). They may be life-threatening. Sometimes they grow back after removal.

FIGURE 43-1 Tumors. A, A benign tumor grows within a local area. B, A malignant tumor invades other tissues.

FIGURE 43-2 Malignant tumor on the skin. (From Belcher AE: Cancer nursing, St Louis, 1992, Mosby.)

Metastasis is the spread of cancer to other body parts (Fig. 43-3, p. 694). Cancer cells break off the tumor and travel to other body parts. New tumors grow at those sites. This occurs if cancer is not treated and controlled.

FIGURE 43-3 A, Tumor in the lung. B, Tumor has metastasized to the other lung. (Modified from Belcher AE: Cancer nursing, St Louis, 1992, Mosby.)

Cancer can occur almost anywhere. If detected early, cancer can be treated and controlled (Box 43-1, p. 695).

Box 43-1

Cancer—

Signs and Symptoms

General Signs and Symptoms

• Unexplained weight loss

• Fever

• Fatigue

• Pain

• Skin changes—darker looking skin, reddened skin, itching, excessive hair growth

• Jaundice (yellowish skin and eyes)

• Change in bowel habits

• Change in bladder function

• Sores that do not heal

• White patches in the mouth

• White spots on the tongue

• Unusual bleeding or discharge

• Thickening or lump in the breast or any other part of the body

• Indigestion or trouble swallowing

• Change in a wart or mole or new skin change

• Nagging cough or hoarseness

Brain Tumor

• Headaches (usually worse in the morning)

• Nausea and vomiting

• Changes in speech, vision, or hearing

• Problems with balance and walking

• Changes in mood, personality, or ability to concentrate

• Problems with memory

• Seizures or convulsions

• Numbness or tingling in the arms or legs

Cervix

• Abnormal vaginal bleeding

• Between regular menstrual periods

• After intercourse, douching, or pelvic exam

• Longer or heavier menstrual periods

• After menopause

• Increased vaginal discharge

• Pelvic pain

• Pain during sex

Breast

• Swelling of all or part of a breast

• Irritation or dimpling of the skin

• Pain in a breast or nipple

• A nipple turned inward into the breast

• Discharge (fluid) from the nipple, especially if bloody

• Scaly, red, or thickened nipple or skin

Bladder

• Hematuria (urine looks rusty or dark red)

• Urinary urgency or frequency

• Feeling unable to empty the bladder

• Needing to strain (bear down) to void

• Dysuria

Colon and Rectum

• Change in bowel habits—diarrhea, constipation, narrow stools

• Feeling that the bowel does not empty completely

• Rectal bleeding

• Blood (bright red or very dark) in the stool

• Cramping or abdominal pain

• Weight loss

• Fatigue

• Weakness

Kidney

• Hematuria (urine looks rusty or dark red)

• Pain in the side that does not go away

• An abnormal lump or mass in the side

• Weight loss

• Fever

• Fatigue

Larynx

• A hoarse voice or other voice changes for more than 3 weeks

• A sore throat or trouble swallowing for more than 6 weeks

• A lump in the neck

• Dyspnea

• A cough that does not go away

• An earache that does not go away

Leukemia

• Weight loss

• Painless, swollen lymph nodes in the neck or underarm

• Fevers or night sweats

• Frequent infections

• Fatigue

• Weakness

• Feeling dizzy or light-headed

• Loss of appetite

• Bleeding or bruising (bleeding gums, nose bleeds)

• Abdominal swelling or discomfort

• Weight loss

• Shortness of breath

Lung

• A cough that does not go away

• Changes in a chronic cough

• Dyspnea

• Wheezing

• Shortness of breath

• Chest pain

• Coughing up blood (hemoptysis)

Lymphoma

• Painless, swollen lymph nodes in the neck, underarm, or groin

• Weight loss

• Fever

• Night sweats

• Coughing, dyspnea, or chest pain

• Weakness or fatigue

• Pain, swelling, or full feeling in the abdomen

Melanoma

• Change in the shape, color, size, or feel of a mole (a brown, tan, or black spot on the skin that is flat or raised and round or oval)

• New mole or spot

• A spot that looks different from other spots

• Uneven mole shape—one half does not match the other half

• Mole edges are ragged, notched, or blurred

• Mole color is uneven with shades of black, brown, and tan; areas of pink, red, white, or blue

• Mole is hard or lumpy or itchy, tender, or painful

• Mole surface is bleeding, scaly, or oozing

Mouth and Lips

• White or red patches inside the mouth or on the lips

• A mouth or lip sore that does not heal

• Bleeding in the mouth

• Loose teeth or problems wearing dentures

• Dysphagia

• A lump in the neck

• Earache that does not go away

• Numbness of the lower lip and chin

Pancreas

• Jaundice—dark urine, pale stools, yellow skin and eyes

• Upper abdominal pain

• Middle back pain not improved with position change

• Nausea and vomiting

• Stools that float in the toilet

• Fatigue

• Anorexia or full feeling

Skin

• Flat, firm, or pale area or blue, brown, or black areas

• Pink, red, shiny, or pearly bump

• Oozing, rough, scaly, or crusted areas

• Red-colored patches

Prostate

• Problems urinating

• Slow or weak urine flow

• Frequent urination, especially at night

• Blood in the urine

• Erection problems

• Pain in the back, hips, or chest

• Weakness or numbness in the legs or feet

• Loss of bowel or bladder control

Thyroid

• Lump or swelling in the neck

• Hoarseness or voice changes

• Dysphagia

• Dyspnea

• Pain in the front of the neck and sometimes the ears

• Constant cough

Uterus

• Abnormal vaginal bleeding, spotting, or discharge

• Vaginal bleeding or spotting after menopause

• Vaginal discharge

• Pelvic pain

Modified from National Cancer Institute

• What you need to know about™ brain tumors, updated May 2009.

• What you need to know about™ cervical cancer, revised January 2012.

• What you need to know about™ bladder cancer, updated August 2010.

• What you need to know about™ kidney cancer, updated August 2010.

• What you need to know about™ cancer of the larynx, updated August 2010.

• What you need to know about™ non-Hodgkin lymphoma, updated September 2007.

• What you need to know about™ oral cancer, updated July 2009.

• What you need to know about™ cancer of the pancreas, updated May 2010.

American Cancer Society

• Signs and symptoms of cancer: what are signs and symptoms? revised August 11, 2014.

• Signs and symptoms of breast cancer, revised June 10, 2015.

• Signs and symptoms of colorectal cancer, revised August 13, 2015.

• Signs and symptoms of acute lymphocytic leukemia, revised January 12, 2015.

• Signs and symptoms of melanoma skin cancer, revised March 20, 2015.

• Signs and symptoms of basal and squamous cell skin cancers, revised April 3, 2015.

• Signs and symptoms of prostate cancer, revised March 12, 2015.

• Signs and symptoms of thyroid cancer, revised March 17, 2015.

• Signs and symptoms of uterine sarcomas, revised March 18, 2015.

Mayo Clinic, Diseases and conditions: lung cancer, March 19, 2014.

See Focus on Children and Older Persons: Cancer, p. 696.

Focus on Children and Older Persons

Cancer

Children

Sites of cancer in children are the same as for adults. However, some cancers are more common in children. They include:

Often signs and symptoms are similar to common illnesses and injuries. Children should see a doctor when the following signs and symptoms do not go away.