Samenvatting minor oncologie verpleegkunde 2024
,Darmkanker .................................................................................................................................................. 11
Anatomie en fysiologie ..................................................................................................................................... 11
Problemen met de darmen ............................................................................................................................... 12
Etiologie en epidemiologie ............................................................................................................................... 12
Preventie........................................................................................................................................................... 13
Symptomatologie ............................................................................................................................................. 14
Diagnostiek ....................................................................................................................................................... 14
Pathologie ........................................................................................................................................................ 15
Behandeling ...................................................................................................................................................... 16
Chirurgie ...................................................................................................................................................... 16
Postoperatieve zorg ..................................................................................................................................... 18
Adjuvante behandelingen............................................................................................................................ 19
Palliatieve zorg............................................................................................................................................. 20
Follow-up ..................................................................................................................................................... 20
Rectumcarcinoom ............................................................................................................................................. 21
Preventie ..................................................................................................................................................... 21
Symptomatologie ........................................................................................................................................ 21
Diagnostiek .................................................................................................................................................. 21
Behandeling ................................................................................................................................................. 22
Chirurgie ...................................................................................................................................................... 22
Postoperatieve complicaties ....................................................................................................................... 23
Palliatieve zorg............................................................................................................................................. 24
Prognose en follow up ................................................................................................................................. 24
Stoma-, wond en incontinentiezorg.................................................................................................................. 24
Urinestoma .................................................................................................................................................. 24
Stomaproblemen ......................................................................................................................................... 24
Mammacarcinoom........................................................................................................................................ 26
Anatomie en fysiologie ..................................................................................................................................... 26
Etiologie en epidemiologie ............................................................................................................................... 27
Preventie........................................................................................................................................................... 28
Vroegtijdige screening ................................................................................................................................. 28
Risicofactoren .............................................................................................................................................. 29
Symptomatologie ............................................................................................................................................. 30
Diagnostiek ....................................................................................................................................................... 30
Anamnese en lichamelijk onderzoek ........................................................................................................... 31
Radiologisch onderzoek ............................................................................................................................... 32
Pathologie ........................................................................................................................................................ 33
Soorten borstkanker .................................................................................................................................... 34
Ductaal carcinoma in situ (DCIS) ............................................................................................................. 34
Lobulair carcinoma in situ (LCIS) ............................................................................................................. 34
Invasief carcinoom NST. .......................................................................................................................... 34
Invasief lobulair carcinoom. .................................................................................................................... 34
Hormoongevoelige borstkanker. ............................................................................................................ 35
HER2-positieve borstkanker.................................................................................................................... 35
Triple negatieve borstkanker. ................................................................................................................. 35
Inflammatoire borstkanker. .................................................................................................................... 35
, Carcinoom in situ ......................................................................................................................................... 35
Lokaal uitgebreid mammacarcinoom .......................................................................................................... 35
Stadium IIB-ziekte: .................................................................................................................................. 35
Stadium IIIA-ziekte: ................................................................................................................................. 36
Stadium IIIB-ziekte: ................................................................................................................................. 36
Stadium IIIC-ziekte: ................................................................................................................................. 36
Behandeling ...................................................................................................................................................... 37
Lokale en locoregionale behandeling .......................................................................................................... 37
Mammasparende therapie = MST .......................................................................................................... 37
Gemodificeerde radicale mastectomie = GRM ....................................................................................... 38
Lumpectomie .......................................................................................................................................... 38
Oncoplastische mammachirurgie ........................................................................................................... 38
Mastectomie ........................................................................................................................................... 38
Chirurgie van de oksel ............................................................................................................................. 38
Radiotherapie .............................................................................................................................................. 39
(Neo)-Adjuvante systeemtherapie .......................................................................................................... 40
Neo-adjuvante systeemtherapie ............................................................................................................ 40
Adjuvante systeemtherapie .................................................................................................................... 41
Mamareconstructie .......................................................................................................................................... 41
Technieken .................................................................................................................................................. 41
Prothese .................................................................................................................................................. 41
Reconstructie met eigen weefsel ................................................................................................................ 41
Weefselverplaatsing ............................................................................................................................... 41
DIEP-LAP.................................................................................................................................................. 41
S-GAP ...................................................................................................................................................... 42
Overige reconstructie methoden ............................................................................................................ 42
Reconstructie tepel en tepelhof ............................................................................................................. 42
Behandeling gemetastaseerde ziekte ............................................................................................................... 42
Systeemtherapie .......................................................................................................................................... 42
- Anti-hormonale therapie ............................................................................................................... 42
- Hormoontherapie .......................................................................................................................... 42
- Palliatieve chemotherapie ............................................................................................................. 43
- Immunotherapie ........................................................................................................................... 43
- Targeted therapie .......................................................................................................................... 43
- Toediening van bisfosnaten .......................................................................................................... 43
Palliatieve radiotherapie ......................................................................................................................... 44
Prognose en follow up ...................................................................................................................................... 44
Follow-up ..................................................................................................................................................... 45
Specifieke zorg problematiek en mogelijke interventies................................................................................... 45
Complicaties ................................................................................................................................................ 45
Bijwerkingen van chemotherapie: .......................................................................................................... 46
Lymfoedeem ........................................................................................................................................... 46
Lichamelijke en psychosociale problemen: ............................................................................................ 47
Dermatologische oncologie ........................................................................................................................... 48
Anatomie en fysiologie ..................................................................................................................................... 48
Etiologie en epidemiologie ............................................................................................................................... 49
Preventie........................................................................................................................................................... 50
Primaire preventie ....................................................................................................................................... 50
Secundaire preventie ................................................................................................................................... 51
Tertiaire Preventie ....................................................................................................................................... 51
Symptomatologie ............................................................................................................................................. 51
, Anamnese .................................................................................................................................................... 51
Lichamelijk onderzoek ................................................................................................................................. 52
ABCDE regel: ........................................................................................................................................... 52
Basaalcelcarcinoom .......................................................................................................................................... 53
Etiologie en epidemiologie .......................................................................................................................... 53
Etiologie .................................................................................................................................................. 53
Vormen ................................................................................................................................................... 53
Symptomatologie ........................................................................................................................................ 53
Diagnostiek en stadiëring ............................................................................................................................ 53
Behandeling ................................................................................................................................................. 54
1. Chirurgie ........................................................................................................................................ 54
2. Mohs micrografische chirurgie (MMC).......................................................................................... 54
3. Cryotherapie .................................................................................................................................. 54
4. Lokale therapie met cytostatische (5-FU) of immuunmodulerende (imiquimod) cremes ............ 55
5. Fotodynamische therapie .............................................................................................................. 55
6. Radiotherapie ................................................................................................................................ 55
7. Doelgerichte therapie.................................................................................................................... 55
Prognose en follow-up................................................................................................................................. 55
Plaveiselcelcarcinoom....................................................................................................................................... 56
Etiologie en epidemiologie .......................................................................................................................... 56
Risicofactoren .............................................................................................................................................. 56
Symptomatologie ........................................................................................................................................ 56
Diagnostiek en stadiëring ............................................................................................................................ 57
Behandeling ................................................................................................................................................. 57
1. Chirurgie ........................................................................................................................................ 57
2. Radiotherapie ................................................................................................................................ 58
3. Immuuntherapie ........................................................................................................................... 58
4. Overige .......................................................................................................................................... 58
Prognose en follow up ................................................................................................................................. 58
Prognose ................................................................................................................................................. 58
Follow-up ................................................................................................................................................ 58
Melanoom ........................................................................................................................................................ 59
Epidemiologie en etiologie .......................................................................................................................... 59
Risicofactoren .............................................................................................................................................. 59
Endogeen ................................................................................................................................................ 59
Exogeen................................................................................................................................................... 59
Metastasen ............................................................................................................................................. 59
Diagnostiek en stadiëring ............................................................................................................................ 60
Histologisch onderzoek................................................................................................................................ 61
Pathologisch onderzoek: ............................................................................................................................. 61
Behandeling ................................................................................................................................................. 61
Stadium I&II ............................................................................................................................................ 61
Bij stadium III .......................................................................................................................................... 62
Systemische behandeling........................................................................................................................ 64
Schildwachtklierprocedure ..................................................................................................................... 64
Follow-up en prognose ................................................................................................................................ 64
Merkelcelcarcinoom ......................................................................................................................................... 66
Epidemiologie en etiologie .......................................................................................................................... 66
Symptomatologie ........................................................................................................................................ 66
Behandeling ................................................................................................................................................. 66
Prognose en follow up ................................................................................................................................. 66
Symptomatologie ............................................................................................................................................. 67
Diagnostiek ....................................................................................................................................................... 67
,Darmkanker .................................................................................................................................................. 11
Anatomie en fysiologie ..................................................................................................................................... 11
Problemen met de darmen ............................................................................................................................... 12
Etiologie en epidemiologie ............................................................................................................................... 12
Preventie........................................................................................................................................................... 13
Symptomatologie ............................................................................................................................................. 14
Diagnostiek ....................................................................................................................................................... 14
Pathologie ........................................................................................................................................................ 15
Behandeling ...................................................................................................................................................... 16
Chirurgie ...................................................................................................................................................... 16
Postoperatieve zorg ..................................................................................................................................... 18
Adjuvante behandelingen............................................................................................................................ 19
Palliatieve zorg............................................................................................................................................. 20
Follow-up ..................................................................................................................................................... 20
Rectumcarcinoom ............................................................................................................................................. 21
Preventie ..................................................................................................................................................... 21
Symptomatologie ........................................................................................................................................ 21
Diagnostiek .................................................................................................................................................. 21
Behandeling ................................................................................................................................................. 22
Chirurgie ...................................................................................................................................................... 22
Postoperatieve complicaties ....................................................................................................................... 23
Palliatieve zorg............................................................................................................................................. 24
Prognose en follow up ................................................................................................................................. 24
Stoma-, wond en incontinentiezorg.................................................................................................................. 24
Urinestoma .................................................................................................................................................. 24
Stomaproblemen ......................................................................................................................................... 24
Mammacarcinoom........................................................................................................................................ 26
Anatomie en fysiologie ..................................................................................................................................... 26
Etiologie en epidemiologie ............................................................................................................................... 27
Preventie........................................................................................................................................................... 28
Vroegtijdige screening ................................................................................................................................. 28
Risicofactoren .............................................................................................................................................. 29
Symptomatologie ............................................................................................................................................. 30
Diagnostiek ....................................................................................................................................................... 30
Anamnese en lichamelijk onderzoek ........................................................................................................... 31
Radiologisch onderzoek ............................................................................................................................... 32
Pathologie ........................................................................................................................................................ 33
Soorten borstkanker .................................................................................................................................... 34
Ductaal carcinoma in situ (DCIS) ............................................................................................................. 34
Lobulair carcinoma in situ (LCIS) ............................................................................................................. 34
Invasief carcinoom NST. .......................................................................................................................... 34
Invasief lobulair carcinoom. .................................................................................................................... 34
Hormoongevoelige borstkanker. ............................................................................................................ 35
HER2-positieve borstkanker.................................................................................................................... 35
Triple negatieve borstkanker. ................................................................................................................. 35
Inflammatoire borstkanker. .................................................................................................................... 35
, Carcinoom in situ ......................................................................................................................................... 35
Lokaal uitgebreid mammacarcinoom .......................................................................................................... 35
Stadium IIB-ziekte: .................................................................................................................................. 35
Stadium IIIA-ziekte: ................................................................................................................................. 36
Stadium IIIB-ziekte: ................................................................................................................................. 36
Stadium IIIC-ziekte: ................................................................................................................................. 36
Behandeling ...................................................................................................................................................... 37
Lokale en locoregionale behandeling .......................................................................................................... 37
Mammasparende therapie = MST .......................................................................................................... 37
Gemodificeerde radicale mastectomie = GRM ....................................................................................... 38
Lumpectomie .......................................................................................................................................... 38
Oncoplastische mammachirurgie ........................................................................................................... 38
Mastectomie ........................................................................................................................................... 38
Chirurgie van de oksel ............................................................................................................................. 38
Radiotherapie .............................................................................................................................................. 39
(Neo)-Adjuvante systeemtherapie .......................................................................................................... 40
Neo-adjuvante systeemtherapie ............................................................................................................ 40
Adjuvante systeemtherapie .................................................................................................................... 41
Mamareconstructie .......................................................................................................................................... 41
Technieken .................................................................................................................................................. 41
Prothese .................................................................................................................................................. 41
Reconstructie met eigen weefsel ................................................................................................................ 41
Weefselverplaatsing ............................................................................................................................... 41
DIEP-LAP.................................................................................................................................................. 41
S-GAP ...................................................................................................................................................... 42
Overige reconstructie methoden ............................................................................................................ 42
Reconstructie tepel en tepelhof ............................................................................................................. 42
Behandeling gemetastaseerde ziekte ............................................................................................................... 42
Systeemtherapie .......................................................................................................................................... 42
- Anti-hormonale therapie ............................................................................................................... 42
- Hormoontherapie .......................................................................................................................... 42
- Palliatieve chemotherapie ............................................................................................................. 43
- Immunotherapie ........................................................................................................................... 43
- Targeted therapie .......................................................................................................................... 43
- Toediening van bisfosnaten .......................................................................................................... 43
Palliatieve radiotherapie ......................................................................................................................... 44
Prognose en follow up ...................................................................................................................................... 44
Follow-up ..................................................................................................................................................... 45
Specifieke zorg problematiek en mogelijke interventies................................................................................... 45
Complicaties ................................................................................................................................................ 45
Bijwerkingen van chemotherapie: .......................................................................................................... 46
Lymfoedeem ........................................................................................................................................... 46
Lichamelijke en psychosociale problemen: ............................................................................................ 47
Dermatologische oncologie ........................................................................................................................... 48
Anatomie en fysiologie ..................................................................................................................................... 48
Etiologie en epidemiologie ............................................................................................................................... 49
Preventie........................................................................................................................................................... 50
Primaire preventie ....................................................................................................................................... 50
Secundaire preventie ................................................................................................................................... 51
Tertiaire Preventie ....................................................................................................................................... 51
Symptomatologie ............................................................................................................................................. 51
, Anamnese .................................................................................................................................................... 51
Lichamelijk onderzoek ................................................................................................................................. 52
ABCDE regel: ........................................................................................................................................... 52
Basaalcelcarcinoom .......................................................................................................................................... 53
Etiologie en epidemiologie .......................................................................................................................... 53
Etiologie .................................................................................................................................................. 53
Vormen ................................................................................................................................................... 53
Symptomatologie ........................................................................................................................................ 53
Diagnostiek en stadiëring ............................................................................................................................ 53
Behandeling ................................................................................................................................................. 54
1. Chirurgie ........................................................................................................................................ 54
2. Mohs micrografische chirurgie (MMC).......................................................................................... 54
3. Cryotherapie .................................................................................................................................. 54
4. Lokale therapie met cytostatische (5-FU) of immuunmodulerende (imiquimod) cremes ............ 55
5. Fotodynamische therapie .............................................................................................................. 55
6. Radiotherapie ................................................................................................................................ 55
7. Doelgerichte therapie.................................................................................................................... 55
Prognose en follow-up................................................................................................................................. 55
Plaveiselcelcarcinoom....................................................................................................................................... 56
Etiologie en epidemiologie .......................................................................................................................... 56
Risicofactoren .............................................................................................................................................. 56
Symptomatologie ........................................................................................................................................ 56
Diagnostiek en stadiëring ............................................................................................................................ 57
Behandeling ................................................................................................................................................. 57
1. Chirurgie ........................................................................................................................................ 57
2. Radiotherapie ................................................................................................................................ 58
3. Immuuntherapie ........................................................................................................................... 58
4. Overige .......................................................................................................................................... 58
Prognose en follow up ................................................................................................................................. 58
Prognose ................................................................................................................................................. 58
Follow-up ................................................................................................................................................ 58
Melanoom ........................................................................................................................................................ 59
Epidemiologie en etiologie .......................................................................................................................... 59
Risicofactoren .............................................................................................................................................. 59
Endogeen ................................................................................................................................................ 59
Exogeen................................................................................................................................................... 59
Metastasen ............................................................................................................................................. 59
Diagnostiek en stadiëring ............................................................................................................................ 60
Histologisch onderzoek................................................................................................................................ 61
Pathologisch onderzoek: ............................................................................................................................. 61
Behandeling ................................................................................................................................................. 61
Stadium I&II ............................................................................................................................................ 61
Bij stadium III .......................................................................................................................................... 62
Systemische behandeling........................................................................................................................ 64
Schildwachtklierprocedure ..................................................................................................................... 64
Follow-up en prognose ................................................................................................................................ 64
Merkelcelcarcinoom ......................................................................................................................................... 66
Epidemiologie en etiologie .......................................................................................................................... 66
Symptomatologie ........................................................................................................................................ 66
Behandeling ................................................................................................................................................. 66
Prognose en follow up ................................................................................................................................. 66
Symptomatologie ............................................................................................................................................. 67
Diagnostiek ....................................................................................................................................................... 67
