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Med-Surg > Oncology > Flashcards

Oncology Flashcards

1
Q

what is cancer

A

A disease in which abnormal cells divide without control and are able to invade other tissues; cancer cells can spread to other parts of the body through the blood and lymph systems

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2
Q

intrinsic factors

A

heredity, hormones, immunity, age

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3
Q

extrinsic factors

A

exposure to external, ingested, and/or inhaled substances

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4
Q

malignant

A
  • rapid rate of growth
  • invades surrounding tissue
  • metastasizes via the bloodstream and lymphatic system
  • usually poor cell differentiation
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5
Q

benign

A
  • slow rate of growth
  • expands in the same tissue
  • does not spread
    nearly normal cell differentiation
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6
Q

types of metastatic invasion

A

lymphatic, arteriovenous, serous cavity, CSF

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7
Q

most common types of cancer in Canada

A

 Lung, breast, colorectal and prostate cancer

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8
Q

lung cancer accounts for __% of all new cancer cases

A

14%

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9
Q

breast cancer accounts for about __% of all new cancer cases in women

A

25%

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10
Q

colorectal cancer accounts for __% of all new cancer cases

A

13%

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11
Q

primary prevention

A
  • Identify risk factors
  • Healthy diet
  • Moderate alcohol intake
  • Sun safety
  • Avoid known carcinogens (tobacco products, asbestos)
  • Wear PPE when working with carcinogens
  • Vaccines (HPV)
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12
Q

early detection uses the acronym

A

CAUTION

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13
Q

what does CAUTION stand for

A

Change in bowel or bladder habits
A sore that doesn’t heal
Unusual bleeding or discharge
Thickening of a lump in the breast or elsewhere
Indigestion or difficulty swallowing
Obvious changes in a wart or mole
Nagging cough or hoarseness

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14
Q

what is cancer staging

A

Describes the extent or severity of cancer based on the extent of spread in the body

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15
Q

why is staging important

A
  • Estimates the patient’s prognosis
  • Plan treatment
  • Important in identifying clinical trials (research studies) that may be suitable for a particular patient
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16
Q

elements of staging

A
  • Location of the primary tumor
  • Tumor size & number of tumors
  • Lymph node involvement
  • Presence or absence of metastasis
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17
Q

what is the TNM system

A
  • The extent of the tumor (T)
  • The extent of spread to the lymph nodes (N)
  • The presence of metastasis (M)
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18
Q

situ mean

A

Early cancer present only in the layer of cells in which it began

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19
Q

localized

A

Limited to the organ in which it began

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20
Q

regional

A

Spread beyond its primary site to nearby lymph nodes or organs and tissues

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21
Q

distant

A

Spread from primary site to distant organs or distant lymph nodes

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22
Q

stage 0

A

Carcinoma in situ

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23
Q

stage I, II, and III

A

Higher numbers indicate more extensive disease: larger tumor size and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or organs adjacent to the location of the primary tumor.

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24
Q

stage IV

A

The cancer has spread to other organs.

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25
Q

tumor grading

A

Is a system used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread

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26
Q

how is grade determined

A
  • A biopsy is taken and then examined by a pathologist
  • The pathologist determines whether the tumor is benign or malignant, and the tumor grade
27
Q

Grade 1 tumor

A

mild dysplasia; well differentiated

28
Q

Grade 2 tumor

A

moderate dysplasia; mod. differentiated

29
Q

Grade 3 tumor

A

severe dysplasia; poorly differentiated

30
Q

Grade 4 tumor

A

anaplasia; undifferentiated

31
Q

how does tumor grade affect a pts options?

A
  • A lower grade generally indicates a better prognosis
  • Grading is a factor in developing a treatment plan
32
Q

goals of treatment

A
  • cure (eradicates the disease)
  • control spread
  • palliative (controls disease and distressing symptoms)
33
Q

chemotherapy

A

Treatment with chemicals that disrupts the cell cycle and kills malignant cells

34
Q

2 types of chemotherapy

A

(1) cell cycle phase non-specific
(2) cell cycle phase specific

35
Q

goal of chemotherapy

A

to reduce number of cells

36
Q

radiation

A
  • Use of ionizing radiation to destroy cancer cells
  • Breaks the chemical bonds in DNA, leading to damage of the cells
  • Aims for non-clonogenic cells → cells cannot regenerate
  • Skin reactions common S/E
37
Q

general side effects of chemotherapy & radiation

A
  • Fatigue
  • Bone marrow suppression
38
Q

skin side effects of chemotherapy & radiation

A
  • Erythema
  • Dry/moist desquamation
  • Alopecia
39
Q

brain side effects of chemotherapy & radiation

A

cerebral edema

40
Q

mouth side effects of chemotherapy & radiation

A
  • Mucositis
  • Opportunistic infections
  • Dry mouth
  • Taste changes
  • Dental decay
41
Q

neck side effects of chemotherapy & radiation

A
  • Pharyngitis
  • Laryngitis
  • Esophagitis
42
Q

thorax side effects of chemotherapy & radiation

A
  • Pneumonia
  • Pulmonary toxicity
43
Q

abdomen and pelvis side effects of chemotherapy & radiation

A
  • N&V
  • Diarrhea
  • Cystitis (hemorrhagic)
  • Altered sexual dysfunction
  • Infertility
  • Premature menopause
44
Q

two types of lung cancer

A
  • Non-small cell lung cancer (NSCLC)
  • Small cell lung cancer (SCLC)
45
Q

small cell lung cancer (SCLC)

A
  • Small cell carcinoma
  • Combined small cell carcinoma
46
Q

non-small cell lung cancer (NSCLC)

A
  • Squamous cell carcinoma
  • Adenocarcinoma
  • Large cell undifferentiated carcinoma
47
Q

squamous cell carcinoma

A
  • almost always caused by cigarrete smoking , common in men
  • 30% of lung cancers, arises in bronchial epithelium
  • does not commonly metastasize
  • surgical resection common
48
Q

adenocarcinoma

A
  • associated with lung scarring and fibrosis (not related to smoking)
  • 40% of lung cancers, usually women, arises in peripheral portion of lungs
  • usually no manifestations until widespread
  • surgical resection common, does not respond to chemo well
49
Q

large cell undifferentiated carcinoma

A
  • associated with cigarette smoking and environmental carcinogens
  • 10% of lung cancers, highly metastatic, commonly peripheral
  • surgery not usually attempted due to high rate of metastases
50
Q

small cell anaplastic undifferentiated

A
  • associated with cigarette smoking and environmental carcinogens
  • 20-25% of lung cancers, commonly central
  • most malignant form/poor
    prognosis*
  • spreads via lymphatic system and bloodstream
  • chemotherapy and adjuvant radiation therapy
  • average median survival is 12-18 months
51
Q

signs and symptoms of lung cancer

A
  • Recurrent pneumonia and/or bronchitis
  • Persistent cough +/- sputum
  • Blood tinged sputum (hemoptysis)
  • Persistent mild to severe localized chest pain
  • Dyspnea and wheezing if bronchial obstruction
  • Hoarseness
52
Q

later manifestations of lung cancer

A
  • Pleural effusion
  • Bone pain
  • Dysphagia
  • Neurological changes (weakness; headaches; numbness in a limb; dizziness; seizures
53
Q

treatment of lung cancer

A
  • Surgical (pneumonectomy; lobectomy; segment or wedge resection; laser)
  • Chemotherapy
  • Radiation
  • Targeted therapies (for some types of NSCLC)
    - Liessa (gefetinib)
    - Tarceva (erlotinib)
  • Photodynamic therapy
54
Q

oncological emergencies

A

spinal cord compression, superior vena cava syndrome, leukostasis

55
Q

spinal cord compression

A
  • Metastatic disease in the vertebral column, most commonly at the level of C5 - C6
  • Can result in permanent neurological damage
56
Q

Clinical manifestations of spinal cord compression

A

Pain, motor weakness, sensory impairment

57
Q

diagnosis of spinal cord compression

A

MRI

58
Q

treatment of spinal cord compression

A

surgery, chemotherapy, radiation and drugs (corticosteroids)

59
Q

superior vena cava (SVC) syndrome

A
  • Obstruction of the SVC through development of a thrombosis; tumor invasion of the SVC; external compression of the SVC by a tumor
  • Malignant disease of the thorax most common
  • venous enlargement d/t venous drainage in the upper trunk
60
Q

clinical manifestations superior vena cava syndrome

A
  • speed at which the obstruction develops
  • degree of blood flow obstruction
61
Q

treatment for superior vena cava syndrome

A

depends on the cause of the obstruction

62
Q

leukostasis

A
  • Partial or complete obstruction of blood flow d/t ↑↑ numbers of circulating leukocytes
  • Increased blood viscosity & aggregation→ slower blood flow through capillaries → impaired capillary circulation and end-organ damage (brain & lungs)
63
Q

clinical manifestations of leukostasis

A

neurological, pulmonary, kidney, heart

Med-Surg (15 decks)

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