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Cancer Flashcards

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1
Q

what is the reccomended exercised dosage for those with cancer - minutes

A

150 min

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1
Q

what is the reccomended exercised dosage for those with cancer - aeorbic

A

moderate-intensity aer-
obic exercise spread over 3–5 days

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2
Q

what is the reccomended exercised dosage for those with cancer - resistance

A

2-3 days per week

8–10 muscle groups,
8–10 repetitions, 2 sets

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3
Q

each session should include

A

Each session should include a warm-up and
cool-down

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4
Q

what is the best risk predictor for cancer

A

age

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5
Q

80% of all cancers are diagnosed in people age BLANK

A

55+

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6
Q

~1/3 of projected cancer deaths related to what modifiable factors

A

obesity/ overweight,
inactivity,
poor nutrition

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7
Q

cancer and SES relationship

A

People with low SES have higher death rates than those with higher SES

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8
Q

Uninsured and minority patients are more likely to be diagnosed in what stage of cancer

A

later stage

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9
Q

what is the most common type of cancer

A

non-melanoma skin cancer

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10
Q

other leading cancers

A

Breast
Lung
Prostate
Colorectal

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11
Q

What is Cancer?

A

A large group of diseases characterized by uncontrolled cell proliferation and spread of abnormal cells.

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12
Q

Benign

A

non-cancerous

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13
Q

Pre-Cancerous

A

Carcinoma in Situ

A group of abnormal cells that could become cancerous

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14
Q

Malignant

A

Cancerous

Cells have the ability to invade and destroy nearby tissue and spread to other parts of the body

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15
Q

why is cancer staging important

A

Important to determine prognosis and to be able to compare one type of cancer to another

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16
Q

is staging the same for every cancer

A

Staging is different for every cancer!

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17
Q

TNM Staging - T

A

size and invasiveness of the primary tumor (0-4)

If multiple tumors are present in one organ, use highest T

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18
Q

TNM Staging - N

A

regional lymph node involvement (usually 0-4)

The N# does NOT reflect the exact # of nodes involved!

Low N = better prognosis
High N = surgically inaccessible, worse prognosis

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19
Q

TNM Staging - M

A

Distant spread (mets) to anatomical sites

X = not determined
0 = no distant mets
1 = distant metastasis

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20
Q

Anatomic Staging - what is it based on

A

0-IV staging based on size and spread

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21
Q

Anatomic Staging 0

A

Pre-malignant; “carcinoma in situ”

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22
Q

Anatomic Staging 1

A

Like stage 0, but confirmed malignant

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23
Q

Anatomic Staging 11

A

Local, but high risk of spread due to size

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24
Anatomic Staging 111
Local cancer beginning to spread locally
25
Anatomic Staging 1V
Confirmed Metastasis (distant site)
26
what is Grading
A measure of cancer cell abnormality when compared to healthy cells. Each cancer has unique grading systems Generally, follows grade 1-4:
27
Grading 1
Most closely resemble normal cells; well-differentiated tumors; low grade.
28
Grading 2
Somewhat abnormal; moderately differentiated; intermediate grade
29
Grading 3
Very abnormal; poorly differentiated, since they no longer have an architectural structure or pattern; high grade
30
Grading 4
undifferentiated cancers; most abnormal looking cells; highest grade and typically grow and spread faster than lower grade tumors.
31
What is Metastasis?
cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumors (metastatic tumors) in other parts of the body.
32
Is the metastatic tumor is the same type of cancer as the primary tumor?
yes
33
Cells break away from the primary tumor site and travel through the body via 3 pathways:
Hemotogenous Lymphatic Transcoelomic (direct extension)
34
Most Common Sites of Metastases
Lymph nodes Liver Lungs Bone Brain
35
Osteolytic
a progressive condition where bone tissue is destroyed.
36
Osteoblastic
bone formation
37
Initial Signs of Cancer
Anemia Thrombocytopenia Elevated CRP, ESR Pallor/Jaundice Fever Constipation/Diarrhea
38
Initial Symptoms of Cancer
Pain Changes in Basic Functions Changes in Normal Appearance Bleeding/Bruising Cough Indigestion Fatigue out of proportion to exertion Poor temperature regulation Swelling/Lumps Weight gain/loss of unknown origin
39
what is Antiangiogenic
a type of cancer treatment suppresses blood supply formation
40
Diagnose surgery
biopsy determine extent of disease
41
Traditional axillary lymph node dissection removes removes what
portion of lymph nodes
42
what is Sentinel lymph node dissection
Instead of removing 10 or more lymph nodes and analyzing all of them to look for cancer, remove only the one node that is most likely to have it. If this node is clean, chances are the other nodes have not been affected.
43
tumor removal surgery
often curative and is sometimes followed by additional treatment to be sure any remaining cancer is eradicated
44
reconstruction following removal surgery
Sometimes tumor removal may result in significant body changes such as amputation or breast removal
45
BRCA+. surgery indication
BRCA are the breast cancer genes 1 & 2. People who inherit harmful variants in one of these genes have increased risks of several cancers - most notably breast and ovarian cancer
46
palliative surgery
aimed at removing some of the tumor in an effort to make a patient more comfortable and diminish negative side effects.
47
is Radiation (XRT) selevtive
no it is non-selective target all tissue is that area
48
what does radiation do
a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors Targets DNA; Breaks hydrogen bonds to prevent ongoing replication of cancerous cells
49
Side Effects of XRT depends on what
DOSE and FIELD
50
XRT Pre-operatively
Shrink tumor
51
XRT Intra-operative
bolus dose to shrink tumor
52
XRT Post-operatively
to kill micrometastasis
53
XRT Palliatively
to decrease pain; seizure activity
54
XRT normal dosage
5 days/week for 4 weeks
55
Radiation methods
Teletherapy: external beam, most common Proton Therapy Brachytherapy: short distance from sealed radiation source & target, implant radioactive seeds. Best for localized tumors Systemic – ingestion or injection of radioactive substance
56
what are the side effects of radiation
radiation dermistis Mucositis Fibrosis Pain Bone necrosis/ demineralization High dose XRT causes Osteolysis & AVN Epiphyseal plate in children is sensitive Radiation-induced malignancy
57
signs to watch for in a patient who might be developing radiation dermatitis:
Reddening of white skin or darkening of skin that is black or brown. Itchy skin. Dry and peeling skin. Swelling. Blistering. Open sores that may appear where your skin is sweaty or damp, such as your armpits or under your breasts common side effect of external radiation
58
Mucositis
when your mouth or gut is sore and inflamed GI symptoms such as: emesis, cramps, diarrhea, and/or hemorrhage
59
Radiation fibrosis syndrome (RFS)
a progressive fibrotic tissue sclerosis late complication of radiation therapy and may occur weeks or even years after treatment chronic vascular dysfunction and lymphatic issues
60
myelo-radiculo-plexo-neuro-myopathy
Radiation can damage the spinal cord, nerve roots, plexus, local peripheral nerves, and muscles within the radiation field. can result in pain, sensory loss, weakness, and other signs and symptoms.
61
what is Osteoradionecrosis
bone death due to radiation
62
Bone necrosis/ demineralization
usually reversible Bone softening in 1st 6-8 weeks Return to full density may take 6 months
63
High dose XRT causes what to happen to the bones
Osteolysis & AVN
64
Epiphyseal plate in children is sensitive so what long term effect can we see
Irreversible LLD and scoliosis
65
what is Chemotherapy
A wide variety of chemical agents used to destroy cancer cells. These drugs affect cell DNA synthesis or function within the cell cycle
66
is chemo selevtive or non-selective
Nonselective Can destroy normal cells, especially hepatic, epithelial, bone marrow and hair cells. Generally results in toxicities and side effects.
67
Cocktails chemo
Combinations of drugs used to target cancer cells in various stages of the cell cycle.
68
Chemotherapy system Side-Effects depends on what
Depends on drug AND combination
69
chemo dosing - general
Depends on the type of cancer, the drug, the patient, etc
70
chemo dosing - infusion
1 infusion every 2-4 weeks x6 treatments each infusion lasts a few hours
71
chemo dosing - oral
1 week on, 2 weeks off
72
chemo ADE
CICI system toxicity Induced Peripheral Neuropathy
73
what is Chemotherapy-Induced Cognitive Impairment (CICI)
subtle to moderate impairments in several cognitive domains
74
what causes CICI
Chemotoxicity Reduced hormone levels Proinflammatory immune response Fatigue, Distress
75
signs/symptoms of CICI
Disorientation & difficulty multitasking Slowed performance Trouble concentrating & learning Short attention span, Mental fatigue
76
what should you do if you think someone has CICI
MOCA MMSE and then refer the patient
77
what impact chemo inducer peri neuropathy
can develop or worsen with increasing doses often occurs as stocking/ glove polyneuropathy Sesnory fibers are usually affected more than motor and motor more than autonomic.
78
“coasting” and CIPN
gets worse after chemotherapy is stopped. Commonly, symptoms occur weeks to months after chemotherapy. They can get worse with additional cycles of chemotherapy.
79
what is immunotherapy
uses certain parts of a person’s immune system to fight cancer cell replication and spread. Stimulate or boost your own immune system Receive lab-formulated immune cell “assistance” cancer specific and there are many different types
80
Cachexia
wasting” disorder that causes extreme weight loss and muscle wasting, and can include loss of body fat.
81
Sarcopenia
involuntary loss of skeletal muscle mass
82
what is Cancer Related Fatigue
A persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning
83
Cancer-Related Fatigue intensity
Intensity generally increases with Rx time
84
Cancer-Related Fatigue symptoms
Fatigue not relieved by rest Dyspnea Decreased concentration Decreased endurance for daily tasks
85
factors that influence survivorship
type stage treatment protocol co-morbidites individual behaviors

pt management 3 (10 decks)

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