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    Interdyscyplinarna opieka nad pacjentem z chorobą nowotworową
    (Oficyna Wydawnicza AFM, 2010) Ceglarek, Dorota; Dominiak, Katarzyna; Reder, Angelika; Szupik, Teresa; Kotowska, Mariola; Dębska, Grażyna; Migacz, Anna; Cepuch, Grażyna; Foryś, Zofia; Śliwa, Elżbieta; Zaborowska, Anna; Pasek, Małgorzata; Krajewski, Maciej; Krajewski, Maciej; Bernad, Dorota; Stolińska, Agnieszka; Szukała, Ewa; Szeremiota, Anna; Gawlik, Małgorzata; Jurzak, Magdalena; Goździalska, Anna; Gawędzka, Anna; Lizak, Dorota; Jaśkiewicz, Jerzy; Dębska, Grażyna; Pasek, Małgorzata
    Z radością oddajemy do rąk Czytelników monografię, która powstała przy współpracy Polskiego Stowarzyszenia Pielęgniarek Onkologicznych oraz Wydziału Zdrowia i Nauk Medycznych Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego. Celem niniejszej publikacji jest przygotowanie pielęgniarki do pełnienia specjalistycznej, profesjonalnej opieki nad chorym z chorobą nowotworową oraz nad jego rodziną. Monografi a składa się z części opracowanych zarówno przez praktyków, jak i teoretyków; jest pierwszą z cyklu publikacji przeznaczonych dla osób zajmujących się opieką nad chorym onkologicznie. Jej celem jest przedstawienie przede wszystkim modeli opieki nad pacjentami, praktycznych aspektów relacji pacjent – pielęgniarka, oraz doniesień z tych badań naukowych, których wyniki mają zastosowanie w praktyce pielęgniarskiej.
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    Pacjent z podejrzeniem czerniaka w Poradni Chirurgii Onkologicznej
    (Oficyna Wydawnicza AFM, 2010) Dębska, Grażyna; Migacz, Anna; Cepuch, Grażyna
    Recent years have brought several changes in nursing care concerning the professional role of nurses. New challenges regarding health education and health promotion are observed next to the old traditional roles, which mainly included following physicians’ orders. Nurse’s skills in the field of health education should be used not only for patients with diagnosed melanoma but also for those who are at risk of this disease, in the form of preventive actions. Moreover, a person coming to the outpatient surgical oncology clinic with a suspicion of melanoma should become an objective of these actions. Melanoma is a type of very dangerous and poorly predictable cancer, which oft en has poor prognosis. Therefore, early diagnosis as well as fast removal of skin melanoma, contrary to common opinions, are actions giving the biggest chance for long survival. The role of a nurse employed in the outpatient surgical oncology clinic has a special signifi cance when early detection of suspicious skin changes is concerned. The nurse is the fi rst medical professional examining the patients reporting to the clinic in order to remove the suspicious changes. Since this problem is quite complicated, the objective of this work was to develop standard methods for “Nursing care of a patient reporting to the outpatient surgical oncology clinic in order to remove suspicious naevus”. The second problem emphasized in this work concerned the educational role of a nurse in melanoma prevention towards patients and their families. That is why a health education programme in the outpatient surgical oncology clinic for patients and their families was developed aiming at early detection and diagnosis of melanoma. The abovementioned standards and educational programme should be used for the improvement of nursing service quality in the outpatient surgical oncology clinic.
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    Udział metaloproteinaz macierzy pozakomórkowej w transformacji prawidłowych melanocytów w komórki czerniaka złośliwego
    (Oficyna Wydawnicza AFM, 2010) Jurzak, Magdalena; Dębska, Grażyna; Cepuch, Grażyna; Foryś, Zofia
    The most common localisation of melanoma is skin, however it may also occur within oral mucosa, eyeball, and brain. Melanoma results from carcinogenic transformation of normal melanocytes and may originate in pigment changes or de novo in normal skin. The occurrence and growth of melanoma are due to both genetic predispositions and environmental factors, especially UV radiation [1, 2]. The process of transformation of melanocytes into dysplastic cells, and further into melanoma cells with radial spread without metastatic tendencies as well as vertical spread with possible metastases, is multistage. It requires changes in: signal transduction patterns, proliferative activity, migration ability, and ability of cancer cells to destroy the extracellular matrix (ECM). Extracellular matrix metalloproteinases are enzymes capable of destruction of three-dimensional ECM structure, therefore enable the migration of cancer cells. The disturbance of the interactions between cells in the primary lesion together with the ability to transform and destroy structural barriers of the ECM as well as intensified mobility of cancer cells determine its further infiltration to the surrounding tissues, carcinogenic cells migration and distant metastases [3]. During the transformation of normal melanocytes into melanoma cells the expression of extracellular matrix metalloproteinases changes between the consecutive stages of cancer development. Vertical growth and the formation of metastases requires strict cooperation between melanoma and normal skin cells since during the first stages of infiltration keratinocytes and fibroblasts produce extracellular matrix metalloproteinases [4, 5, 6]. Their expression may be regulated by the tumour itself due to melanoma cells ability to produce EMMPRIN (extracellular matrix metalloproteinase inducer). This factor stimulates fi broblasts surrounding cancer to synthesise extracellular matrix metalloproteinases [7]. The role of extracellular matrix metalloproteinases in the cancer invasion is determined by some mechanisms infl uencing the expression and activation of these enzymes, substrate specificity of each extracellular matrix metalloproteinase, their influence on cytokine net, growth factors, and mutual interactions between cells and the extracellular matrix surrounding them [3].