Flashcards in Exam 3: Cellular Function (Cancer) Deck (93):
Incidence and death rates of cancer higher in what population? (2)
Higher in males than females
Higher in black people
Cancer with the highest incidence for women
Cancer with the highest death rate for women
Highest incidence = breast cancer
Highest death rate = lung cancer
Cancer with the highest incidence for men
Cancer with the highest death rate for men
Highest incidence = prostate cancer
Highest death rate = lung cancer
Another term for cancer
Cancer cells infiltrate lymph and blood vessels, which carry the mutant cells to other parts of the body.
Surface epithelial tumor:
Malignant: Squamous Cell Cancer
Glandular epithelial cell tumor:
Blood vessel tumor:
Lymph Vessel tumor:
Lymph tissue tumor
Nerve cell tumor:
Glial tissue tumor:
Benign: Regular shape, cells are well-differentiated
Malignant: Irregular shape
Tumor spread to adjacent tissues:
Benign: Non-invasive: Does not invade surrounding tissue
Malignant: Invasive: Invades surrounding tissue.
Malignant: Metastasizes to distant sites
Benign: Encapsulated (usually by fibrous capsule)
Malignant: Not encapsulated
Tumor potential for growth:
Benign: Decreased potential for growth
Malignant: Increased potential for growth
Tumor recurrence after surgical excision:
Benign: Decreased recurrence
Malignant: Increased recurrence
Tumor as the cause of death:
Benign: Doesn't usually cause death unless location interferes with vital function
Malignant: Usually causes death unless growth can be controlled
Three mechanisms of cancer spread:
4 Risk categories for cancer
2) Genetic / familial
3) Hormonal agents
___% of cancer cases are idiopathic
25% of all cancer deaths...
are associated with ONE chemical in cigarettes!
Two genes that increase the risk of ovarian cancer
What family history should you take when looking at cancer
Immediate relatives (parents, siblings)
Three factors that correlate with a higher incidence of breast cancer
• Early onset menses
• Late menopause
• Have never given birth
Recommended fruit and vegetable intake
5-9 per day
Standard guidelines to detect/screen BREAST CANCER (2)
- Mammogram q 2 years
- Clinical breast exam:
q 4 years 20-39
q 1 year age 40+
Standard guidelines to detect/screen COLON AND RECTAL CANCER (2)
If 50 years or older:
Yearly fecal occult blood test and one of the following:
- Sigmoidoscopy every 5 years OR
- Colonoscopy every 10 years
Standard guidelines to detect/screen PROSTATE CANCER (2)
- Yearly digital rectal exam
- PSA as needed
Standard guidelines to detect/screen CERVICAL CANCER
- Yearly GYN exam
- PAP test yearly 21+ (earlier if sexually active) -- q 3 years after 3 or more negative PAPs
Five general cancer symptoms (Greenfield)
- Unexplained weight loss
- Unexplained fever
- Skin clues
Seven common cancer symptoms (American Cancer Society)
1) Change in bowel / bladder function
2) Sores that do not heal
3) Unusual bleeding or discharge
4) Thickening, lump
5) Indigestion or difficulty swallowing
6) Recent change or difficulty swallowing
7) Nagging cough or hoarseness
How do tumor markers work?
The higher the number, the greater the likelihood of cancer -- not definitive. Often used to determine treatment efficacy
- Ca 125
- Ca 15-3
- Ca 19-9
Computed Tomography: Mechanism
Very narrow beam of x-ray in successive layers
What test would be given before an MRI? Why?
CT Scan, shorter duration
What does nuclear medicine imaging look at? (3)
Looks at oxygen uptake, glucose transport, blood flow
What color would a Nuclear Medicine Imaging be?
- If cancerous:
- If non-cancerous
• Cancerous: Areas of high metabolic rates → GLOW RED
• Non-cancerous: Non-malignant will glow blue, green
What test helps observe if a tumor is shrinking?
Two cytology tests
- PAP smear
- Sputum sample
What is a biopsy?
Physically removing a piece of tissue
What is the most definitive way to diagnose cancer?
What should you do before treating a tumor?
Diagnostic surgery ie biopsy
Purpose of staging a tumor
Determines the size of tumor and metastasis
Three classifications when staging
T: Primary tumor
N: Lymph node involvement
M: Metastasis is present
Purpose of grading a tumor
Classification that predicts the prognosis
Four classifications of grading
o I: Small, no metastasis
o II: Large, without lymph spread
o III: Larger cancer with lymph node involvement
o IV: Aggressive and less responsive to treatment
What type of surgery is the gold standard?
What type of surgery is not really done anymore?
Wide or radical treatment, where large portions of the muscle or other tissue are removed.
Another term for palliative surgery
Patients who have _____ prior to surgery are at greater risk for complications post-op
Three cancer surgery complications
• Infection, wound healing
• Pulmonary or renal issues
What are the benefits of intra-op radiation? (4)
o Lower dose
o Less toxicity
o Precisely target radiation
o No localized tissue problems
What is pancytopenia?
Decreased WBC, RBC and platelets.
Radiation toxicity: Digestive ADEs (7)
- Loss of taste
- Dry mouth
- Decreased salivation
- Trouble swallowing
Where are needles / seeds / beads used?
Interstitial compartments, such as breast, prostate
Benefit of needles / seeds / beads
Less likely to become dislodged
First two weeks of needles / seeds / beads
Can't be around children or pregnant women
What is chemotherapy?
Mechanism of chemotherapy
- Can be cell-cycle specific
- Can be phase specific
- Alkalating agents
- Hormonal agents
What do cell-cycle specific cancer drugs do?
Destroy cells that are actively reproducing
What portion of the cell cycle does phase specific chemotherapy target?
S-PHASE: DNA synthesis
Three common side-effects of chemo
- Bone marrow suppression
What does "Dose-limiting" mean
More doses increases effects
Six dose-limiting side-effects of chemo
o Hemorrhagic cystitis: Affects bladder
o Tubular necrosis: Renal failure
o Cardiotoxicity, pericarditis
o Cumulative: Neurotoxicity, numbness, tingling, “chemo-brain” – Can last about a year after treatment
What is a "vesicant"?
Name an estrogen receptor blocker
When is Herceptin given?
If tumor is positive for HER2/nue receptors
Another term for Bone Marrow Transplatn
HEmatopoitic Stem cell transplant
Bone marrow transplant is indicated for ______
Three sources of bone marrow transplant -- which is the most common?
1) Allogenic ** Most common
What does allogenic mean?
Transplant from a selected donor
What does autologous mean?
Transplant from self
What does synergic mean?
Transplant from identical twin
Before receiving an allogenic transplant, a patient will receive (2):
1) Ablative chemo
2) Possibly a total body radiation
After receiving ablative chemo / radiation before a bone marrow transplant, patient is at higher risk for (3)
• Respiratory issues
What is happening with graft-versus-host disease?
The donor t-lymphocytes can recognize the recipient as "foreign and attack the recipient
What is the most critical time for Graft-versus-Host disease?
First 100 days
Is Graft-versus-host disease acute or chronic?
Can be either
Prophylactic immunosuppressant drugs for graft-versus-host disease (2)
- High dose steroids
How is a patient prepared for an autologous bone marrow transplant? (3)
1) Patient's marrow is harvested, preserved and treated for chemo
2) After harvest, patient is treated with chemo and possibly full-body radiation
3) Patient's own marrow is infused, must undergo engraftment
Benefit of stem cell transplatn
Engraftment occurs faster
What type of nursing care is used in a stem cell transplant?
REVERSE ISOLATION -- isolation to protect the patient from the healthcare team's germs, not the other way around