NLE Oncology Nursing — Cancer Pathophysiology, Prevention and DetectionConcept Map

Concept

Pathophysiology of Cancer

Sub Concepts

• Normal Cell Regulation
• Genetic Mutations
• Oncogenes and Tumor Suppressor Genes
• Carcinogenesis Process
• Invasion and Metastasis

Relationship To Central

Foundation explaining how cancer develops at cellular and molecular level

Concept

Tumor Characteristics and Classification

Sub Concepts

• Benign vs Malignant Tumors
• Grading (Cellular Differentiation)
• Staging (TNM System)
• Tumor Nomenclature
• Sites of Metastasis

Relationship To Central

Clinical descriptors that distinguish cancer types and severity

Concept

Cancer Detection and Diagnosis

Sub Concepts

• Warning Signs (CAUTION)
• Screening and Early Detection
• Diagnostic Tests
• Biopsy Types
• Tumor Markers

Relationship To Central

Methods to identify and confirm malignancy

Concept

Cancer Prevention

Sub Concepts

• Primary Prevention (Risk Reduction)
• Secondary Prevention (Early Detection)
• Lifestyle Modifications
• Vaccinations
• Occupational Safety

Relationship To Central

Strategies to reduce cancer incidence and risk

Concept

Cancer in the Philippines

Sub Concepts

• Leading Cancer Types
• Department of Health Programs
• RA 11215 (NICCA)
• Cancer Assistance Fund
• Nursing Advocacy

Relationship To Central

National epidemiology and healthcare response

Concept

Nursing Management

Sub Concepts

• Health Education
• Self-Examination Teaching
• Diagnostic Support
• Community Advocacy
• Cultural Competence

Relationship To Central

Professional interventions aligned with RA 9173 Nursing Practice Act

To

Carcinogenesis Process

From

Proto-oncogenes and Tumor Suppressor Genes

Strength

strong

Relationship

Mutations in these genes drive the three stages of carcinogenesis; normal protective functions are lost

To

Promotion Stage

From

Carcinogenesis Process

Strength

strong

Relationship

The promotion stage is reversible, making it the critical window for primary prevention interventions

To

Failure of Apoptosis

From

Tumor Suppressor Gene Loss

Strength

strong

Relationship

When p53 and other suppressor genes are inactivated, programmed cell death cannot occur, allowing malignant cells to persist

To

Progression Stage

From

Angiogenesis

Strength

strong

Relationship

Tumor development of its own blood supply marks the transition to aggressive, progressive malignancy

To

Lymphatic System Spread

From

Metastasis

Strength

strong

Relationship

The lymphatic route is the most common pathway for carcinoma spread; regional node involvement is assessed in TNM staging

To

Lung Liver Bone Brain

From

Metastatic Sites

Strength

strong

Relationship

These are the four most common organs affected by distant metastasis across cancer types

To

Well Differentiation

From

Benign Tumors

Strength

strong

Relationship

Benign tumors retain normal cellular structure and appearance; slow growth; encapsulation confines the lesion

To

Anaplasia and Invasiveness

From

Malignant Tumors

Strength

strong

Relationship

Loss of differentiation and infiltrative growth are hallmarks of cancer; enables invasion and metastasis

To

Cellular Differentiation

From

Grading System

Strength

strong

Relationship

Grade reflects how abnormal cells appear microscopically; Grade 4 is anaplastic and most aggressive

To

Overall Stage 0-IV

From

TNM Staging

Strength

strong

Relationship

Combination of T, N, and M components produces an integrated stage that predicts prognosis and guides treatment

To

Distant Metastasis

From

Stage IV Cancer

Strength

strong

Relationship

Presence of M1 (distant metastasis) defines Stage IV, the most advanced and poorest prognosis

To

Early Detection Screening

From

CAUTION Warning Signs

Strength

strong

Relationship

Patient recognition of CAUTION signs prompts evaluation; nurses teach awareness as part of secondary prevention

To

Cervical Cancer Prevention

From

Pap Smear Screening

Strength

strong

Relationship

Detects precancerous HPV changes; combined with HPV vaccination, dramatically reduces cervical cancer incidence

To

Breast Cancer Early Detection

From

Mammography

Strength

strong

Relationship

Routine mammography screening from age 40 detects breast cancer at earlier, more treatable stages

To

Colorectal Cancer Prevention

From

Colonoscopy

Strength

strong

Relationship

Detects and removes polyps before malignant transformation; considered primary prevention at the polyp level

To

Definitive Cancer Diagnosis

From

Biopsy

Strength

strong

Relationship

Histopathologic examination of tissue is the gold standard; imaging and tumor markers support but do not replace biopsy

To

Treatment Monitoring

From

Tumor Markers

Strength

moderate

Relationship

PSA, CA-125, CEA, AFP are used to monitor response to therapy and detect recurrence; not for initial diagnosis

To

Lung Cancer Prevention

From

Tobacco Avoidance

Strength

strong

Relationship

Smoking cessation and avoidance of secondhand smoke is the most effective primary prevention for lung cancer

To

Cervical Cancer Prevention

From

HPV Vaccination

Strength

strong

Relationship

HPV vaccine prevents infection with oncogenic strains; primary prevention before exposure occurs

To

Liver Cancer Prevention

From

Hepatitis B Vaccination

Strength

strong

Relationship

Hep B vaccine prevents chronic infection that leads to hepatocellular carcinoma; national childhood program in Philippines

To

Colorectal and Breast Cancer Prevention

From

Healthy Diet and Exercise

Strength

moderate

Relationship

Reduces risk through maintained weight, improved gut motility, and hormonal balance

To

Melanoma and Skin Cancer Prevention

From

Sun Protection

Strength

strong

Relationship

Reduces UV exposure, the primary modifiable risk factor for malignant and nonmalignant skin cancers

To

Breast Lung Colorectal Liver Cervical

From

Leading Cancers in Philippines

Strength

strong

Relationship

These five cancer types account for the majority of cancer burden in the Filipino population

To

Liver Cancer Prevalence

From

Hepatitis B Endemicity

Strength

strong

Relationship

Philippines has moderate to high hepatitis B prevalence; chronic infection is the major risk for hepatocellular carcinoma

To

Cervical Cancer Incidence

From

HPV Prevalence

Strength

strong

Relationship

HPV infection is necessary but not sufficient for cervical cancer; vaccination and screening are key prevention strategies

To

Lung Cancer Leadership in Men

From

Smoking Prevalence in Males

Strength

strong

Relationship

High male smoking rates in Philippines drive lung cancer as top cancer in men; ongoing public health challenge

To

National Cancer Control Program

From

RA 11215 NICCA

Strength

strong

Relationship

Republic Act 11215 (2019) legally mandates integrated cancer control across prevention, detection, treatment, and financial protection

To

Cancer Screening Programs

From

Department of Health

Strength

strong

Relationship

DOH implements national screening initiatives, trains providers, and coordinates cancer services in provincial and municipal levels

To

Financial Protection for Patients

From

Cancer Assistance Fund

Strength

moderate

Relationship

RA 11215 established the fund to reduce financial burden and improve access to treatment for poor cancer patients

To

Primary and Secondary Prevention

From

Nursing Health Education

Strength

strong

Relationship

Nurses are frontline educators for risk factor counseling, CAUTION sign awareness, and screening promotion in communities

To

Filipino Cancer Patients

From

Family-Centered Care

Strength

strong

Relationship

Family involvement in decision-making and care is culturally essential and improves patient compliance and outcomes

To

Overcoming Fatalism and Delays

From

Cultural Sensitivity

Strength

moderate

Relationship

Nurses must address Filipino beliefs in kapalaran and balangkas to encourage early symptom reporting and screening

To

Nursing Scope in Cancer Care

From

RA 9173 Nursing Practice Act

Strength

strong

Relationship

The law defines nursing functions in assessment, education, advocacy, and care coordination in oncology and prevention settings

To

Cancer-Related Patient Problems

From

NANDA Nursing Diagnoses

Strength

strong

Relationship

Common diagnoses include Risk for Ineffective Coping, Deficient Knowledge, Fear, and Risk for Delayed Help-Seeking

To

Nursing Priority Setting

From

Maslow Hierarchy of Needs

Strength

strong

Relationship

Physiologic needs (pain, symptom control) are addressed before psychosocial and education interventions