oncology

Question 1

carcinoma

Answer 1

• malignancy originating from epithelial cells of organs
• ex: lung carcinoma subsets - large cell carcinoma, adenocarcinoma, squamous cell carcinoma
• most cx in US is carcinoma

Question 2

general s/s of cancer

Answer 2

C - change in bowel/bladder
A - a sore that will not heal
U - unsual bleeding/discharge
T - thickening/lump develops
I - indigestion or difficulty swallowing
O - obvious change in wart/mole
N - nagging cough/hoarseness
- unexplained weight loss, fatigue, anorexia, anemia, pain, weakness

Question 3

cancer prevention

Answer 3

• primary prevention: elimination of modifiable risk factors
• secondary: early detection, preventatives
• tertiary: prevent disability that can occur secondary to cx treatment

Question 4

types of tissue and tumor

Answer 4

• epithelium - carcinoma, adenocarcinoma: in skin, mucous membrane, lining of bladder
• pigmented cells - malignant malenoma: moles
• connective tissue - sarcomas: striated muscle, blood vessels, fat, bone
• nerve tissues - astrocytoma, glioma, blastoma: brain, nerves, SC, retina
• lymhoid tissue - lymphoma: lymph, spleen
• hematopoietic - leukemia, myelodysplasia

Question 5

TNM staging

Answer 5

• T - primary tumor size and extent
• N - lymph node involvement
• M - metastasis presence
• can correspond to stage designation that further defines severity

Question 6

national cancer institue staging

Answer 6

• stage 0: early melignancy, present only in layer of cells in which it began - not in all cancers
• stage 1: malignancy limited to tissue of origin w/ no lymph node involvement or metastasis
• stage 2: malignancy spreading into adjacent tissues, lymph nodes can show signs of micrometastases
• stage 3: malignancy that has spread to adjacent tissue showing signs of fixation to deeper structures - high likelihood of lymph node involvement
• stage 4: malignancy metastsaize beyond primary site, to bone or other organ

Question 7

other staging for cancer

Answer 7

• clinical - based on findings of a patient’s physical exam, lab values, imaging tests, biopsy
• pathologic: based on tissue samples in surgery

Question 8

bronchial carcinoma

Answer 8

• any epithelial carcinoma occurring in bronchopulmonary tree

Question 9

one of the most curable cancers

Answer 9

hodgkin lymphoma

Question 10

skin cancers

Answer 10

• basal cell carcinoma: slow growing, rarely metastazies; originates in epidermis, most common form; good prognosis
• malignant melanoma: originates from malnocytes and can be superficial, nodular, acral; early diagnosis vital - metastasizes quickly; 100% curable with early diagnosis

Question 11

leukemia

Answer 11

• cancer of blood when leukocytes change into malignant cells
• acute lymphoblastic leukemia and acute myelogneous leukemia

Question 12

most common malignant tumor in children

Answer 12

neuroblastoma
- wilms’ tumor - embyonal neuroblastoma found in kidney btw 1-4 YO

Question 13

anemia

Answer 13

• low levels of hemoglobin or hematrocrit

Question 14

thrombocytopenia

Answer 14

• low platelet counts

Question 15

neutropenia

Answer 15

• neutrophil count below normal laboratry reference values placing patient at risk for serious infection

Question 16

oncology treatment options

Answer 16

• surgery
• radiation - ionizing radiation or particle radiatoin
• chemotherapy - group of drugs to destroy malignant cells; not for metastatic
• biotherapy (immunotherapy) - uses agents to change relationship btw malignancy and host; stregnthen pt biological response to malignant cells
• antiangiogenic therapy - use of thalidomide and suppression of blood supply formation
• other pharm therapies: hormone therapy
• palliative treatment - symptom management

Question 17

guidelines for patients undergoing cancer treatment

Answer 17

• check physician orders fot pts with bone metastasis for WB status and mobility precautions
• monitor blood values - platelet and hematocrit
• exercise should be 40-65% of peak HR, heart rate reserve, VO2 max
• RPE should not > 12
• treatment visits should be scheduled for when pt E is max
• treatment should be modified as needed to accommodate side effects
• no massage or heat over irritated areas

Question 18

heat and electrotherapeutic modalities and cx

Answer 18

• contraindicated for use over active malignancy but not necessarily contraindicated elsewhere on body d/t potential for facilitating growth
• can be overlooked for pts with palliative goals or terminal illness

Question 19

alkylating agents

Answer 19

• bind DNA strands together to prevent replication
• mustargen, busulfex, leukeran

Question 20

antiobiotic agents

cancer

Answer 20

• d/t high toxicity and ability to interfere with DNA and RNA synthesis and subsequent cell division
• adriamycin, mithracin, cosmegen

Question 21

antimetabolite agents

cancer

Answer 21

• impair biosynthesis of genetic material and interrupt cellcular pathways that synthesize DNA and RNA
• create imposter to endogenous metabolites in body to form nonfunctional genetic production incapable of reproduction
• esp used for rapidly dividing neoplastic cells
• leustatin, adrucil, fludara, trxall

Question 22

biologic response modifier agents

Answer 22

• interferons, interluekin 2, and monoclonal antibodies that are responsible for enhancing body’s own ability to respond to neoplastic growth
• not cytotoxic but facilitate immune response to destroy malignant tissues
• proleukin, avastin, intron A

Question 23

heavy metal compounds

cancer

Answer 23

• platinum coodination complexes
• act as alkylating agents that inhibit DNA translation and replication

Question 24

adjuvant

Answer 24

• treatment provided in addition to other cure-focused interventions with intention of preventing cancer recurrence

Question 25

benign neoplasm

Answer 25

• abnormal cell growth that is usually slow growing and harmless, closely resembling composition of adjacent tissues

Question 26

cancer

Answer 26

• group of diseases characterized by uncontrolled cell proliferation with mutation and spreading of abnormal cells

Question 27

dysplasia

Answer 27

abnormal development of cells or tissues that is early sign of neoplasia

Question 28

hyperplasia

Answer 28

increase in cell number that may be normal or abnormal depending on additional characteristics

Question 29

metaplasia

Answer 29

change in cell from one type to another that may be normal or abnormal

Question 30

neoadjuvant

Answer 30

chemotherapy or radiation given prior to surgical oncology intervention

Question 31

tumor (neoplasm)

Answer 31

• abnormal new growth of tissue that increases overall mass
• benign or cancerous, primary (from cells that belong to area of tumor) or secondary (from metastasis)

Question 32

tumor classification

Answer 32

• cell type, tissue of origin, amount of differentiation, benign vs malignant, anatomic site