How should older patients with rectal cancer be treated?
Oct 16, 2016 · Question 1 1 out of 1 points An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should Response Feedback: Antiemetics should be administered proactively …
Who led the decision not to operate on patients with rectal cancer?
An adult client who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin.The nurse has conducted client teaching about the possibility of nausea and vomiting. In order to reduce the client's risk of severe nausea, the …
Are older patients with colon cancer less likely to receive guidelines-recommended therapies?
An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should A . place the patient on a low-residue diet.
How are the stages of rectal cancer indicated?
Oct 15, 2015 · Abstract. Colorectal cancer has a high incidence, and approximately 60% of colorectal cancer patients are older than 70, with this incidence likely increasing in the near future. Elderly patients (> 70-75 years of age) are a very heterogeneous group, ranging from the very fit to the very frail. Traditionally, these patients have often been ...
What is methotrexate prescribed for?
A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:
How long can cancer cells stay dormant?
No cancer cells have been identified that can remain dormant for more than 2 years. T/F
Do cancerous cells grow in an uncontrollable fashion?
Cancerous cells grow in an uncontrollable fashion.
How to deal with rectal cancer?
As you learn more about rectal cancer, you may become more confident in making treatment decisions. Keep friends and family close. Keeping your close relationships strong will help you deal with your rectal cancer.
How is rectal cancer treated?
Rectal cancer is often treated with surgery to remove the cancer cells. Which operation is best for you depends on your particular situation, such as the location and stage of your cancer, how aggressive the cancer cells are, your overall health, and your preferences.
What is the purpose of colonoscopy?
Colonoscopy. Colonoscopy. During a colonoscopy, the doctor inserts a colonoscope into your rectum to check for abnormalities in your entire colon. Rectal cancer can be found during a screening test for colorectal cancer. Or it may be suspected based on your symptoms.
What is the next step in rectal cancer?
Once you're diagnosed with rectal cancer, the next step is to determine the cancer's extent (stage). The stage of your cancer helps determine your prognosis and your treatment options. Complete blood count (CBC). This test reports the numbers of different types of cells in your blood.
What is the procedure to check for colon cancer?
Tests and procedures used to confirm the diagnosis include: Using a scope to examine the inside of your colon and rectum (colonoscopy). Colonoscopy uses a long, flexible tube (colonoscope) attached to a video camera and monitor to view your colon and rectum.
What is tissue test?
The tissue sample is sent to a lab to be examined by doctors who specialize in analyzing blood and body tissues (pathologists). Tests can determine whether the cells are cancer, whether they're aggressive and which genes in the cancer cells are abnormal.
Can chemotherapy help cancer?
Chemoradiotherapy may be recommended: Before surgery. Chemoradiotherapy may help shrink the cancer enough to make a less invasive surgery possible. The combined treatment may increase the chance that your operation will leave the anal area intact so waste can leave the body normally after surgery.
How to treat rheumatoid arthritis in a 25 year old female?
A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to: use an effective contraceptive. drink milk with the medication. expect a mild rash and itching. take a pain reliever for sore throat.
Why should you inspect the site frequently for redness or swelling?
Inspect the site frequently for redness or swelling Explanation: Site inspection is a major intervention for preventing extravasation. Distal veins should be used. Small veins in the hand or wrist should be avoided. An infusion pump should be avoided because it can continue to administer the drug under pressure, leading to severe extravasation.
How long after doxorubicin injection does urine turn red?
Reassure the client that it is a harmless and expected response to the drug. Explanation: Reddish urine is observed within a day or two after doxorubicin injection. The client should be reassured that it is a harmless and expected response to the drug. Nonpharmacologic interventions should be reviewed only if the client reports nausea and vomiting. Though it is necessary to reassure the client about adequate monitoring and follow-up in her home setting and caution her against taking aspirin, these suggestions do not pertain to the occurrence of reddish urine.
Why do nurses give allopurinol?
allopurinol Explanation: The nurse may be asked to administer allopurinol to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis. Amifostine binds with metabolites of cisplatin to protect the kidneys from nephrotoxic effects, reduces xerostomia. Mesna binds with metabolites of ifosfamide to protect the bladder from hemorrhagic cystitis. Leucovorin provides folic acid to cells after methotrexate administration.
Which antimetabolite drugs incorporate themselves into the cellular components during the S phase of cell division?
Mercaptopurine (Purinethol) Capecitabine (Xeloda) Fluorouracil (Adrucil) Explanation: Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division and include mercaptopurine (Purinethol), capecitabine (Xeloda), and fluorouracil (Adrucil).
Why is ovarian cancer considered aggressive?
A patient is diagnosed with ovarian cancer. Why is considered to be an aggressive form of cancer? It is fed by calcium in women who take estrogen. It is fed by the hormones produced by the ovaries. The younger the client, the more aggressive the form. The woman has a supply of testosterone from the ovaries.
What are the factors that influence the growth of tumors?
Explanation: Factors that influence the growth of tumors include blood and nutrient supply, immune response, and hormonal stimulation. The client's tumor is fed by the hormones produced by the ovaries. The tumor is not fed by calcium. A younger client may have more aggressive forms of cancer based on the increased hormone production in the younger client. The client is not producing testosterone from the ovaries.
Why is rectal cancer surgery important?
The aim of rectal cancer surgery in older patients should be not only to avoid local recurrence but also to maintain health and function with a view to optimizing their chances of coping with their treatment. Older patients are keen to avoid a permanent stoma and may accept a higher risk of local recurrence to achieve this. The impact of cancer surgery on quality of life is very important in elderly people. Sphincter function, assessed clinically and if necessary after manometry, is an essential element to consider in the preoperative assessment and the decision-making procedure. The delay of surgery following short-course radiotherapy has also been associated with a decrease in postoperative morbidity.
What factors should be taken into account when treating colorectal cancer?
Many factors should be taken into account, including fitness for treatment, the wishes of the patient and family, and quality of life. This review will focus on the existing evidence for surgical, oncologic, and palliative treatment in patients over 70 years old with colorectal cancer.
What did all authors contribute to the manuscript?
Author contributions: All authors contributed to the design of the article and review of the literature; Millan M edited the manuscript; all authors participated in the critical revision and approval of the final version of the article.
What are the factors that influence the decision to treat colon cancer?
Decisions about cancer treatment in the elderly may be influenced by a number of factors, including pre-existing health problems (comorbidities) and other conditions that might cause the potential risks of surgery, chemotherapy, and radiotherapy to outweigh the benefits of treatment. Risk stratification based on comorbidities and biochemical and physiological markers could help to decide whether to perform surgery, what type of surgery, and the timing of surgery. Physiological rather than chronological age should determine the management of cancer in each individual [ 5 ].
What are the difficulties of individualizing cancer treatment?
The main difficulty for individualizing treatment in elderly patients is the capacity to evaluate vulnerability to treatment. Several aspects should be taken into account [ 8 ], which include: (1) an estimation of life-expectancy based on functional evaluation and co-morbidities; (2) an estimation of the risk of cancer-related morbidity: a: Tumor stage at diagnosis; b: Risk of recurrence and tumor progression; and c: Tumor aggressiveness; (3) an evaluation of the conditions that could interfere in the cancer treatment and tolerance; a Comprehensive Geriatric Assessment [ 7] (CGA), which includes: a: undernutrition (recent loss of > 5% weight/body mass index < 19); b: polypharmacy (more than 10 medications); c: social isolation; d: depression; e: cognitive disorder; f: risk of falls; g: side effects of neoplasia: sensory deterioration, urinary incontinence, sexual dysfunction; h: comorbidities (number and severity of co-existing illnesses); and (4) an evaluation of the goals of the patient (what the patient expects from treatment). An important aspect of this evaluation is quality of life (subjective evaluation of life as a whole). The instruments that can be used to measure quality of life include, at least three of the following 10 aspects [ 9, 10 ]: Pain and other somatic symptoms, functional capacity, social and family well-being, emotional well-being, spirituality, satisfaction with care, future hopes and wishes, sexuality, body image, and social and work-related function.
What is aging in cancer?
Aging may be defined as a progressive decline in the functional reserve of multiple organ systems. This process is highly individualized, and poorly reflected in chronological age. The treatment of cancer should be based on the assessment of the physiological age, the patient’s life expectancy, and tolerance to treatment [ 4 ]. Older patients risk being undertreated, and, therefore, presenting a worse oncologic outcome. If they are over treated, however, there is an increased risk of morbidity and mortality [ 5 ].
How to treat cancer in elderly?
Surveys have found that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete [ 179 ]. The treatment plan should be comprehensive: cancer-specific treatment, symptom-specific treatment, supportive treatment modalities, and end-of-life care [ 180 ].
What is the code for colonoscopy?
To report screening colonoscopy on a patient not considered high risk for colorectal cancer, use HCPCS code G0121 and diagnosis code Z12.11 ( encounter for screening for malignant neoplasm of the colon ).
How often can you get a colonoscopy with Medicare?
Medicare beneficiaries without high risk factors are eligible for screening colonoscopy every ten years. Beneficiaries at high risk for developing colorectal cancer are eligible once every 24 months. Medicare considers an individual at high risk for developing colorectal cancer as one who has one or more of the following:
What does modifier PT mean in CPT?
Add modifier PT to the CPT ® codes above to indicate that a scheduled screening colonoscopy was converted to diagnostic or therapeutic. Modifier PT should be added to the anesthesia service as well. This informs Medicare that it was a service performed for screening and the patient will not be charged a deductible. There will be a co-pay due.
What does PT mean in CPT?
The PT modifier ( colorectal cancer screening test, converted to diagnostic test or other procedure) is appended to the CPT ® code.
What is G0121 in medical terms?
G0121 ( colorectal cancer screening; colonoscopy on individual not meeting the criteria for high risk.
What is a colonoscopy screening?
As such, “screening” describes a colonoscopy that is routinely performed on an asymptomatic person for the purpose of testing for the presence of colorectal cancer or colorectal polyps. Whether a polyp or cancer is ultimately found does not ...
What is a G0121?
Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen (s) by brushing or washing, with or without colon decompression (separate procedure) G0121 ( colorectal cancer screening; colonoscopy on individual not meeting the criteria for high risk.
What is the treatment for upper GI with small bowel?
Upper GI with small bowel follow through with Gastrografin
When does gastroesophageal reflux occur?
Gastroesophageal reflux is a common complaint in infants less than 1 year of age. In the first year of age, the pylorus is not fully developed and therefore not fully functional, leading to occasional episodes of reflux (also called spitting up).
How old is Vicodin in Mexico?
A 69-year-old immigrant from Mexico comes into the hospital with a 2-day history of severe pain in his left calf. He took Vicodin that a neighbor gave him with only minimal relief. Over the last day, he has lost sensation and movement in his left foot, which prompted him to finally come to the hospital.
Where does Stanford type B dissection begin?
A Stanford type B dissection begins in the descending aorta, distal to the takeoff of the left subclavian artery (A–D). Stanford Type B dissections are much less likely to cause acute complications since the ascending aorta/aortic arch are not involved.
Where is the bladder located in the sac?
Most often contains colon or bladder in the posterior aspect of the sac
Should bowel obstruction be manually reduced in the emergency department?
Should be manually reduced in the emergency department provided there is no evidence of bo wel obstruction
Does the size of the defect predict that it will not likely close on its own?
The size of the defect predicts that it will not likely close on its own
What is the procedure to detect colorectal cancer?
Biopsy. Usually if a suspected colorectal cancer is found by any screening or diagnostic test, it is biopsied during a colonoscopy. In a biopsy, the doctor removes a small piece of tissue with a special instrument passed through the scope.
How do you know if you have colorectal cancer?
This test can help tell if colorectal cancer has spread to nearby lymph nodes or to your liver, lungs, or other organs.
Why do we use tumor markers?
Tumor marker tests are used most often along with other tests to monitor patients who have already been diagnosed with colorectal cancer. They may help show how well treatment is working or provide an early warning that a cancer has returned.
What does CBC mean in cancer?
Complete blood count (CBC): This test measures the different types of cells in your blood. It can show if you have anemia (too few red blood cells). Some people with colorectal cancer become anemic because the tumor has been bleeding for a long time.
What tests can you take to see if you have cancer?
These tests also can be used to help monitor your disease if you’ve been diagnosed with cancer. Complete blood count (CBC): This test measures the different types of cells in your blood.
What do doctors look for in cancer?
Gene tests: If the cancer has spread (metastasized), doctors will probably look for specific gene changes in the cancer cells that might help determine which drugs will be more helpful in treatment than others. For example, doctors now typically test the cancer cells for changes in the KRAS, NRAS, and BRAF genes.
Why do you need a stool test?
If you are seeing the doctor because of anemia or symptoms you are having (other than obvious bleeding from your rectum or blood in your stools), he or she may recommend a stool test to check for blood that isn’t visible to the naked eye (occult blood), which might be a sign of cancer.
Diagnosis
Treatment
- Rectal cancer treatment often involves a combination of therapies. When possible, surgery is used to cut away the cancer cells. Other treatments, such as chemotherapy and radiation therapy, may be used after surgery to kill any cancer cells that remain and reduce the risk that cancer will return. If surgeons are concerned that the cancer can't be r...
Clinical Trials
- Explore Mayo Clinic studiestesting new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Coping and Support
- A diagnosis of cancer can be overwhelming. With time you'll find ways to cope with the distress and uncertainty of cancer. Until then, you may find that it helps to: 1. Learn enough about rectal cancer to make decisions about your care.Ask your doctor about your cancer, including your treatment options and, if you like, your prognosis. As you learn more about rectal cancer, you ma…
Preparing For Your Appointment
- If your doctor suspects that you may have rectal cancer, you'll likely be referred to one or more specialists who treat rectal cancer, including: 1. A doctor who treats digestive diseases (gastroenterologist) 2. A doctor who treats cancer (oncologist) 3. A surgeon specializing in procedures involving the colon and rectum (colorectal surgeon) 4. A doctor who uses radiation t…