Bsc nursing cancer total topics

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BSc Nursing oncology cancer syllabus topics India 2024

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BSc Nursing 3rd year medical surgical nursing cancer chapter topics India INC syllabus

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Here is a complete, structured breakdown of all cancer/oncology topics covered in the BSc Nursing curriculum (as per Indian Nursing Council guidelines, primarily under Medical-Surgical Nursing II in 3rd Year):

BSc Nursing - Cancer / Oncology: Complete Topic List

UNIT 1: Introduction & Epidemiology of Cancer

Definition of cancer
Prevalence and incidence statistics (national and global)
Risk factors - chemical, physical, biological, lifestyle, genetic
Causes and contributing factors
Cancer prevention strategies
Health promotion and early detection
Screening programs (PAP smear, mammography, BSE, FNAC)
Warning signs of cancer (CAUTION signs)

UNIT 2: Biology & Pathophysiology of Cancer

Cell cycle - phases (G1, S, G2, M)
Characteristics of normal cells vs. cancer cells
Carcinogenesis - initiation, promotion, progression stages
Definitions: dysplasia, metaplasia, anaplasia, neoplasia
Benign vs. malignant tumor characteristics
Genomics and genetics of cancer - oncogenes, tumor suppressor genes
Metastasis - modes and mechanisms (direct spread, lymphatic, hematogenous, transcoelomic)
Molecular biology of cancer
Tumor microenvironment

UNIT 3: Classification, Staging & Grading

Classification of tumors - by tissue of origin (carcinoma, sarcoma, lymphoma, leukemia, mixed)
Staging - TNM staging system (Tumor, Node, Metastasis)
Grading - Grade I to IV (degree of differentiation)
Cancer staging I to IV
Nurses' responsibilities in staging and grading

UNIT 4: Diagnostic Tests & Investigations

Tumor markers and biomarkers (CEA, PSA, AFP, CA-125, CA-19.9, etc.)
Cytology tests (PAP smear, FNAC)
Biopsy - excisional, incisional, needle
Bone marrow aspiration and trephine biopsy
Endoscopy and laparoscopy
Histopathology and immunohistochemistry
Imaging: CT scan, MRI, PET scan, ultrasound
Radionuclide imaging and use of radioisotopes
Functional and metabolic imaging
Mammography
Nurses' responsibilities during diagnostic procedures

UNIT 5: Treatment Modalities

A. Surgery

Types of cancer surgery - curative, palliative, prophylactic, reconstructive
Pre- and post-operative nursing management
Principles of surgical oncology

B. Chemotherapy

Classification of chemotherapeutic agents:
- Alkylating agents
- Antimetabolites
- Plant alkaloids (vinca alkaloids, taxanes)
- Antitumor antibiotics
- Topoisomerase inhibitors
- Targeted therapy agents
Mechanism of action
Routes of administration - oral, IV, intrathecal, intravesical
Side effects and toxicities: myelosuppression, mucositis, alopecia, nausea, peripheral neuropathy
Nursing management during chemotherapy
Safe handling of cytotoxic drugs
Central Venous Access Devices (CVADs) - PICC line, Hickman catheter, Chemo port, central lines
Extravasation management

C. Radiotherapy

Types: external beam, brachytherapy, stereotactic
Mechanism of action (ionizing radiation, DNA damage)
Side effects: skin reactions, fatigue, radiation mucositis, bone marrow suppression
Nursing care during radiotherapy
Radiation safety and protection (ALARA principle)

D. Immunotherapy

Concept of immune surveillance
Types: monoclonal antibodies, checkpoint inhibitors, cytokines (IL-2, interferon)
CAR-T cell therapy
Side effects and nursing management

E. Hormone Therapy

Hormone-responsive cancers (breast, prostate, endometrial)
Drugs: Tamoxifen, Aromatase inhibitors, LHRH agonists
Nursing responsibilities

F. Targeted Therapy

Tyrosine kinase inhibitors (Imatinib, Erlotinib)
HER2-targeted therapy (Trastuzumab)
VEGF inhibitors (Bevacizumab)

G. Gene Therapy

Concept and current status
Types: gene replacement, gene silencing, oncolytic viruses

H. Stem Cell & Bone Marrow Transplantation (BMT)

Types: autologous, allogeneic, syngeneic
Hematopoietic stem cell collection and preservation
Nursing care of transplant recipient
Engraftment syndrome management
Graft-vs-host disease (GVHD)
Preparation for discharge and home care

I. Other/Alternative Therapies

Complementary therapies (yoga, meditation, acupuncture)
Herbal and nutritional therapies

UNIT 6: Common Malignancies (System-wise)

System	Cancers Covered
Head & Neck	Oral cancer, Laryngeal cancer
Respiratory	Lung cancer
GI Tract	Stomach cancer, Colorectal cancer, Liver cancer
Hematological	Leukemias (ALL, AML, CLL, CML), Lymphomas (Hodgkin's, Non-Hodgkin's), Multiple myeloma
Female Reproductive	Breast cancer, Cervical cancer, Ovarian cancer, Uterine/Endometrial cancer
Male Reproductive	Prostate cancer, Testicular cancer
Urinary	Renal cell carcinoma, Bladder cancer
Neurological	Brain tumors (Gliomas, Meningiomas)
Musculoskeletal	Osteosarcoma, Ewing's sarcoma
Skin	Melanoma, Basal cell carcinoma, Squamous cell carcinoma
Pediatric	Wilms' tumor, Neuroblastoma, Retinoblastoma, ALL in children

For each cancer, the following are covered:

Epidemiology and etiology
Pathophysiology
Classification / staging
Clinical manifestations (signs and symptoms)
Diagnostic investigations
Medical and surgical management
Nursing assessment and nursing diagnoses
Nursing care plan (pre-op, intra-op, post-op)
Patient and family education
Prognosis

UNIT 7: Nursing Assessment of Cancer Patients

Comprehensive history taking
Physical examination (head-to-toe)
Psychological, social, cultural and spiritual assessment
Symptom assessment: pain, fatigue, nutritional status
Nursing diagnosis formulation
Assessment in pediatric and adult patients

UNIT 8: Oncological Emergencies

Superior Vena Cava Syndrome (SVCS)
Spinal cord compression
Cardiac tamponade
Hypercalcemia of malignancy
Tumor lysis syndrome (TLS)
Disseminated Intravascular Coagulation (DIC)
Septic shock in neutropenic patients (Febrile neutropenia)
Syndrome of Inappropriate ADH secretion (SIADH)
Pathologic fractures

UNIT 9: Infection Control in Oncology

Immunity in cancer patients (immunosuppression)
Principles of asepsis, sterilization and disinfection
Standard precautions and barrier nursing
Protective/reverse isolation
Biomedical waste management
Fumigation
Safe handling of cytotoxic waste
Standard Operating Procedures (SOPs) for infection control and chemotherapy

UNIT 10: Psychosocial, Cultural & Spiritual Aspects

Human behavior and coping with cancer
Stages of grief (Kubler-Ross model) applied to cancer
Factors influencing psychosocial adjustment
Sociocultural attitudes toward cancer
Anxiety, depression, and body image disturbances
Guidance and counselling techniques
Spiritual and cultural care
Communication with cancer patients and families
Breaking bad news

UNIT 11: Palliative Care & Pain Management

Concept and philosophy of palliative care
WHO analgesic ladder for cancer pain
Pharmacological management: NSAIDs, Opioids, adjuvants
Non-pharmacological pain management
Symptom management - dyspnea, nausea, constipation, anorexia, fatigue
Hospice care - concept and principles
Care of the dying patient
Care of the dead body
Bereavement counselling for families

UNIT 12: Rehabilitation, Nutritional Support & Home Care

Principles of cancer rehabilitation
Physical rehabilitation (mastectomy, laryngectomy, ostomy care)
Nutritional assessment and support - enteral and parenteral nutrition
Dietary management in cancer
Home care of cancer patients
Discharge planning
Community resources and cancer support groups

UNIT 13: Procedures & Equipment in Oncology (Clinical Skills)

Bone marrow aspiration and biopsy (assist)
Hematopoietic stem cell collection and preservation
Insertion and care of CVADs (PICC, Hickman, Chemo port, central lines)
Apheresis machine
Platelet agitator
Bio-safety cabinet
Thawing machine
Cryopreservation
Blood component refrigerator
Conducting unit audits

UNIT 14: Quality Control & SOP Preparation

Preparation of SOP for infection control in oncology
Preparation of SOP for chemotherapy administration
Conducting unit audit

UNIT 15: Professionalism & Evidence-Based Practice in Oncology Nursing

Scope of oncology nursing practice
Roles and responsibilities of cancer nurses in different settings (OPD, inpatient, ICU, palliative, home)
Evidence-based practice in oncology
Research in oncology nursing
Patient education and counselling methods
Clinical leadership and resource management

Quick Reference: Key Cancer Nursing Skills (Practical)

Comprehensive assessment of adult and pediatric cancer patients
Writing nursing care plans for cancer patients
Counselling patients and families
Screening for common cancers (PAP smear, BSE, FNAC assist)
Assisting in biopsies and bone marrow aspiration
Chemotherapy administration (safety, extravasation management)
Radiation safety practices
Pain assessment tools (VAS, NRS, FACES scale)
Stoma care (colostomy, urostomy)
Central line care and CVAD maintenance
Palliative care and EOL nursing
Breast self-examination (BSE) demonstration and teaching

This covers the complete cancer/oncology topic list as per the Indian Nursing Council (INC) BSc Nursing syllabus, primarily in 3rd Year Medical-Surgical Nursing II (100 theory hours) along with related clinical postings (400 practical hours). Topics may also appear in related chapters of Child Health Nursing (pediatric cancers), Pharmacology, and Pathology.

Comman pathology physiology of eye

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Here is a complete, well-structured breakdown of the common pathology and physiology of the eye as covered in nursing and medical curricula:

Common Pathology & Physiology of the Eye

PART A: PHYSIOLOGY OF THE EYE

1. Structure & Function Overview

The eye is the organ of vision. Key functional structures:

Structure	Function
Cornea	Transparent outer covering; refracts light (~70% of total refraction)
Lens	Fine-focuses light onto retina (accommodation); ~30% of refraction
Aqueous humor	Nourishes cornea and lens; maintains intraocular pressure (IOP)
Vitreous humor	Fills posterior segment; maintains eye shape
Retina	Contains photoreceptors (rods and cones); converts light to nerve signals
Optic nerve	Transmits visual signals to the brain
Iris	Controls pupil size; regulates light entry
Ciliary body	Produces aqueous humor; controls lens shape for accommodation
Macula/fovea	Area of highest visual acuity (color vision via cones)

2. Aqueous Humor Dynamics (Critical for Glaucoma)

Produced by the pars plicata of the ciliary body in the posterior chamber
Flows through the pupil into the anterior chamber
Drains primarily through the trabecular meshwork into Schlemm's canal
Normal IOP: 10-21 mmHg
If drainage is impaired → IOP rises → optic nerve damage

Diagram: (A) Normal eye anatomy, (B) Normal aqueous flow, (C) Primary angle-closure glaucoma with iris bombé, (D) Neovascular glaucoma - from Robbins Basic Pathology

3. Visual Pathway (Physiology of Sight)

Light enters cornea → refracted
Passes through aqueous humor → pupil → lens (fine focus) → vitreous → retina
Photoreceptors - rods (dim light/peripheral vision) and cones (color/central vision) convert light to electrical signals
Signals travel via optic nerve → optic chiasm → optic tract → lateral geniculate nucleus → visual cortex (occipital lobe)

4. Accommodation Reflex

Near vision: ciliary muscle contracts → suspensory ligaments relax → lens becomes more convex (more powerful)
Far vision: ciliary muscle relaxes → lens flattens

5. Pupillary Light Reflex

Light hits retina → optic nerve (afferent) → Edinger-Westphal nucleus → oculomotor nerve (efferent) → pupil constriction (miosis)
Tests integrity of CN II (afferent) and CN III (efferent)

PART B: COMMON EYE PATHOLOGIES

1. CATARACT

Definition: Opacity (clouding) of the lens that impairs vision.

Types:

Nuclear (most common): Aging-related opacification of the lens nucleus (nuclear sclerosis)
Cortical: Spoke-like opacities from the periphery inward
Posterior subcapsular: Near the back of the lens; common with steroid use

Causes / Risk Factors:

Aging (most common)
Diabetes mellitus
Corticosteroid use (long-term)
Radiation / UV exposure
Trauma
Congenital (galactosemia, rubella)
Wilson disease, atopic dermatitis

Pathophysiology:

Normal lens epithelium does NOT shed dead cells - cells accumulate in the lens center with aging
Protein aggregation and oxidation make lens fibers opaque
Liquefaction of lens cortex and urochrome pigment accumulation also contribute

Clinical Features:

Gradual, painless loss of vision
Glare/halos around lights
Faded or yellowed colors
Frequent change in glasses prescription
"Second sight" (temporary improvement in near vision in early nuclear cataract)

Treatment:

Surgery: Phacoemulsification + intraocular lens (IOL) implantation (most common)
The lens capsule is left intact; prosthetic IOL inserted

(Robbins Basic Pathology, p. 868)

2. GLAUCOMA

Definition: A group of diseases causing optic neuropathy, usually associated with elevated IOP. Results in irreversible vision loss.

Normal IOP: 10-21 mmHg. Glaucoma typically >21 mmHg (but normal-tension glaucoma also exists).

Classification:

Type	Mechanism
Primary Open-Angle (POAG)	Most common type. Trabecular meshwork resistance increases; angle remains open. Gradual, painless
Primary Angle-Closure (PACG)	Iris occludes trabecular meshwork; common in hyperopia (shallow anterior chamber). Can be acute (emergency)
Secondary Open-Angle	Particulate debris (RBCs post-trauma, necrotic tumor) blocks meshwork
Neovascular	VEGF-driven neovascular membrane covers iris and closes angle; occurs in diabetic retinopathy, retinal vein occlusion
Congenital	Developmental anomaly of drainage angle (trabeculodysgenesis)

Pathophysiology:

Aqueous humor cannot drain → IOP rises → pressure damages optic nerve head
Ganglion cells and retinal nerve fiber layer are lost
Results in progressive peripheral visual field loss → tunnel vision → blindness

Clinical Features:

POAG: Insidious, asymptomatic until late. Peripheral field loss first
Acute angle-closure: Sudden severe eye pain, headache, nausea/vomiting, colored halos, red eye, mid-dilated fixed pupil - EMERGENCY

Investigations:

Tonometry (IOP measurement)
Gonioscopy (angle assessment)
Visual field testing (perimetry)
Optic disc assessment (cup-to-disc ratio >0.6 suspicious)
OCT (retinal nerve fiber layer thickness)

Treatment:

Eye drops: Beta-blockers (Timolol), Prostaglandin analogues (Latanoprost), Alpha-2 agonists (Brimonidine), Carbonic anhydrase inhibitors (Dorzolamide)
Laser: Laser trabeculoplasty (open-angle), Laser iridotomy (angle-closure)
Surgery: Trabeculectomy, glaucoma drainage devices

(Robbins Basic Pathology, p. 869-870)

3. DIABETIC RETINOPATHY

Most common cause of blindness in working-age adults (20-60 years).

Pathophysiology:

Chronic hyperglycemia → basement membrane thickening of retinal capillaries → pericyte loss → microaneurysms → increased vascular permeability → retinal ischemia → VEGF upregulation → neovascularization

Stages / Classification:

Stage	Features
Non-Proliferative DR (NPDR) - Mild	Microaneurysms only
NPDR - Moderate	Microaneurysms, dot-blot hemorrhages, hard exudates
NPDR - Severe	Venous beading, IRMA (intraretinal microvascular abnormalities), >20 hemorrhages in 4 quadrants
Proliferative DR (PDR)	New blood vessel formation (neovascularization) on disc/retina; risk of vitreous hemorrhage and tractional retinal detachment
Diabetic Macular Edema (DME)	Can occur at any stage; major cause of visual impairment

Clinical Features:

Gradual blurring of vision
Floaters (vitreous hemorrhage)
Sudden vision loss (retinal detachment or vitreous hemorrhage)

Treatment:

Tight glycemic and BP control (prevention)
Laser photocoagulation (NPDR and PDR)
Anti-VEGF injections (Ranibizumab, Bevacizumab) for DME and PDR
Vitrectomy for vitreous hemorrhage / traction detachment

4. RETINAL DETACHMENT

Definition: Separation of the neurosensory retina from the retinal pigment epithelium (RPE).

Types:

Type	Mechanism
Rhegmatogenous	Tear/hole in retina allows fluid to enter; most common
Tractional	Fibrovascular bands pull retina away (e.g., PDR, sickle cell)
Exudative	Fluid from inflamed/tumorous vessels accumulates (no tear)

Risk Factors: High myopia, previous trauma, cataract surgery, family history, diabetic retinopathy

Clinical Features:

Flashes of light (photopsia)
Floaters (sudden increase)
"Curtain coming down" / shadow in visual field
Painless loss of vision
Macular detachment = central vision loss

Treatment: Surgical urgency - Laser retinopexy, cryotherapy, scleral buckle, pneumatic retinopexy, vitrectomy

5. CONJUNCTIVITIS ("Pink Eye")

Definition: Inflammation of the conjunctiva.

Types & Causes:

Type	Cause	Key Features
Bacterial	S. pneumoniae, H. influenzae, S. aureus, Pseudomonas	Purulent discharge, crusting, no lymphadenopathy
Viral	Adenovirus (most common), Herpes, Enterovirus	Watery discharge, preauricular lymphadenopathy, highly contagious
Allergic	Allergens (pollen, dust mites)	Itching (hallmark), bilateral, clear watery discharge, seasonal
Chlamydial (Trachoma)	Chlamydia trachomatis	Leading cause of preventable blindness worldwide; follicular conjunctivitis, pannus formation
Neonatal (Ophthalmia neonatorum)	N. gonorrhoeae (hyperacute), C. trachomatis	Severe in gonorrheal - can perforate cornea
Chemical/Toxic	Drugs, chlorine, UV	Acute, exposure history

Clinical Features common to all:

Red eye (conjunctival injection)
Discharge (purulent/watery/mucoid)
Foreign body sensation, gritty feeling
Photophobia
Blurred vision (usually mild)

Treatment:

Bacterial: Topical antibiotics (ciprofloxacin, chloramphenicol eye drops)
Viral: Self-limiting; lubricants, cold compresses
Allergic: Topical antihistamines, mast cell stabilizers, avoid allergens
Trachoma: Azithromycin (SAFE strategy - Surgery, Antibiotics, Facial cleanliness, Environmental improvement)

6. UVEITIS

Definition: Inflammation of the uveal tract (iris, ciliary body, choroid).

Classification:

Anterior uveitis (iritis/iridocyclitis) - most common
Intermediate uveitis (pars planitis)
Posterior uveitis (choroiditis, retinitis)
Panuveitis (all layers)

Causes:

Autoimmune: Juvenile idiopathic arthritis (JIA), ankylosing spondylitis, sarcoidosis
Infectious: Toxoplasmosis (most common cause of posterior uveitis), CMV (in AIDS), TB, HSV
Sympathetic ophthalmia - bilateral granulomatous uveitis after penetrating eye injury (trauma to one eye triggers immune reaction in both)

Clinical Features (Anterior):

Deep aching eye pain
Photophobia (characteristic)
Lacrimation (watery eye)
Ciliary flush (redness around cornea)
Keratic precipitates (KPs) on corneal endothelium
Hypopyon (pus in anterior chamber)
Posterior synechiae (adhesion of iris to lens)

Treatment: Topical/systemic steroids, cycloplegics (atropine to prevent synechiae), treat underlying cause

(Robbins Basic Pathology)

7. REFRACTIVE ERRORS

Condition	Defect	Correction
Myopia (near-sightedness)	Eyeball too long / cornea too curved; image focuses in front of retina	Concave (diverging) lens
Hyperopia (far-sightedness)	Eyeball too short; image focuses behind retina	Convex (converging) lens
Astigmatism	Irregular curvature of cornea/lens; multiple focal points	Cylindrical lens
Presbyopia	Age-related loss of accommodation (lens stiffening, ciliary muscle weakness); difficulty reading	Reading glasses (convex)

8. AGE-RELATED MACULAR DEGENERATION (AMD)

Leading cause of irreversible central vision loss in adults >50 years.

Types:

Dry AMD (Atrophic): 85-90% of cases. Drusen deposits under macula → gradual geographic atrophy of RPE. Slow central vision loss.
Wet AMD (Neovascular/Exudative): 10-15% of cases but causes 90% of severe vision loss. Choroidal neovascularization → fluid/blood under retina. Rapid loss.

Symptoms:

Blurred central vision
Metamorphopsia (straight lines appear wavy - Amsler grid test)
Central scotoma (blank spot)
Colors appear washed out
Peripheral vision preserved

Treatment:

Dry: No cure; AREDS2 vitamins (antioxidants) slow progression
Wet: Anti-VEGF injections (Ranibizumab, Aflibercept, Bevacizumab) - intravitreal; first-line

9. CORNEAL PATHOLOGY

Condition	Key Features
Keratitis	Corneal inflammation; bacterial (S. aureus, Pseudomonas), viral (HSV - dendritic ulcer), fungal, acanthamoeba (contact lens users). Severe pain, photophobia, reduced vision
Corneal Ulcer	Loss of corneal epithelium with underlying stromal involvement; emergency
Keratoconus	Progressive thinning and cone-shaped deformity of cornea; irregular astigmatism; managed with rigid contact lenses or corneal transplant
Pterygium	Triangular growth of fibrovascular tissue from conjunctiva onto cornea; linked to UV exposure

10. STRABISMUS (SQUINT)

Definition: Misalignment of the eyes; failure of binocular vision.

Types:

Esotropia (convergent - eye turns inward)
Exotropia (divergent - eye turns outward)
Hypertropia/hypotropia (vertical deviation)

Complication: Amblyopia ("lazy eye") - suppression of visual input from misaligned eye leads to irreversible poor vision if untreated in childhood

Treatment: Patching (amblyopia), glasses, orthoptic exercises, surgery

11. RETINOBLASTOMA (Pediatric)

Most common intraocular malignancy in children. Mutation of RB1 gene (chromosome 13q14) - classic example of tumor suppressor gene loss.

Clinical Features:

Leukocoria (white pupillary reflex/"cat's eye") - most common presenting sign
Strabismus
Painful red eye (advanced disease)

Treatment: Chemotherapy, laser, cryotherapy, enucleation for advanced cases

PART C: QUICK SUMMARY TABLE

Disease	Key Mechanism	Vision Loss Pattern	Key Sign
Cataract	Lens protein aggregation	Gradual, painless blurring	Absent red reflex
POAG	Trabecular outflow resistance	Peripheral → central	Increased cup:disc ratio
Acute Angle-Closure	Pupillary block → angle occlusion	Sudden, severe	Mid-dilated fixed pupil, hard eye
Diabetic Retinopathy	Microangiopathy + VEGF	Variable	Microaneurysms, neovascularization
AMD	Drusen/RPE atrophy or CNV	Central vision only	Drusen on fundus, Amsler grid distortion
Retinal Detachment	Separation of neuroretina	"Curtain" shadow	Billowing retina on fundoscopy
Conjunctivitis	Infection/allergy of conjunctiva	Mild blurring	Red eye, discharge
Uveitis	Intraocular inflammation	Variable	Photophobia, KPs, hypopyon
Myopia	Elongated axial length	Distant objects blurred	Corrected with concave lens

Sources: Robbins Basic Pathology (p. 868-870), Kanski's Clinical Ophthalmology 10th Ed., Ganong's Review of Medical Physiology 26th Ed., Goldman-Cecil Medicine.

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