ASKEP KANKER LIDAH
• Definition of oral cancer:
Cancer that forms in
tissues of the oral cavity
(the mouth) or the
oropharynx (the part of
the throat at the back of
the mouth).
• Estimated new cases and
deaths
New cases: 39,400 (oral
cavity and pharynx)
Deaths: 7,900 (oral cavity
and pharynx)
PATOFISIOLOGI
• Karsinoma sel squamosa  ulserasi dan nyeri
• Mestastase awal pada nodus imfatikus
servikalis
• Tumor yang terletak pada basis lidah sangat
sulit dideteksi
The Oral Cavity and Oropharynx
10 BESAR CA KEPALA LEHER
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Oral Cancer
Throat Cancer
Lip Cancer
Tongue Cancer
Squamous Cell Cancer of the Oral Tongue
Squamous Cell Cancer of the Base of Tongue
Voice Box Cancer
True Cord Cancer
Cancer of the Supraglotic Larynx
Subglottic Squamous Cell Cancer
Medical Director
Squamous cell carcinoma of the
tongue in a 50 year old non-smoker
Squamous cell carcinoma of the base
of the tongue.
Squamous cell carcinoma of the
tongue
ETIOLOGI
• The exact cause of tongue cancer is
unknown
• Smoking cigarettes, cigars, or a pipe
• Use of chewing tobacco, snuff, or
other tobacco products
• Heavy alcohol consumption
FAKTOR RESIKO
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Sex: male
Poor oral and dental hygiene
Age: 40 and over
Irritation of the mucous membranes in the
mouth due to smoking and drinking
• History of mouth ulcers
• Family history due to genetic predisposition
Percentage of nurses identifying risk
factors associated with oral cancer.
KELUHAN UTAMA
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Skin lesion, lump, or ulcer on the tongue
Difficulty swallowing /Disfagia
Mouth sores and mouth pain
Numbness or difficulty moving the tongue
Change in speech (due to inability to move the
tongue over the teeth when speaking)
• Pain when chewing and speaking
• Bleeding from the tongue
Percentage of nurses identifying oral
changes associated with oral cancer.
Percentage of nurses identifying
anatomical sites for identification
during examination of the mouth.
PEMERIKSAAN FISIK & DIAGNOSIS
• Examination of your tongue for lumps or masses
• Use of a fiberoptic scope—a thin tube with a tiny
camera to examine the base of the tongue
• A tongue biopsy —removal of a sample of tongue
tissue to test for cancer cells
• CT scan —a type of x-ray that uses a computer to
make pictures of the mouth
• Chest x-ray to determine if the cancer has spread
to the lungs
TREATMENT
• Treatment depends on the stage of the cancer, as well as the
size and location of the tumor.
• Surgery This is surgical removal of the cancerous tumor and
nearby tissue, and possibly nearby lymph nodes. This is often
the preferred treatment when the tumor is on the visible side
of the tongue, when it is quite small (less than 2 cm), and
when it is lateralized to one side and does not involve the
base of the tongue.
• Radiation Therapy (or Radiotherapy) This is the use of
radiation to kill cancer cells and shrink tumors. This method is
used when the cancer is at the back of the tongue.
• Chemotherapy Chemotherapy is sometimes used with
radiation to destroy the cancerous growth, especially if
surgery is not planned.
Rehabilitation and Follow-Up
• Therapy to improve tongue movement,
chewing, and swallowing
• Speech therapy, if use of the tongue is
affected
• Close monitoring of your mouth, throat,
esophagus, and lungs to see if the cancer has
come back or spread
HEALTH EDUCATION
• Don't smoke or use tobacco products.
• Avoid heavy alcohol consumption.
• See doctor regularly for check-ups and cancer
screening exams.
Diagnosa Keperawatan
1. Risk for ineffective airway clearance, related
to oral surgery
2. Risk for imbalanced nutrition: Less than body
requirements, related to oral surgery
3. Impaired verbal communication, related to
excision of a portion of the tongue
4. Disturbed body image, related to surgical
excision of the tongue
KRITERIA HASIL
• Maintain a patent airway and remain free of
respiratory distress.
• Maintain a stable weight and level of
hydration.
• Effectively communicate with staff and family
using a magic slate and flash cards.
• Communicate an increased ability to accept
changes in body image.
PLANNING AND IMPLEMENTATION
1. Assess airway patency and respiratory status
every hour until stable.
2. Maintain semi-Fowler’s position, supporting
arms. Encourage to turn, cough, and deep
breathe every 2 to 4 hours.
3. Teach the importance of activity, turning,
coughing, and deep breathing.
4. Monitor daily weights.
5. Consult with dietitian to assess calorie needs
and plan appropriate enteral feeding. Assess
response to enteral feedings.
PLANNING AND IMPLEMENTATION
• Demonstrate and allow to practice using magic
slate and flash cards prior to surgery.
• Allow adequate time for communication efforts.
• Keep emergency call system in reach at all times
and answer light promptly. Alert all staff of
inability to respond verbally.
• Encourage expression of feelings regarding
perceived and actual changes.
• Provide emotional support, encourage self-care
and participation in decision making.