Nursing care in patients with sarcoma

Sarkomi čine vrlo heterogenu skupinu rijetkih solidnih tumora mezenhimalnog podrijetla s vrlo različitim kliničkim i patohistološkim obilježjima. Dijelimo ih u dvije skupine: sarkome mekih tkiva i sarkome kostiju. Zloćudni tumori ili sarkomi mekih tkiva čine manje od 1% svih malignoma u odraslih te oko 15% svih zloćudnih tumora u dječjoj dobi. Najčešće se pojavljuju na udovima (donji udovi 30% a gornji 10%), zatim intraadbominalno (20% viscelarni organi, 15% retroperitonealno), trupu 10%, glavi i vratu 10%. Tumori kostiju još su rjeđi i čine samo 0,2% svih malignoma. Najčešće se javlja osteosarkom (35% svih tumora), hondrosarkom (30%), Ewingow sarkom (15%) i gigantocelularni tumor (GCT). Tumori mekih tkiva pojavljuju se kao bezbolne mase koje mogu biti prisutne tjednima ili mjesecima. Bol ili edem ovise o pritisku ili infiltraciji priležećih organa i struktura. Slabost, gubitak tjelesne težine ili anemija obično upućuju na postojanje metastatske bolesti. Simptomi tumora kostiju su bol i edem. Specifično je da se bol javlja prije edema i pojačava se noću. Agresivni tumori mogu imati opće simptome kao gubitak tjelesne težine, vrućicu, slabost i anemiju. Sarkomi se liječe kirurškim putem, radioterapijom i kemoterapijom. Postupci liječenja osim željenih imaju i neželjena djelovanje pa važnu ulogu u skrbi za bolesnika ima medicinska sestra. Skrb za onkološkog bolesnika iznimno je zahtjevna a medicinske sestre koje se brinu o njima moraju biti educirane. Osim uloge u skrbi za bolesnika koji je u aktivnom liječenju medicinske sestre nerijetko se brinu i o bolesnicima kojima je potrebna palijativna skrb.Sarcomas are extremely heterogeneous group of rare solid tumors of mesenchymal cell origin with distinct clinical and pathohistological characteristics. We divide them into two categories: soft tissue sarcomas and bone sarcomas. Malignant tumors or sarcomas of the soft tissue account for less than 1% of all malignomas in adults and approximately 15% of all malignant tumors in childhood. They most commonly appear on the limbs (upper 30%, lower 10%), then intraabdominally (20% visceral organs, 15% retroperitoneally), on the trunk 10%, on the head and neck 10%. Bone tumors are even rarer and make up only 0,2% of all malignomas. Osteosarcoma occurs most frequently (35% of all tumors), chondrosarcoma (30%), Ewing's sarcoma (15%) and giant-cell tumor (GCT). Soft tissue tumors occur as a painless mass that can be present for weeks or months. Pain or edema depend on pressure or infiltration of the adjacent organs and structures. Weakness, weight loss and anemia usually indicate metastatic disease. Symptoms of bone tumors are pain and edema. It is specific that the pain occurs before edema and intensifies at night. Aggressive tumors may have general symptoms such as weight loss, fever, weakness and anemia. Sarcomas are treated surgically, via radiotherapy or chemotherapy. The treatment, other than desired effects, also has some side effects, so nurses play an important role in patient care. Caring for an oncology patient is extremely demanding and nurses have to be educated. Besides their role in the care for the patient who is in active treatment, nurses often take care of the one that requires palliative care