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Disease 2 > Cancer > Flashcards

Cancer Flashcards

1
Q

What is the generic definition of cancer?

A

Abnormal new tissue growth characterized by progressive uncontrolled multiplication of cells

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2
Q

What is the abnormal growth of cells called?

A

Neoplasm
Tumor

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3
Q

What are the traits of a benign tumor?

A

Tumor is encapsulated in connective tissue
Contains fairly well differentiated cells
Cells retain recognizable tissue structure
Do not travel through blood vessels or lymphatics or form secondary tumors in other organs

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4
Q

What is a tumor designated if it is encapsulated in connective tissue/

A

Benign

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5
Q

T/F: benign tumors are harmless

A

False. While they do not spread to other parts of the body, their growth can put pressure on surrounding organs and structures like the brain
Most people dont use theirs anyway so its up for debate

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6
Q

Describe the growth of cells in malignant tumors

A

Unorganized

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7
Q

What does a malignant tumor do that a benign tumor does not?

A

Invade surrounding structures, tissues, blood vessels and lymphatics

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8
Q

Cancers that arise from the epithelial tissues are called what?

A

Carcinomas

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8
Q

What can happen as a side effect of rapid tumor growth?

A

The tumors can grow so rapidly that the new cells deprive the older cells of nutrition resulting in necrosis or cavity formation within the tumor

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9
Q

What are carcinomas?

A

Cancers that arise from epithelial tissue

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10
Q

What are adenocarcinomas?

A

Cancers arising out of glandular tissues

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11
Q

Cancers arising out of glandular tissues are what?

A

Adenocarcinomas

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12
Q

Cancers arising from connective tissue are called what?

A

Sarcomas

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13
Q

What are sarcomas?

A

Cancers arising from connective tissues

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14
Q

A tumor that arises from bronchial mucosa is called what?

A

Bronchogenic carcinoma

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14
Q

What is the fancy term for lung cancer?

A

Bronchogenic carcinoma

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15
Q

Which type of lung cancer has the strongest correlation with smoking?

A

Small cell lung carcinoma

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15
Q

What are the 4 major types of lung cancer?

A

Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Small cell (oat cell) carcinoma

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16
Q

Describe the growth rate and size of small cell carcinomas

A

Grow rapidly
Grow large

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17
Q

When does a small cell carcinoma tend to metastasize?

A

Early

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18
Q

What percent of patients with small cell carcinoma respond to treatment?

A

90%

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19
Q

If left untreated, how long do individuals with small cell carcinoma tend to live?

A

1-3 months

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20
Q

T/F: nearly all patients who have had small cell carcinoma relapse within 36 months

A

False. Nearly all patients who have had small cell carcinoma relapse within 24 months

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21
Q

Squamous cell carcinomas make up what percent of all bronchogenic carcinomas?

A

25-30%

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21
Q

What tissue do squamous cell carcinomas arise from?

A

Bronchial epithelium

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22
Q

Small cell lung carcinomas make up what percent of all bronchogenic carcinomas?

A

10-15%

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23
Q

Describe the general location squamous cell carcinomas

A

Central bronchus or hilum

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24
Q

Describe the growth rate of a squamous cell carcinoma

A

Slow
Squamous is flat, turtles are flattish

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24
Q

A bronchogenic carcinoma found in the central bronchus or hilum is most likely…

A

A squamous cell carcinoma

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25
Q

At what point do squamous cell carcinomas tend to metastasize?

A

Late

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26
Q

Adenocarcinomas make up what percentage of bronchogenic carcinomas?

A

40%

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27
Q

Where do adenocarcinomas tend to arise?

A

From a gland

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28
Q

Describe the growth rate of adenocarcinomas

A

Moderate growth rate

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28
Q

At what point do adenocarcinomas metastasize?

A

Early

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29
Q

Where do adenocarcinomas tend to be located in the lung?

A

Generally situated in the periphery of the lung

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30
Q

A cancer that is located in the periphery of the lung could be an

A

Adenocarcinoma

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31
Q

What percentage of bronchogenic carcinomas are large cell carcinomas

A

10-15%

32
Q

Describe the growth rate of large cell carcinomas

A

Rapid growth

33
Q

At what point do large cell carcinomas metastasize?

A

They metastasize early to distant locations

34
Q

Where do large cell carcinomas tend to be located in the lungs?

A

Peripherally or centrally

35
Q

What are some pulmonary complications associated with large cell carcinomas?

A

Chest wall pain
Pleural effusion
PNA
Hemoptysis
Pulmonary cavities

36
Q

T/F: Lung cancer is the leading cause of cancer related deaths in the US

A

True

37
Q

What is the 5 year survival rate from lung cancer

A

Approximately 15%

38
Q

How many people die from lung cancer annually?

A

> 154k

39
Q

How many new cases of lung cancer are diagnosed in the US annually?

A

234k

40
Q

What is the average age at the time of diagnosis with lung cancer?

A

70

41
Q

T/F: White men are about 25% more like to develop lung cancer than black men

A

False. Black men are about 20% more likely to develop lung cancer than white men

42
Q

What are the first and second most common causes of lung cancer?

A

Smoking
Radon

42
Q

T/F: Black women are less likely to develop lung cancer than white women

A

True. Black women are 10% less likely to develop lung cancer than white women

43
Q

T/F: Different cigarettes have different risks associated with them

A

False. All cigarettes generally pose the same amount of risk with menthol being considered to be higher risk as it encourages deeper inhalation

44
Q

What symptoms are associated with lung cancer?

A

Progressively worsening cough
Chest pain
Hoarse voice
Poor appetite and weight loss
Dyspnea
Fatigue
Frequent respiratory infections
Sudden onset of wheezing

45
Q

What are some symptoms that could mean that the cancer has spread to other parts of the body?

A

Bone pain
Neurologic problems
arm/leg weakness/numbness
Dizziness
Seizures
Jaundice
Enlarged lymph nodes

46
Q

Pancoast syndrome, superior vena cava syndrome, and paraneoplastic syndrome are suggestive of what?

A

Lung cancer

47
Q

What is pancoast syndrome?

A

Unilateral effects of a nerve being compressed by a tumor in the upper portion of the lung
Drooping or weakness in one eyelid (ptosis), small pupil in same eye, reduced or absent perspiration on same side of face

47
Q

What is superior vena cava syndrome?

A

Swelling of the vessels of the face, neck, arms, and upper chest due to a tumor in the right upper lung obstructing venous blood flow at the superior vena cava

48
Q

What are paraneoplastic syndromes?

A

Remote effects of a tumor that are not directly related to its growth or metastasis
Hypercalcemia, excessive bone growth, blood clots

49
Q

What is the second diagnostic question you should ask when considering lung cancer?

A

Is the tumor benign or malignant?

49
Q

What is the first diagnostic question you should ask when considering lung cancer?

A

Is the cancer primary or secondary?
Did the cancer start in the lungs or did cancer somewhere else spread to the lungs

50
Q

What is the 3rd diagnostic question that you should ask when considering lung cancer?

A

What type of cells make up the tumor

50
Q

What are the diagnostic procedures when dealing with lung cancer?

A

Confirm the presence of lung carcinoma
Establish the cancer cell type
Confirm the stage of cancer

51
Q

When looking for cancer, what could a CXR tell you?

A

Whether or not there are any masses or nodules

52
Q

When looking for cancer, what could a CT scan tell you?

A

Clear image of tumor, its location, size, and whether or not there is anything in the lymph nodes

53
Q

When looking for cancer, what could a PET scan tell you?

A

Whether or not the mass is metabolically active

54
Q

When looking for cancer, what can an MRI tell you?

A

Whether or not its spread to the brain or spinal cord

55
Q

What would a sputum cytology tell you when looking for cancer?

A

Information on cell forms

56
Q

What does an EBUS do when looking for cancer?

A

Endobronchial ultrasound
Allows for lymph node biopsy

57
Q

What purpose would a thoracentesis serve when looking for cancer?

A

Sample fluid from pleural space, look for cancer cells

58
Q

Describe the TMN staging of lung cancer

A

Tumor = how big, is it spreading
Lymph nodes = metastasis there yet? How far from the source?
Metastases = how far? How many? How much?
0-4 represents level of severity, 0=meh, 4=PANIC

59
Q

T/F: A new onset cough is not a concerning symptom in regards to cancer in patients who are current or former smokers

A

False. A new onset cough in a smoker or former smoker should ring raise suspicion for cancer with a cough presenting in 50-75% of patients upon presentation

60
Q

Patients who have cancer present with a cough ______ of the time

A

50-75%

61
Q

What symptom frequently is a tipping point for patients to seek help for their respiratory symptoms?

A

Hemoptysis
Coughing up blood is generally alarming

62
Q

Patient with cancer present with dyspnea how often?

A

Occurs in 25-40% of the time

63
Q

How can cancer affect the results of PFT?

A

Cancer can present as obstructive or restrictive or both depending on where the mass is located

64
Q

When might cancer present as an obstructive issue on a PFT?

A

Cancer may present as obstructive when the malignancy obstructs a major airway

65
Q

When might cancer present as a restrictive disease on a PFT?

A

When large amount of pulmonary tissue, chess wall or diaphragm are involved in the disease process such as with extensive bronchioalveolar carcinoma

66
Q

Describe the effects a localized lung cancer may have on an ABG

A

Increases pH
Decreased PaCO2
Decreased but Normal HCO3
Decreased PaO2
Decreased Sat

67
Q

Describe the effects an extensive or widespread cancer could have on an ABG?

A

Decreased pH
Increased PaCO2
Increased but Normal HCO3
Decreased PaO2
Decreased Sat

68
Q

What signs on a CXR might be indicative of cancer?

A

Small oval or coin lesion
Large irregular mass
Alveolar consolidation
Atelectasis
Pleural effusion

69
Q

What are supportive care options RTs have for working with cancer patients

A

Oxygen therapy
Airway clearance therapy
Lung expansion therapy
Inhaled medications

70
Q

How can heliox help patients with cancer?

A

If there is an airway restriction from the tumor growth, heliox can pass by it easier that normal oxygen therapy due to decreased turbulence

71
Q

What are the three main ways cancer patients treatment is managed?

A

Supportive care
Curative or palliative treatment
Specialized treatments

72
Q

What practices qualify as curative or palliative treatment?

A

Chemotherapy
Radiotherapy
Surgery

72
Q

What practices qualify as supportive care?

A

Oxygen therapy
Airway clearance therapy
Lung expansion
Inhaled medications

73
Q

What is the goal of immunotherapy?

A

Trigger the bodys immune system to fight the cancer

74
Q

Describe therapies that can “starve” the tumor

A

Angiogenesis inhibitors
Target the blood supply to the tumor

75
Q

What does epidermal growth factor receptor inhibitor therapy do/

A

Turns off the biological signal to grow

76
Q

What is radiofrequency ablation?

A

“Cooking” a tumor

77
Q

What are different surgical options that cancer patients might have?

A

Pneumonectomy
Lobectomy
Segmentectomy or wedge resection
Sleeve resection
Video assisted thoracic surgery

78
Q

Describe a sleeve resection

A

Remove cancerous portion of the lung along with portion of the bronchus that attaches to it then reconnect the remain segments to the remaining portion of the bronchus

79
Q

If a tumor is creating an airway obstruction, what are surgical options to treat it?

A

Debulking the tumor
Stent placement

80
Q

Tumors can lead to uncontrolled bleeding, how can this be treated?

A

Argon plasma coagulation

80
Q

T/F: Routine CXRs are recommended for screening for lung cancer

A

False, it is not recommended for most patients.

Disease 2 (16 decks)

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