CA Flashcards
CA benign and malignant
- Group of diseases characterized by the abnormal growth of cells.
- Benign (differentiated cells generally harmless unless encroaching on adjoining structures) and malignant cells (undifferentiated cells growing uncontrollably and causing destruction to surrounding tissues and organs- i.e. carcinoma, sarcomas, leukemia, melanoma
CA risks
- Most cancers probably develop from a combination of genetic and environmental factors.
- Cigarette smoking, heavy use of alcohol, physical inacticity- being overweight or obese, ultraviolet light contribute or cause several types of cancers
•Infectious agents such as (HBV) Hepatitis B virus (liver), (HPV) Human Papillomavirus (cervical, oral=throat), (HIV) Human Immunodeficiency Virus (Kaposi’s sarcoma), (H. Pylori) Helicobacter pylori (stomach) have been related to certain cancers.
Diet?
Staging and grading CA
Staging via TNM system:
T: TUMOR- extent (size and number) of the primary tumor
N: NODE- lymph nodes involved
M: METASTASIS- presence or absence and extent
•highly differentiated vs poorly differentiated
Highly differentiated
resemble original cells more strongly- are associated with a lower grade and less aggressive tumor
Poorly differentiated
increasing difficulty in identifying original cell- more aggressive and advanced tumor
CA s/s
• unusual bleeding or discharge •unexplained weight loss of 10 pounds or more •fever •fatigue •pain •persistent cough or hoarseness without known cause •skin changes: -hyperpigmentation - jaundice (skin and/or eyes) - erythema (reddened skin) - pruritis (itching) - excessive hair growth
CA management
4 major types:
1) surgical removal of tumor (and nodes)
2) radiation
3) chemo
4) biotherapy- includes immunotherapy, hormonal therapy, bone marrow transplant, and monoclonal antibodies
Indications for invasive surgical management
- Removal of precancerous lesions or organs at high risk for cancer
- Establishing a diagnosis by biopsy
- Assist in staging by sampling lymph nodes
- Definitive treatment by removal of primary tumor
- Reconstruction of a limb or organ with or without skin grafting
- Palliative such as decopresive or bypass procedures
CA complications
- Infections
- Loss of muscular structural support or function
- Loss of neurological structures affecting strength and sensation
- Lymphedema
- Disfigurement
Radiation therapy
•used to eradicate tumor cells, while minimizing damage to healthy tissues. Also used in palliative care to relieve pain when cure is not possible
•delivered by external beam:
brachotherapy- placement of radioactive sources into tissues and passageways (take care with fluid excretions post may require special handling; or radioimmunotherapy- intraoperative single dose radiation to exposed tumor or resected tumor bed.
Radiaotherapy side effects
•Skin reactions/ burns- fragile- easily damaged tissue with inability to dissipate heat •Fatigue •Weight loss •Myelosuppression (bone marrow suppression) •Site specific toxicities: – Limb edema , lymphedema - Alopecia - Cerebral edema - Seizures - Visual disturbances - Cough - Pneumonitis - Fibrosis- decreased ROM - N+V+D - Cystitis - Cardiomyopathy - Myelopathy/ plexopathy- decreased sensation and strength
radiation therapy and the skin
radiation may lead to decreased extensibility of the skin, fascia, and deeper tissues. Special care should be taken with skin over beamed area because it will likely be very fragile, easily burn, have an inability to dissipate heat and may have decreased sensation- contradicting heat, cold, massage, modalities over the area
•scarring and fibrosis of tissues underneath may lead to adhesions and decreased ROM
•Plexopathy and neuropathy (loss of sensation and motor control) may lead to decreased sensation and strength in dermatomes and myotomes
•radiation may induce other malignancies to occur
Chemotherapy
•Can be performed preoperatively or postoperatively
•Usually delivered systemically via IV or central lines
•Side effects include:
-Nausea and vomiting
-“Cancer pain”
- Toxicity specific to certain systems
- Lost of hair and other fast growing cells, i.e:
•Platelets= Thrombocytopenia- decreased ability to clot- increased bleeding, hemorrhaging, hemarthrosis and bruising
•Red Blood Cells= Anemia- decreasing activity and exercise tolerance, increasing dyspnea on exertion, pallor, tachycardia, heart palpitations
•White Blood Cells= Leukopenia- increased susceptibility to infection
chemotherapy things to monitor
- pt needs proper nutritional support due to possible decreased appetite and inability to absorb nutrients due to vomitting
- VS should always be monitiored
- lab values: especially platelets, RBC, WBC count
biological or immunotherapy
- uses a patient’s defense system as a mechanism to treat CA
- can be highly targeted while minimizing toxicity
