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Flashcards in Cancer Deck (18)
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1

Risk Factors for Cancer

  • Non-Modifiable
    • age
    • previous h/o cancer
    • ethnicity
    • gender
    • heredity
    • age, menopause 
    • inflammatory bowel dx
    • fat distribution 
  • Modifiable
    • smoking
    • chemical exposure
    • urban dwelling
    • alcohol
    • sedentary or obesity
    • insuline resistance 

2

Four most Common Risk Factors for Cancer

  1. Age over 50 (single most important)
  2. Ethnicity
  3. Family History (1st degree)
  4. Environment and Lifestyle 

Risk factors for recurrence are specific to type of cancer

3

3 Major Types of Cancer

  • Carcinomas
    • malignant tumor that comprises epithelial tissue (ectoderm)
    • skin, intestine, stomach, breast, lungs (85%) 
    • spread locally and through metastasis
  • Sarcomas
    • fleshy growth, arising in connective tissues (mesoderm) 
    • bone, cartilage, muscle, fibrous, fat, synovium
    • metastasize hematogenously
  • Cancer Blood/Lymph
    • lymphomas - lymhoid tissue  spread by infiltration
    • leukemias - hematologic system - bone marrow - spread by invasion/ infiltration

4

Most common sites for Cancer metastasis

  1. bone
  2. CNS
  3. Lung
  4. Pleural Cavity
  5. Liver
  6. Lymph nodes
  7. peritoneum

5

How does metastases occur?

Tumor angiogenesis:

blood vessels from surrounding tissue grow into solid tumor, invade host blood vessels and d/c into venous drainage. 

Cancer cells spread throughout the body through the blood stream, lymphatics or neighboring cells

at secondary sites, malignant cells continue to reproduce and new tumors develop

6

First manifestations of primary cancer

  1. changes in vital signs
  2. proximal muscle weakness
  3. change in DTRs

7

Explain what "CAUTIONS" means

C = changes in bowel or bladder habits

A = a sore that does not heal in 6 weeks

U = unusual bleeding or d/c

T = thickening or lump in breast or elsewhere

I = indigestion or diffculty swallowing

O = obvious change in wart or mole

N = Nagging cough or hoarseness

S = supplemental s/s - unexplained weight loss, changes in vital signs, frequent infections, night pain, pathologic fracture, proximal muscle weakness, change in DTRs

8

Lab Value guidelines for chemotherapy clients where aerobic exercise is contraindicated 

  • Platelet count = <50,000/mm3
  • hemoglobin = <10g/dL
  • WBC <3000/mm3
  • absoulte granulocytes <2500/mm3

9

Key Points for Cancer

  1. When screening for CA always remember -PMH, Clinical Presentation, Associated s/s
  2. Red flags with h/o CA
  3. Spinal malignancy occurs more often in lumbar than cervical and is usually metastatic rather than primary
  4. Spinal Cord compression may appear as back pain, leg weakness, and b/b symptoms
  5. 50% of clients with back pain from malignanc have an identifiable preceding trauma or injury to account for p!
  6. Jaundice with back pain may indicate liver metastases
  7. Signs of nerve root compression may be the first indicator with cancer
  8. lung, breast, prostate, thyroid, and lymphatics are primary sites responsible for met. bone dx
  9. changes in nodes raise a red flag.  supraclavicular and inguinal nodes are common metastatic sites for cancer

10

Lung Cancer Risk Factors

  1. Age >50
  2. smoking or tobacco use
  3. passive smoking
  4. low consumption of fruits/veggies
  5. genetic predisposition
  6. exposure to asbestos, uranium, radon
  7. previous lung disease 

11

Risk Factors for Breast Cancer

>70% of women diagnosed with breast cancer have no identified risk factors 

  1. >60
  2. women >men
  3. caucasion>all others
  4. genetic: BRCA1/BRCA2
  5. family hx 1st degree
  6. PMH - breast, uterine, ovarian, colon cancer
  7. total lifelong exposure to estrogen
  8. radiation to the chest
  9. excessive alcohol consumption

12

Risk Factors for Prostate Cancer

  1. age >50
  2. race AA > all others
  3. family hx - 1st degree relative 

13

Risk Factors for Colon Cancer

  1. age >50
  2. PMH - polyps, previous CA, inflammatory bowel dx
  3. family hx - 1st degree relative with colon CA
  4. genetics - 5%
  5. Race - AA> all others
  6. diet high in red meats and processed meats
  7. obesity
  8. physical inactvity
  9. smoking
  10. alcohol
  11. type 2 diabetes

14

Bone Cancer

  • Pain Descriptors = sharp, severe, worse at night, constant, mechanical, relieved by NSAIDs
  • 2 Primary types: lytic - erosion of sections, or blastic - diffiuse pattern of degeneration 
  • consequence of bone metastases
    • pain
    • hypercalcemia
    • pathologic fracture
    • spinal cord compression
    • bone marrow failure
    • anemia
    • loss of ambulation 
    • thromboembolitic dx

15

Cancer Metastasis to Liver

  • jaundice
  • malaise and fatigue
  • RUQ pain
  • referred pain to shoulder
  • *bilateral carpal tunnel syndrome

16

Metastasis to Brain

  • increased intracranial pressure
    • headache (worse upon awakening)
    • n/v
    • malaise, anorexia, weakness
    • alteration in mental process
  • abrupt change in personality
  • seizures

17

Metastasis to Spinal Cord

  1. neuro signs can be the first sign of cancer
  2. severe back pain in 95% 
  3. bowel and bladder changes
  4. decreased DTRs

18

Red Flag Physical Findings with Cancer

  • a lump anywhere, not just breast
  • skin lesions
  • palpable, hard, observable lymph nodes
  • idiopathic proximal muscle weakness
  • change in one or more DTRs
  • Bilateral symptoms - carpal or tarsal
  • non capsular patters of shoulder or hip